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REPUBLIC OF INDONESIA STATE NEWS
No. 175, 2010 MINISTRY OF WOMEN ' S EMPOWERMENT AND CHILD PROTECTION. The success of breastfeeding. Steps.
REGULATION OF WOMEN ' S EMPOWERMENT STATE MINISTERS
AND PROTECTION OF THE CHILD REPUBLIC INDONESIA NUMBER 03 2010
ABOUT
IMPLEMENTATION OF TEN STEPS TOWARDS THE SUCCESS OF BREASTFEEDING WITH THE GRACE OF ALMIGHTY GOD MINISTER WOMEN ' S EMPOWERMENT COUNTRY AND
THE PROTECTION OF THE REPUBLIC OF INDONESIA,
DRAWS: A. that each child has the right to grow and develop optimally both physical, spiritual and intelligent mental to realize the best life for the child;
b. Article 128 of the Law No. 36 of the Year 2009 on Health mandating about babies is entitled to mother's milk water, and as long as the giving of the mother's milk, government, local government and society must support the mother and baby. in full with the provision of special time and facilities;
c. that there are still many babies who do not get mother 's milk water with various causes so that the child does n' t get enough nutrition as well as the baby' s immune decline;
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d. that in the implementation of the World Mother's Milk Water Week of the Year
2010 which coincides with 20 years of the Declaration of Innocenti has mandated the need for ten steps towards the success of breastfeeding;
e. that to realize gender equality in the application of Ten Steps Towards Success Breastfeeding needs support of all parties including husbands, families, communities, workplaces, health care facilities and health care;
f. that based on the consideration of the letter a, the letter b, the letter c, the letter d and the letter e need to specify the Minister's Rule about the application of ten steps towards the success of the breastfeeding;
Given: 1. Law No. 23 Year 2002 on Child Protection (State Sheet of the Republic of Indonesia 2002 No. 109, Additional Gazette of the Republic of Indonesia Number 4235);
2. Law Number 36 Year 2009 on Health (State Gazette of Indonesia Year 2009 Number 144, Additional Gazette Republic of Indonesia Number 5063);
3. Presidential Decree No. 5 of 2010 on the National Long-term Development Plan 2010-2014;
4. Presidential Decree No. 84 /P of the Year 2009 on the Establishment of a United Indonesia Cabinet II;
Establits
:
DECIDE:
REGULATION OF THE MINISTER OF STATE EMPOWERMENT AND PROTECTION OF THE REPUBLIC INDONESIA ON THE APPLICATION OF TEN STEPS TOWARDS THE SUCCESS OF BREASTFEEDING.
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CHAPTER I OF THE GENERAL PROVISIONS
Article 1 In this Regulation is referred to: 1. Gender Equality is the commonality of the conditions and position for men and
women to obtain the opportunity and rights as a human being, to be able to play a role and participate in political, economic, social cultural, educational, defense, social security and commonality in enjoying the outcome of a balanced development.
2. The next Mother's Milk Water is called breast milk, which contains white blood cells, immunoglobulins, enzymes and hormones, as well as specific proteins, and other nutritional substances that are necessary for child growth and development.
3. Exclusive breastfeeding is the gift of only mother's milk water without food or other beverages to the baby from birth until the age of six months.
4. A Health Care Facility is a tool and or a place that is used to host health care efforts both promoted, preventive, curative and rehabilitative performed by the Government, Pemda and or the public.
5. The ASI support group called KP-ASI is a group formed by health care facilities and the public to support maternity, new mothers giving birth and nursing mothers.
Article 2 With the Minister ' s Regulation The application of ten steps to the success of breastfeeding, as set forth in the Order of the Regulation of the Minister, is an integral part of the Regulation.
Article 3 of the Order of the Ten Steps Fulfillment Towards the success of breastfeeding this is as a guide to service facilities health, with community and family support in carrying out the 10-step implementation towards the success of breastfeeding.
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Section 4
The purpose of creating ten steps towards the success of this breastfeeding is to ensure access and quality of service for mothers to breastfeed after giving birth and to guarantee the baby get Exclusive ASI.
CHAPTER II OF THE IMPLEMENTATION OF
Section 5 Of The Ten Step Implementation Of The Ten Steps Towards The Success Of Breastfeeding Is:
a. The Health Care Service (SPK) has a written Increased Breastfeeding Policy (PP-ASI) policy which is routinely communicated to all officers;
b. conducting training for officers in terms of knowledge and skills to apply such policies;
c. explained to all pregnant mothers about the benefits of breastfeeding and their screening begins since the pregnancy, the baby ' s childhood was born. until the age of 2 (two) years including how to cope with the difficulty of breastfeeding;
d. help mom start breastfeeding her baby in 30 minutes after giving birth, which is done in the maternity room. When you get a caesar operation, the baby is disussed after 30 minutes of sober mother;
e. help the mother how to breastfeed properly and how to maintain breastfeeding even though the mother is separated from the baby over medical indications;
f. not give any food or drink other than breast milk to a newborn baby;
g. Perform an outpatient by striving for a mother with a baby 24 hours a day;
h. help the mother breastfeed the baby watermelon, with no restrictions on the old and the frequency of breastfeeding;
i. do not give dot or basil to breast-fed babies;
j. Attempted to create KP-ASI and mother to the group when returning home from a maternity hospital/health care facility.
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Article 6
The health care facility in organizing a ten-step implementation towards the success of breastfeeding is performed according to the development of the needs, priority of mother and baby, as well as health care there is.
Article 7
In terms of mother and baby experiencing a health disorder, then the execution of ten steps towards the success of breastfeeding is tailored to the condition of mother and baby with regard to the best needs and interests of the mother and baby.
Article 8
The unit addressing the empowerment of women and child protection as well as related services and the public can perform socialization and dissemination of the Ten Steps To The Success of Breastfeeding.
Article 9
(1) The Governor, may conduct coaching on the execution of the Application of Ten Step towards the success of breastfeeding in health care facilities at the levels of Propinsi and District/City.
(2) The Regent and the Mayor can conduct coaching on the implementation of the Ten Steps Implementation Towards The Success Of Breastfeeding at the health care facility at the Regency/City level.
CHAPTER III CLOSING
Article 10 of this Regulation is beginning to apply to the date of the undrased.
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For everyone to know, the Regulation of the Minister of State for Women and Protection of the Child of the Republic of Indonesia is promulred by its placement in the News of the Republic of Indonesia.
Set in Jakarta On 8 April 2010 MINISTER OF STATE FOR WOMEN ' S EMPOWERMENT AND PROTECTION OF THE CHILD REPUBLIC OF INDONESIA, LINDA AMALIA SARI
UNDRAFILED in Jakarta On 8 April 2010 MINISTER OF LAW AND HUMAN RIGHTS REPUBLIC OF INDONESIA, PATRIALIST AKBAR
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ANNEX OF STATE MINISTER REGULATION
EMPOWERMENT OF WOMEN AND PROTECTION OF THE REPUBLIC OF INDONESIA
NUMBER 03 IN 2010
ABOUT
IMPLEMENTATION OF TEN STEPS TOWARDS SUCCESS
BREASTFEEDING
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ATTACHMENT REGULATION MINISTER OF WOMEN EMPOWERMENT
AND PROTECTION OF THE CHILD REPUBLIC INDONESIA NUMBER 03 2010
ABOUT THE APPLICATION OF TEN STEPS TOWARDS SUCCESS
BREASTFEEDING
BAB I ' M A PRELUDE
A. Background
Pancasila as a state philosophy is the cornerstone of the nation's ideology in the preamble to the 1945 Constitution that requires the state to shoulder the responsibility of committing acts of a nation's life. In an effort to preach the nation's life, the country must give birth to a future generation of intelligent, healthy physical and spiritual peoples. For that it needs the creation of a supportive condition in that direction, among them with the granting of Mother's Milk (ASI) for exclusively 6 months and continued breastfeeding until a 2-year-old child. Article 28B of the paragraph (2) of the Constitution of 1945 states that every child is entitled to the survival, grows and develops and is entitled to the protection of violence and discrimination. The provisions of the Constitution of 1945 indicate that the child is a future generation of future leaders, which is necessary for a healthy, intelligent and qualified child to achieve national goals as defined in the opening of the 1945 Constitution. In addition, according to the 2009 Law of Health, article 128 of the paragraph (1) states that each baby has the right to receive an Exclusive Mother's Milk Water since birth for 6 (six) months, except for medical indications. In verse (2) this section also mentions that during the granting of Mother's Milk, the family, government, local government, and society should support the infant's mother in full with the provision of special time and facilities. Law No. 44 of the Year of the Hospital in particular article 29 letters i require the Hospital to provide a means of prasarana
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common among other means for nursing women and children. In addition, the 2002 No. 23 Act of Child Protection, in article 44 of the paragraph (1) states that the Government is required to provide facilities and organize comprehensive health efforts for the child, in order for each child to be granted a degree. Optimal health since the womb. The situation of breastfeeding in Indonesia is still less joyful. According to the Indonesian Health and Health Survey (SDKI), an Exclusive ASI coverage of 38% (SDKI, 2007), decreased from the 2002-2003 conditions of 39.5% of the infant, while the number of infants under 6 months of infant milk was given. formula increased from 16.7% (SDKI 2002-2003) to 27.9% (SDKI, 2007). This is because there is still a stigma and stereotype that breastfeeding is a woman's affair/mother alone which is still attached to most of the Indonesian community. This view is highly gender-biased, in nature it is women who have the nature to breastfeed, but men are instrumental in providing support for the mother to continue breastfeeding so that the success of breastfeeding is exclusive. up to the age of 6 months of age and continued with breast milk and breast milk companion to two-year-old. Despite this, the lack of maternal and family knowledge of the importance of exclusive breastfeeding and the promotion of formula milk is still a constraint in the Exclusive Breastfeeding Increase Effort. The success and success of the mother in breastfeeding requires the condition of the loneliness between men and women. Although there have been rules and policies published by the relevant agencies but in reality there are still some health care facilities that have not implemented the ten-step application effort towards the success of breastfeeding. Health care in some health care facilities is yet to gain the skills to provide communication, information and education (KIE) to pregnant and nursing mothers about good and correct breastfeeding techniques during their time at the means. Health care. In addition, not all husbands, families, communities, work places in support of the application of ten steps towards the success of breastfeeding. Based on the issue above, the Ministry of Women's Empowerment and Child Protection in accordance with its principal duties and functions as contained in Appendix A Book 2 of Regulation
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President No. 47 of 2010 which contains about Program Priority Activities Ministry of Women's Empowerment and Child Protection among others on Drafting and Harmonization of the Responsive Health Field Policy Gender, as well as in the acceleration order of the Millennium Development Goals (MDGs) target achievement in 2015 in particular the target no 3, 4 and 5, hence the application of ten steps towards the success of breastfeeding supported by the role of the husband, family, Society, workplace, health care and health care facilities.
B. Basic Law 1. Law No. 7 of 1984 on Enactment Of The Convention
Regarding The Elimination Of All Forms Of Discrimination Against Women (Convention on the Elimination of All Forms of Discrimination Against Women) (Sheets Of State Republic Of Indonesia) 1984 No. 29, Additional Gazette of the Republic of Indonesia No. 3277);
2. Law No. 23 Year 2002 on Child Protection (State Sheet of the Republic of Indonesia in 2002 No. 109, Additional Gazette of the Republic of Indonesia No. 4235);
3. Law No. 32 of the Year 2004 on the Local Government of 2004 No. 125, Additional Gazette of the Republic of Indonesia No. 4437), as amended several times, last by Act No. 12 2008 on Second Amendment to the 2004 Act No. 32 of the Local Government (Indonesian Republic of Indonesia 2008 No. 59, Additional Gazette of the Republic of Indonesia No. 4844);
4. Law No. 36 of the Year 2009 on Health (State Gazette of the Republic of Indonesia in 2009 No. 144, Additional Gazette of the Republic of Indonesia No. 5063);
5. Law No. 44 of the Year 2009 on Hospitals (Sheet State Of Indonesia No. 153, Addition Of State Sheet Republic Of Indonesia No. 5072);
6. The Decree of the Minister of Health Number 450 /MENKE/SK/IV/2004 on the Granting Of Mother Milk (ASI) Exclusively On Infants in Indonesia.
7. The decision of the Minister of Health Number 237 /MENKE/SK/IV/1997 on the Marketing of Mother ' s Milk Water Replacement
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C. Purpose and Purpose 1. The intention
The application of ten steps towards the success of the breastfeeding is a reference to the health care facility, with the support of the community and families in implementing the ten-step implementation towards the success of breastfeeding.
2. Purpose
General: An increase in the application of ten steps towards the success of breastfeeding in a health care facility, with community and family support.
Special: 1. Adanya the written policy on increased breastfeeding in health care facility;
2. The presence of skills training for health care at a health care facility in increased breast feeding;
3. The presence of Communication, Information and Education (KIE) on the benefits and penatalacations of breastfeeding;
4. There is a facilitation for the lactating Initiation Initiation (IMD);
5. He was treated for 24 hours a day at a health care facility;
6. The formation of the ASI support group in the health and community services facility.
D. Understanding 1. Gender is a public view of differences in roles, functions
and responsibility between women and men who are the result of cultural social constructions and can change according to the development of the age and support of that society. my own.
2. Gender equality is the commonality of conditions and position for men and women to obtain the opportunity and rights as human beings, in order to be able to play a role and participate in political, economic, social cultural, educational, defence, and social activities. social security and commonality in enjoying the outcome of the development whose impact is balanced.
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3. The next Mother's Milk Water is a living fluid containing white blood cells, immunoglobulins, enzymes and hormones, as well as specific proteins, and other nutritional substances that are necessary for child growth and development.
4. Exclusive breastfeeding is the gift of only mother's milk water without food or other beverages to the baby from birth until the age of six months.
5. The Initiation of Early Mages (IMD) is to immediately put a baby on her mother's chest, skin to skin contact immediately after birth at least 30 minutes to an hour or so until the baby shrints itself
6. The ASI support group called KP-ASI is a group formed by health care facilities and the public to support pregnant mothers, new mothers giving birth and breastfeeding mothers.
7. An idle husband is a husband who is always ready to take care of the problems related to pregnancy, childbirth, parenting and care including breastfeeding and the efforts of the complications.
8. Maternal and Family Assistance is a distraction by the health of the mother and family in particular to the problem/difficulty of breastfeeding.
9. A Health Care Facility is a tool and or a place that is used to host health care efforts both promoted, preventive, curative and rehabilitative performed by the Government, Pemda and or the public.
10. The Mother and Baby Hospital, which is later called the RSSIB, is a public, public and private hospital that has been carrying out ten steps towards the protection of both the Mother and Baby in a fully integrated and plenary way.
E. Target The goal of the ten steps towards the success of the breastfeeding consists of: a. I'm pregnant b. Maternity Mother
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c. I'm nursing a d. Husband and Family e. Society f. Healthcare facility g. Health Care
BAB II
AWARDING
A. The benefit of the Convention on the Rights of the Child, says that every child bears the right to life and certainty to be able to survive as well as growing its optimal fireworks. To achieve the optimal growth, in the Global Strategy for Infant and Young Child Feeding, WHO/UNICEF recommends four important things in the delivery of baby and child food: 1. Provide Mother Milk Water (ASI) to the baby shortly within 30
minutes after the baby is born, 2. Gives only breast milk only or exclusively breastfeeding since
born until the 6-month-old baby, 3. Gives Food Companion Water Mother's milk (MP-ASI) since baby
is 6 months to 2 years old, and 4. Continued breastfeeding until a 2-year-old. The advantages and benefits of breastfeeding for the child can be seen from several aspects: 1. Aspects of Gizi
The benefits of Colostrum (Mother's milk that came out in the first days after the baby was born) The Colostrum contains an immunity substance mainly Imunoglobulin A
(IgA) to protect babies from various infectious diseases especially diarrhea.
The amount of colstrum produced varies depending on the baby ' s hisment in the first days of birth. Although little but enough to meet the nutritional needs of the baby. It is therefore a colostrum should be given to the baby.
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The colostrum contains a high protein, vitamin A and contains low carbohydrates and low fat, so it corresponds to the baby ' s nutritional needs in the first days of birth.
Help out the meconium The first black-green tinja (faeces) or baby shit is greenish.
ASI ' s composition
ASI is easily digested, because in addition to containing the corresponding nutritious substance, it also contains enzymes to scatter the nutrients that are present in such breast milk.
ASI contains high quality nutritional substances that are useful for The growth and development of the bayi/child intelligence.
In addition to containing high protein, ASI has a comparison between Whei and Kasein which is suitable for infants. Whei ratio (a substance that helps absorption and metabolism of proteins into blood vessels in 20-40 minutes) with Kasein (a substance that helps the absorption and metabolism of proteins into blood vessels in 2-4 hours) is one Breast excellence compared to cow's milk. ASI contains Whei: Kasein is more than 65:35. This composition causes the breast protein to be more easily absorbed and metaboled. Whereas in cow's milk it has a comparison of Whei: Casein is 20:80, so it is not easily absorbed and metabosed.
Taurin Composition, DHA and AA on ASI
Taurin is the second most amino acid in the breast milk that is the most common in the breast milk. serves as a neuro-transmitter and plays an important role for the maturation process of the brain cells.
Decosahexanoic Acid (DHA) and Arachidonic Acid (AA) are long-chain unsaturated fatty acids (polyunsaturated fatty acids) required for the formation of optimal brain cells. The number of DHA and AA in breast milk is very sufficient to ensure the growth and intelligence of the child. In addition DHA and AA in the body can be formed/synthesized from the substance of the (precursor) of the order, each of Omega 3 (linolenic acid) and Omega 6 (linoleic acid).
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2. The immunological aspect of breast milk contains anti-infection, clean and contamination-free substances. • Immunoglobulin A (Ig.A) in colostrum or breast milk is quite
high. Secretory Ig.A is not absorbed but it can paralyse E. coli pathogenic bacteria and various viruses in the digestive tract.
Laktoferin is a type of protein that is a component of the immune substance that binds iron in the digestive tract.
Lysozymes, enzymes that protect babies against bacteria (E. coli and salmonella) and the virus. The amount of lysozymes in breast milk is 300 times more than cow's milk.
White blood cells on breast milk in the first 2 weeks of more than 4000 cells per mile. Consisting of 3 types: Bronchus-Asociated Lympocyte Tissue (BALT) respiratory antibody, Gut Asociated Lympocyte Tissue (GALT) antibody respiratory tract, and Mammary Asociated Lympocyte Tissue (MALT) breast tissue antibodies Mother.
A bifidus factor, a type of carbohydrate that contains nitrogen, supports the growth of the bacterium Lactobacillus bifidus. This bacterium maintains the acidity of the baby ' s intestinal flora and is useful to inhibit the growth of adverse bacteria
3. Psychological aspects of maternal confidence in breastfeeding: that mothers are able to breastfeed
with an adequate milk production for infants. Breastfeeding is affected by the mother's emotions and affection for the baby will increase the production of hormones especially oxytocin that will eventually increase breast milk production.
Mother and Baby Interaction: Growth and psychological development of infants depending on the unity of the infant mothers.
Influence of direct-baby contact: baby-baby love bonds occur due to a variety of stimuli such as touch skin (skin to skin contact). The baby will feel safe and satisfied as the baby feels the warmth of the mother 's body and hears a mother' s heart rate already known since the baby is still in the womb.
4. Aspects of the human intelligence interaction and breast milk content are badly needed
for the development of the brain nerve system that can improve the baby's intelligence.
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Research shows that the IQ in breast milk has a 4.3 point IQ point higher at the age of 18 months, 4 to 6 points higher at age 3, and 8.3 points higher at the age of 8.5 years, compared to a baby that was not breast milk.
5. Neurological aspects with breast-sucking, neural coordination swallowing, smoking and breathing that occur in newborn babies can be more perfect.
B. SUPPORT IN IMPROVING ADMINISTRATION There are all sorts of efforts that can be done as a form of support in the increase in breast feeding. Ranging from husband and family, the form of support that can be provided among other concerns, opportunities, atmosphere creation that supports nursing activities, optimal nutritional fulfillment for pregnant and nursing mothers. The provided support is expected to extend to the public sphere, the health care system, the workplace and the company in accordance with the provisions of the laws. Support for increased breastfeeding among them: 1. Support from Husband and Family For Mother Breastfeeding,
A husband has a very large role in helping the mother achieve success in breastfeeding her baby. While breastfeeding the baby, there are two reflexes in Mom's body. The first reflex is the Prolactin Reflex/breast milk production and the second is the Oksitosin Reflex/the feeding of ASI. On this oxytocin reflex, husband and family have an important role in creating calm, comfort and compassion. The happiness, tranquility and comfort that the mother felt would increase the production of the hormone oxytocin, the flow of breast milk was also smooth. In contrast to the grief, physical and mental exhaustion of a mother would inhibit the production of the hormone oxytocin, resulting in the loss of breast milk. This is where the importance of a husband and family roles in preparing, encouraging and supporting the mother and creating an atmosphere that is conducive to pregnant and nursing mothers. A more detailed description of the husband's role support in achieving breastfeeding success as contained in Chapter V.
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2. Support for Pregnant Mother and Breastfeeding to Get an Optimal, A pregnant mother and breastfeeding requires sufficient nutritional intake to be optimal breast milk production. Family members, especially husbands, have important roles in order to get pregnant and breastfeeding guaranteed the intake of their gizas. As long as this is happening in most families are women/wives even nursing, getting the last priority after her husband and children. This causes the production to be inoptimal and is still a case of bad nutrition experienced by pregnant and nursing mothers as well as infants. Besides getting the ultimate nutritional intake, in our society, there is also a ban on family members who are charged for cultural reasons, so as long as they get pregnant and breastfeed, you don't eat certain kinds of foods that are content. The gizas are actually very good. Therefore, the support of the family, including the granting of opportunity, the optimal nutrition is required by a mother in the nursing period.
3. Public Support For Nursing Mothers, Public-wide Support will be able to help the mother in achieving the success of breastfeeding. The public can participate by helping, encouraging and providing as many opportunities as possible for the nursing father and mother to be with her baby and create a close bond of affection. It is very important in society to form a KP-ASI. In the case other than mother-mothers, both nursing or not, also involve husbands, as well as religious figures and public figures. This is where the importance of public and religious figures, that they are respected and embraced by caring and awareness, is expected to be able to provide nursing activities as a result of the work of the people. the movement or culture that is a form of worship. By growing breastfeeding as a movement, culture, as well as one form of worship in society, it is an attempt to continue to create conditions that are conducive to the use of breastfeeding activities.
4. The support of the Health and Health Services Facility for nursing mothers, the support of health care facilities and the health care facility is crucial in achieving the success of breastfeeding. Facilities
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Health Services and Health Officers need to have gender sensitivity included in encouraging mothers and encouraging male active participation in achieving the success of nursing mothers. Health officials are highly respected people in their environment so that what they say and do in work and in the environment of their society will affect other communities around it. Therefore, breastfeeding will become more successful when the Health Officer has a high gender sensitivity, and is supported with the increasing active participation of the husband. Health care and health care facilities should be provided from the primary health care center to tertiary health care centers. From the Hospital that is in the national sphere up to Posyandu and Polindes/Poskesdes at the RT/RW/Village level/Kelurahan need to continue to enhance the socialization and application of Premature Initiation and Provisioning Initiation as well as facilitating the The formation of the KP-ASI in their own neighborhood.
5. Other support besides the role and support of family, community and health care facilities, the success of the mother in breastfeeding is also required by other support: a. The Home Office Support and Public Space Manager.
Breastfeeding, Currently the more nursing mothers are breastfeeding and working in the public sector. The role of women began to change no longer in the domestic sphere alone but headed to the public sphere. It is quite uplifting and it provides a challenge for us so that working mothers can be able to breastfeed during work time in the workplace. Support from employers, workplaces, and the government is crucial for the mother to achieve the success of breastfeeding while staying in the works. One form of support that employers can provide or a workplace is giving time and providing a means of nursing space that meets the health standards for mothers to breastfeed or milk milk during work time at work. In addition to companies/workplaces, breastfeeding/Lactation Room facilities should also be provided in general means such as shopping malls, train stations, bus terminals, airports, traditional markets, and public facilities and facilities other.
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b. Support During Emergency Situations/Conflict For Nursing Mothers, In an emergency situation, nursing mothers desperately need priority access to get clean water, food, shelter/gender responsive shelters and the presence of The facilities for breastfeeding the baby. The aid and dairy formula that does n' t see the needs of nursing mothers and babies will increase the mother ' s failure to re-breastfeed her baby. The support given to nursing mothers can be true and accurate information, the practical help of a trained force/counselor or even a fully empathetic listener by taking a boost and giving the effort to raise and rearing. Immerate the hearts of mothers, up to the provision of shelter and the priority of food and clean water, and the policy of limiting the entry of milk formula.
c. Policy Support For Breastfeeding Mothers, A policy issued by the Ministry/Institute or related services in the area is essential in providing support for the mother in giving breast milk. Currently, the Government through the Ministry of Health has issued Decree of Health Minister Number 450 /Menkes/SK/IV/2004 on Exclusively Breastfeeding on infants in Indonesia and the Decision of Health Minister Number 237 /Menkes/SK/IV/1997 about Marketing Replacement For The Mother's Milk Water. The ten-step policy of the Mother and Baby Hospital which accommodates the exclusive breastfeeding continues to be expanded and enhanced by its scope. Despite the growing number of nursing women working in the public sector, the Government through the Ministry of Women's Empowerment and Child Protection, the Ministry of Labour and Transmigration and the Ministry of Health and the Ministry of Health. publishes the Joint Regulation of Ministers of State Empowerment of Women, Minister of Labour and Transmigration and Minister of Health Number: 48 /Men.PP/XII/2008, PER.27/MEN/XII/2008, 1177 /Menkes/PB/XII/2008 dated December 22, 2008 on the Upgrade Breastfeeding During Workspace Time at Work. This joint rule is expected to be an umbrella for female labor in particular that is breastfeeding so that they can keep breast milk during work time at work, and encourage employers to provide the breastfeeding Room/ASI room. that is compatible with health standards.
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CHAPTER III BREASTFEEDING: QUITE TEN STEPS-TOWARDS STEP
DEAR BABY Declaration Innocenti, which was held in 1990 in Florence Italy, called for the implementation of ten steps towards success The breastfeeding must be applied to the entire maternity facility. The declaration aimed at the protection, promotion and support of breastfeeding is attended by representatives of more than 30 countries including Indonesia. At the Conference that gave birth to the Declaration of Innocenti, it was agreed that throughout the year, we needed to campaign the importance of breast milk and in each of the first weeks of August was made as breast milk week. The ASI ' s memorial was carried out with the intention of resusting the importance of breast milk for the baby and how important it is for the mother in achieving her baby's nursing success. On the 2010 World breastfeeding Week, which coincided with the 20th anniversary of the Declaration of Innocenti, the theme of The World Alliance For Breasfeeding Action (WABA) was " Breastfeeding: Just Ten Steps! -The Baby Friendly Way ", which translates to "Breastfeeding: Enough Ten Steps! -Towards Baby Baby's Step". This theme aims to remind us again of the importance of execution ten steps towards the success of breastfeeding as it has been called in the Innocenti Declaration 20 years ago. Theme Breastfeeding: Just Ten Steps! -The Baby Friendly Way (Breastfeeding: Enough Ten Steps! -Towards Baby Baby's Step)" this becomes very important among others because: Health Care Sarana plays a very important role
in the initiating breastfeeding activities. • Ten steps in achieving breastfeeding success load
a suportive step step that allows Mother to improve their breastfeeding quality and provide guidance and training for the health officer in providing support Breastfeeding.
For the past 20 years, over 20,000 maternity services, or about 28% of all the means of maternity care in the world, have done in full ten steps and have been certified
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as Baby Friendly Hospital Initiative (BFHI). During this time anyway, the exclusive breastfeeding success rate has increased significantly.
Nevertheless, according to the BFHI programs around the world, lack of training, the weakening of the ten steps in the accreditation of maternity facilities have contributed to the know-how or the decline of the exclusive breastfeeding number in some places and situations.
By because of that, it is time to look back on this Ten-step approach and To determine where we're going. A. The Last Progress Baby Friendly Hospital Initiatives (BFHI) and
Ten Steps Towards Success Breastfeeding 1.
Currently, more than 20,000 maternity facilities worldwide report once successfully gaining the status of "Baby Baby". BFHI increases its exclusive breastfeeding coverage at local, national and global levels. Increased breastfeeding is a key factor contributing to the decrease in child mortality rates (UNICEF 2009).
Trend Number (in thousands) Hospital once designed "darling
Baby"
3.989
22
0
13.391
20.323
18.323
18.50315.136
0
5
10
15
20
25
19 92
19 95
19 98
20 01
20 04
20 07
20 10
The concept of Baby Baby has been revised including suggestions for implementation of ten steps towards the success of breastfeeding not only It was held at the hospital, but it was also implemented in other health services as well as in the community. When ten steps towards the success of the breastfeeding are held in full at the Hospital, community-based support can play a role for
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increased its effectiveness. In contrast, while in the Hospital there is only a few steps that are carried out, all the other breastfeeding efforts will become less effective.
2. The challenges of the challenges facing today are still a lack of commitment, worsening the practice of applying ten suckling steps in the hospital, and the lack of health care training that provides counseling to mothers, even when ten The move to the success of the breastfeeding has clearly proved to be much Therefore, it is time to revitalize the execution of ten steps towards the success of breastfeeding with extending its application, not only in the Hospital and in the means of health care alone but instead applying it in Society.
B. "Repair" returns to the pattern/Groove Supporting Breastfeeding 1. Revision Baby Friendly Hospital Initiatives (BFHI) and its developments
In 2007, UNICEF and WHO have conducted the development of the more comprehensive Baby Honey Hospital that is Mother and Baby Hospital that is easier and more and more accessible. using a new approach of "Baby Baby" that could be executed outside of maternity facilities. While many countries have implemented the "Mother-baby friendly" concept, the other recently emerging concept is the concept of "Motherbaby chilbirth Initiatives", containing ten steps to optimize maternity facilities, between Others carry out nine steps for the mother during pregnancy and during childbirth to reduce the unnecessarily interventions during pregnancy and such a copy. The tenth step is also a step towards the success of breastfeeding. Following the footsteps of Baby Baby will improve the coverage of breastfeeding, and increase maternal and infant health degrees around the world.
2. Our breastfeeding practice knows that with the increasing implementation of ten steps baby baby through ten breastfeeding steps, the increased success of the mother in giving the gold standard of breast food is breast milk. This suggests the importance of each maternity place, the Hospital, the Clintons, and now extends to the public sphere to continue to struggle in improving the execution of ten steps towards the success of breastfeeding. Hospital could provide an alternative
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A new way that is easier to carry out these ten breastfeeding steps if a health care facility at the bottom level finds difficulty in carrying out the ten suckling steps at once in one place.
BAB IV
TEN STEPS TOWARDS BREASTFEEDING SUCCESS
WHO and UNICEF have issued a joint statement in 1989 about ten steps towards the success of breastfeeding that is protection, the promotion and support for breastfeeding in the maternity care facility. The 1990 Declaration of Innocenti called on the world to fully execute ten steps towards the success of this breastfeeding in all maternity facilities by the end of 1995. Twenty years later, more than 152 countries have had a Baby's Honey Hospital. They have carried out ten steps towards the success of this breastfeeding, and with the addition of the relevant section of the International Code of ASI ' s Replacement Marketing, help them to survive the promotion of formula milk to the health care power and to the people. In order to apply ten steps to the success of breastfeeding as the Innocenti Declaration agreement of 1990, the government in this case the Ministry of Health has issued the Decree of the Minister of Health Number 450 /Menkes/SK/IV/2004 Date 7 April 2004 on Giving Mother ' s Milk (ASI) Exclusively On Infants in Indonesia. But the implementation is not yet optimal, since it does not involve a husband, family, community, health care and health care facility, whereas husbands, families, people, health care facilities and health care have a very important role. It's important to support the success of breastfeeding. The support form of a husband, family, community, health care and health care facility for the mother in achieving the success of her baby breast is one of the efforts of achieving gender equality. The Ten Steps Towards The Success Of Breastfeeding are: 1. Health Care (SPK) means of increased policy
The PP-ASI is written that is routinely communicated to all officers;
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2. Conduct training for officers in terms of knowledge and skills to implement such policies;
3. Explaining to all pregnant mothers about the benefits of breastfeeding and their screening begins since the pregnancy, babies are born to 2 years of age including how to cope with the difficulty of breastfeeding;
Step up conduct: Explanation and information about the benefits and screening of breastfeeding
in addition to being given to pregnant mothers, also to the husband and family. This is where the importance of building engagement, support and the husband's active role in co-determining the success of the mother to breastfeed her baby.
Which provides an explanation is the health care and companion of mothers and families who have been trained.
The material described among other things about Initiation Initiation, the dangers of formula and dot/basil, coatysing, the right breastfeeding of the right includes overcoming the difficulty of breastfeeding, the management of breastfeeding as a baby is sick.
• This information can be delivered at the time of the pregnancy inspection visit, the period of childbirth to the time of nifas.
Step up: In drafting this draft policy it involves experts
or professionals in the health of mother and child health. • A meeting was held to get input as an attempt
The refinement of the policy draft. • The policy is aplikative in the form of technical/procedure instructions
remains with an explanation fitted with the images. • The minimum compiled policies include Initiation Initiation,
banning the promotion of formula milk and the prohibition of using dot/kempeng, coatysing, the right breastfeeding of breastfeeding, suckling managemen as baby pain etc.
• The policy that has been compiled must always be communicated to the entire health workforce.
Step up: Training is done periodically and is held at the facility
health or other training places adequate. • The facilitator is a competent person in the health of both mothers and children. • Minimal training materials include Initiation Initiation, prohibition
promotion of formula milk and prohibition of use of dot/basil, adjoining of the right breastfeeding industry, including overcoming the difficulties that arise while breastfeeding, Management of breastfeeding while infants are ill and for the mother and family.
The training methods used can be lectures, questions, discussions, simulations etc.
The trainees are all healthcare in the facility. Such health care.
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4. Helps mom start breastfeeding her baby in 30 minutes after giving birth, which is done in the maternity room. When the mother gets a Caesar operation, the baby disusui after 30 minutes of conscious mother;
5. Helps the mother how to breastfeed properly and how to maintain breastfeeding even though the mother is separated from the baby over medical indications;
6. Do not provide any food or drink other than breast milk to the baby
newborn;
Step up: Initiation Initiation is performed both in the maternity and space space
operation. • The initiation of the Early Scare was carried out by the health care that helped
the process of childbirth. • Mothers, husbands and families have the right to ask the service provider
health to perform Initiation Initiation as long as there is no counter indication.
If the mother gets an operation of Caesar and uses a lumbal anesthetic (not anesthesia total), Mother remains helped to breastfeed her baby in the first half hour after the birth of her baby in the operating room.
The initiation of the Early Scare has been shown to be able to reduce the bleeding on the mother thus pressing the Numbers Mother's death and the Death Number of the Baby. Therefore, each maternity facility needs to apply the Premature Initiation Initiation in a fixed procedure from the consultation on the time of the pregnant mother's visit to the time of childbirth and breastfeeding.
Step forward: Which helps the mother to breastfeed properly is power
health, or husband and family. • Ensuring the mother's position and the baby's incision on mother's chest are correct. • Creating a quiet and comfortable atmosphere for nursing mothers. • Helping mom how to cope with the difficulty of breastfeeding her baby. • Helping mothers recognize a baby that is already full, choking, or less
gets breast milk. • Encouraging mothers to keep breastfeeding even though mother and baby should be treated
separated over medical indications. • Improving the role of the husband in supporting the mother can still be breastfeeding.
Step up: Giving an explanation to the mother, father and family that:
-Baby only requires breast milk only-breast milk alone is enough to meet the needs Child nutrition
provides an explanation of the dangers of formula milk and other food/beverages other than breast milk in newbores except for medical indications.
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7. The outpatient has joined the mother with a baby 24 hours a day;
8. Helps the mother breastfeed the baby watermelon, with no restrictions on the old and the frequency of breastfeeding;
9. Not giving a dot or basil to a breast-fed baby;
Step up: Giving the mother her share time to breast-feed her baby. • Help mothers, fathers and families to recognize whether babies are already
satiated, hungry or choking on breast feeding. • Giving an explanation to the mother how to address a physical complaint that
appears while breastfeeding the baby ' s watermelon. • Giving an explanation to the mother that breastfeeding is a part of
worship so that mothers are motivated to breastfeed the baby ' s watermelon. • Giving the father and family an explanation for creating
conditions, situations, calm atmosphere, comfortable, loving care so it gives you confidence for the mother to breastfeed the baby.
Guaranteed the nutritional fulfillment of the mother Breastfeeding is optimally.
Step up: Attend the provision of an outpatient space with the means and
adequate infrastructure. • Practicing mother-in-law with a baby for 24 hours a day
unless there is any indication the baby's medical should be taken care of separately. • Ensure the cleanliness and comfort of the outpatient rooms. • Guarantees order in terms of time for mother and baby. • Trying to keep the mother suckling even if the baby should be
being treated separately for medical indications.
Step up: Giving an explanation to the mother, father and family about the danger
the use of the dot/basil. The basil or the dot has some danger/loss between others causing the baby to have a dependency on the basil (e.g. to be calm/sleep should always wear the mask), the baby is impaired on the growth of the geligi tooth, the baby becomes less develops in its verballed abilities, in addition to the middle-ear infection also increases in babies often wearing basil.
Giving an explanation to the mother, father and family that the baby needs only breast milk.
Melarang promotion of the dot/kempeng both at the health care facility and in the community.
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10. Seeking the formation of KP-ASI and the mother's header to the group when returning from the Hospital/Maternity Hospital/Health Services.
BAB V
The role of the husband in achieving the success of breastfeeding the function of the mother in Nursing a baby cannot be replaced by a husband, but the husband also has an important role in achieving breastfeeding success, the important role of the husband is to provide support for the mother. If the mother feels supported, loved and noticed, there will be a positive emotion that will increase the production of the hormone oxytocin so that the milk production is smooth. Husband support can be realized in the form of emotional support and practical help for the mother. A. A concrete form of husband support for mothers during breastfeeding among others:
1. Keep paying attention to mom. In some cases a husband pays more attention to the baby than paying attention to the mother's needs, while at the time of breastfeeding the mother desperately needs attention.
2. Creating an opportunity for the mother to have more free time with her baby next to rest.
Step implementation: Hold a meeting in order to equalize the perception of the need
KP-ASI. • It forms the KP-ASI from the smallest level (RT/RW to kelurahan) which
its membership consists of breastfeeding mothers, husbands, families, public figures, religious figures.
Shaping KP-ASI at the health care facility Her membership consists of breastfeeding mothers, husbands, families, healthcare.
Holding regular meetings to support each other ' s breastfeeding including overcoming the problems/difficulties that arise during breastfeeding.
Replacing coordination and cooperation between KP-ASI to share information and experience.
• Socializing breast feeding to the public. • Optimizing Posyandu, Polindes, Poskesdes, Puskesmas etc. as a means
implementation of KP-ASI activities. • Engaging male/husband/religious persons in any activity
KP-ASI.
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The husband can prepare everything that the mother and baby need, so that the mother has more time with the baby and has enough time to rest.
3. Try not to express the criticism of the mother. Newborn mothers are generally very sensitive to changes in the shape of the body, therefore criticism related to changes in the shape of the body will be offended and stressed, this will be hampered by breast milk.
4. Take the time to be with the baby especially when the baby is finished suking. Husbands can help to dissuage the baby when it is finished by holding it and allowing the baby to lie down or languish so it creates an emotional connection and familiarity between the father, mother and baby.
5. Be Your Husband Ready, Take Care, Take Care. Take the mother and baby to check her health at a health care facility, so that the husband can find out in the early years of growing a child's work and if there is a health breakdown in both the mother or the baby.
6. Giving mothers the urge to keep breastfeeding. The husband should give the mother the urge to breastfeed her baby exclusively for 6 months and be passed on until a two-year-old child. In some cases, perhaps the mother does not want to breastfeed for aesthetic reasons, then the husband must still give the mother the urge to breastfeed her baby.
7. Creating an atmosphere that is conducive to mothers for breastfeeding. Husbands should be striving so that mothers can breastfeed optimally
by creating a comfortable and quiet atmosphere. 8. Handle the difficulties raised during the mother breastfeeding the baby
In some cases there may be some difficulty among other breast milk does not come out, baby does n' t want to bother and others, then the husband ' s role is ushering in a service facility health to get help besides providing support for the mother to keep breastfeeding.
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B. The steps of being Husband Are Ready to Take Care of (Standby)
The Husband is Ready to Take Care not only to mean the role of the husband in addressing the issue of pregnancy and childbirth, but also including the issue of breastfeeding. Related to Husband Ready To Take Care, then the steps the husband must do is as follows:
1. Learning various things related to breastfeeding.
The husband must know how the mother can deliver breast milk well. By knowing the process of breastfeeding then the difficulties the mother may face will be overcome so that the breastfeeding can be performed optimally.
2. Discuss the difficulties that arise in helping the mother breastfeed.
At any given moment the likelihood of a husband is having trouble running the role of an Idle/Standby husband, therefore do not hesitate to ask and discuss in a forum Members of the husband who are his wife breastfeeding or to the health officer.
3. Maintaining her health.
The good husband ' s health will be very helpful to the mother especially if the mother needs help seizing power. Husbands need to avoid stress so as not to affect the calm of mothers so as to inhibit breast milk.
4. Enhance the ability to be associated with care and childcare.
The husband can improve the ability to carry, bathe and study massage techniques so that it can make babies for better trouble.
Husband support in the form of emotional support and this practical help is the most meaningful form of support for the mother. The breastfeeding process is a process involving all family members and husband's involvement is one of the key roles that determine the success of breastfeeding.
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CHAPTER VI ACTION STEPS
The commitment and concern of all of us in encouraging an effort to be prepared 10 gender-responsive breastfeeding steps should be realized in concrete steps. Breast feeding is not only a matter of mother and baby. Husbands, families, communities, community institutions, educational institutions, religious institutions, businesses, mass media and the government must work together and play a role and are active to provide support for the purpose of a gender-responsive breastfeeding destination. Some of the concrete steps that are expected are done by the relevant party in support of the application of ten gender responsive breastfeeding steps: a. Husband
-Pay attention to the nutritional intake for breastfeeding wives-Helping to do homework that becomes a wife ' s duty a day-
days-Creating conditions, situations, calm atmosphere, comfortable, loving
darling in the effort increasing the mother ' s confidence to breastfeeding-Giving the wife time to rest sufficient-Engage in breastfeeding, by giving breast milk to
baby-Engage and provide support in KP-ASI-Giving support in performing Initiation Initiation early-Ready to take care and keep (standby) in Overcoming difficulties in breastfeeding
b. Family-providing psychological support for nursing mothers experiencing
difficulty in giving breast milk-Creating conditions, situation, quiet, comfortable, loving atmosphere
dear in an effort to improve mother ' s confidence to breastfeed-Increase the knowledge, understanding and awareness of mothers, fathers and
families about the magnitude of breast milk benefits for babies, mothers, families, society and the country. Because the success and agility of the mother in breastfeeding requires the condition of equality between male and female
-Engage and provide support in the ASI Support Group-prioritize the optimal nutritional intake for expectate mothers and During
breastfeeding-Remozes the myth that does not support the mother's success
breastfeeding includes a prohibition on eating a particular type of food that is actually a necessary value for its gizas.
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c. Community-Revitalization of Posyandu and PKK forums to confine the granting
information services on the importance of support for nursing mothers. -Giving special attention to nursing mothers, thus waking up
empathy and sympathy from society to mothers who are breastfeeding. -Engage and provide support via KP-ASI in its environment. -Making breastfeeding as a movement/culture that is
a form of worship. -Creating a condition that is conducive to the activities
breastfeeding. -Advocacy at the community group level and the stakeholder
interest in supporting the Ten Steps Towards Breastfeeding Success.
-Diluting The Campaign On The Importance Of Increased Breastfeeding.
-Straighten the society's perception of myth, stigma and stereotype that lack the exclusive breastfeeding.
-Socializing that breastfeeding is one of the forms of worship.
d. Workspace/Company/Company-Provides maternity leave and childbirth in accordance with the rules
applies. -Provides a depreciation/breast space facility that meets the standard
health. -Provides the opportunity for the working female workforce
breastfeeding to depreciate during work time at work.
-Manage CSR (Community Social Responsibilities) to provide support on the efforts Breastfeeding.
e. Public Space-Attempted the establishment of a breastfeeding space in the public space
(shopping center, terminal, station, airport, port). f. Government
-Composed policies related to implementation of the application of ten steps towards the success of breastfeeding.
-Conduct the socialization, coaching, supervision and evaluation of the execution of ten steps towards success breastfeeding.
-Provides the budget for implementation of a ten-step implementation towards the success of breastfeeding.
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-Doing coaching and increased capacity for strategic stakeholder regarding breastfeeding.
-Ensure the Hospital in Indonesia has followed the concept of BFHI/Darling Baby and has carried out ten steps towards the success of breastfeeding.
Specified in Jakarta on April 8, 2010 MINISTER OF STATE EMPOWERMENT AND WOMEN PROTECTION OF THE CHILD OF THE REPUBLIC OF INDONESIA,
LINDA AMALIA SARI
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