Latar belakang. Angka kesakitan diare pada balita di negara berkembang masih tinggi. Pada beberapa penelitian terbukti efek seng dan probiotik masing masing dalam mencegah diare dapat menurunkan angka kejadian. Namun pemberian secara bersamaan belum banyak diketahui. Tujuan. Membuktikan pengaruh suplementasi seng dan probiotik secara bersamaan pasca perawatan diare akut pada anak terhadap kejadian diare berulang. Metode. Penelitian kohort prospektif lanjutan Studi I "Pengaruh suplementasi seng dan probiotik terhadap durasi diare akut cair anak", selama 3 bulan. Subjek adalah 75 anak usia 6-24 bulan pasca rawat diare akut cair di RS Dr. Kariadi Semarang. Pengelompokkan dilakukan secara acak menjadi 4 kelompok, kelompok I hanya mendapat terapi baku tanpa suplementasi, kelompok II mendapat suplementasi seng, kelompok III diberikan suplementasi probiotik, dan kelompok IV kombinasi seng-probiotik. Setiap kelompok mendapat terapi baku, rehidrasi, dan dietetik. Uji statistik menggunakan analisis kesintasan untuk mengetahui kejadian diare berulang, uji Kruskal Wallis untuk perbedaan frekuensi dan lama diare. Hasil. Kelompok suplementasi seng-probiotik bersamaan memiliki rerata survival diare berulang terlama yaitu 10,94 minggu (CI 95% 9,24 -12,65), dibanding kelompok lainnya, meskipun secara statistik tidak berbeda bermakna (p=0,892). Frekuensi maupun lama diare berulang keempat kelompok pada bulan pertama, kedua dan ketiga pasca suplementasi secara statistik tidak berbeda bermakna. Kesimpulan. Pemberian suplementasi seng-probiotik bersamaan berpengaruh dalam memberikan rerata perlindungan terhadap terjadinya diare berulang lebih lama. Tidak terdapat perbedaan bermakna dalam rerata survival diare berulang, lama dan frekuensi diare berulang di antara keempat kelompok. Sari Pediatri 2011;13(2):96-104.Kata kunci: suplementasi seng, probiotik, diare berulang

Although there is evidence to suggest that frenotomy improves breastfeeding outcomes for tongue-tied (ankyloglossic) infants, less is known about the optimal timing of treatment. In this retrospective cohort study, the timing of frenotomy and its impact on infant and maternal factors were examined in 31 tongue-tied babies with breastfeeding difficulties in a hospital in Jakarta, Indonesia. After frenotomy, all infants improved latching and mothers experienced a subjective improvement in nipple pain and breast engorgement. Frenotomy improved weight gain in infants regardless of type of tongue-tie (p = .001), but greater mean weight gains were achieved in tongue-tied babies who underwent early frenotomy (prior to Day 8) compared to babies who underwent late frenotomy (after Day 8; p = 0.002). Tongue-tie and frenotomy issues need to be addressed during the very first few days of an infant’s life to ensure optimal breastfeeding outcomes.

Background: The World Health Organization has encouraged all facilities providing maternity services and care for newborn infants to adopt the “10 steps” of successful breastfeeding. This includes not giving artificial teats to breastfeeding infants because they may cause nipple confusion. We present a multimodal hospitalization protocol for infants with nipple confusion, a multimodal relactation method that supports breastfeeding couplets.Purpose: To investigate the effectiveness of hospitalization as an intervention for nipple confusion.Method: Data related to nipple confusion in patients hospitalized between January and December 2012 at Kemang Medical Care, Jakarta, Indonesia, was reviewed. Survival analysis was performed to evaluate the relationship between infant age and intervention outcomes.Results: There were 58 cases of nipple confusion during the study period. Most subjects (96.6%) totally rejected breast contact. Forty-six cases (79.3%) used bottles because of tongue-tie. The length of hospitalization varied from 1 (56.9%) to 5 days (3.4%). Fifty-three cases (91.4%) were able to successfully breastfeed using our protocol. Younger babies had greater breastfeeding success.Conclusion: Hospitalization for nipple confusion with multimodal management is effective for treating nipple confusion. Tongue-tie can lead to difficulties in initiating breastfeeding, and early introduction to artificial teats can lead to nipple confusion. Early detection and treatment is desirable.