BACKGROUND In Indonesia, animal protein intake in children is low and might contribute to a high prevalence of stunting. This study was aimed to evaluate the association between animal protein source consumption and stunting in toddlers. METHODS This cross-sectional study obtained secondary data from the Ironcheq questionnaire validation study to detect the risk of iron deficiency in toddlers. The Ironcheq study was carried out in five integrated health service posts (Posyandu) in Jakarta from 2013 to 2014. Data from 172 subjects, consisting of 41 stunted (heightfor-age z-score less than-2) and 131 normal children, were analyzed to evaluate the association between animal protein source consumption and stunting using multivariate logistic regression test. RESULTS Stunted children tend to come from a family with low parental education and socioeconomic status. Consuming growing-up milk (GUM) ≥300 ml/day was protective against stunting (adjusted OR 0.28, 95% CI 0.13-0.63), whereas consuming red meat product ≥5 times/week was a risk factor (crude OR 3.70, 95% CI 1.17-11.74), however after adjusted to age, sex, and other variables in the questionnaire, the OR was not significant (adjusted OR 3.64 95% CI 1.00-13.26). CONCLUSIONS A daily consumption of 300 ml of GUM may be considered to prevent stunting in toddlers. Red meat products (sausage, nugget, and meatball), which are commonly consumed because of its practicality, could not be considered as significant animal protein sources because of a wide variation of their nutritional content.

BackgroundSixty percent of the 10.9 million under-5 deaths every year are related to malnutrition. More than two thirds of malnutrition is caused by inappropriate infant feeding practice. Only 35 % of mothers worldwide provide 4 months of exclusive breast-feeding, while complementary feeding is often untimely, nutritionally inadequate, hygienically poor, and improperly delivered. The existing pediatric nutrition module in our institution does not include proper delivery of food that involves oral–motor skills and feeding behavior. To scale up the knowledge and skill of medical students regarding evidence-based infant feeding practice, we designed a new module composed of comprehensive and integrated lectures with additional multidisciplinary lectures on oral–motor skill development and feeding behavior.MethodsA quasi-experimental study was conducted to evaluate the efficacy of the new module compared to the previous module. Fifth year medical students of Universitas Indonesia were divided into intervention and control groups. The control group received lectures and a paper-based workshop. The intervention group received comprehensive and integrated interactive lectures with additional multidisciplinary lectures on oral–motor skill development and behavioral approaches to feeding problems. A hands-on workshop using real cases shown on recorded video and role-play sessions was also presented to the intervention group. A pre-/post-test, 3-month retention test, and Observed Structured Clinical Examination (OSCE) were performed to evaluate understanding, knowledge retention, and counseling skills.ResultsA linear mixed effect model with a random intercept analysis for pre-test, post-test, and retention test scores showed significant higher result for intervention group compared to control group (p < 0.001). Comprehensive knowledge and counselling skills were better in the intervention group than in the control group as shown by the OSCE score (68.6 vs 59.3, p < 0.001).ConclusionsOur comprehensive integrated infant feeding practice module, which incorporates multidisciplinary learning processes and an interactive hands-on workshop with a role-play session yields better knowledge understanding and counseling skills compared with the existing module. Comprehensive knowledge and good counseling skills of medical students as future doctors are a pre-requisite to provide effective education to parents to support successful infant feeding practices.

[This corrects the article DOI: 10.13181/mji.v28i1.2607]