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The Relationship of Exclusive Breast Milk With Stunting in Children Under the Age of Two Years Tapung Kampar Distric

Based on the 2013 Basic Health Research (RISKESDAS), Short Toddler is one of the health problems of toddlers in Indonesia. The purpose of this study was to identify the relationship between exclusive breastfeeding and the incidence of stunting in children under two years of age in Tapung, Kampar Regency. The study uses observational analysis research methods with case control. The sample in this study were mothers with children under the age of two years in Tapung, Kampar district. The research instrument used was a questionnaire and a weight and height measurement tool. Bivariate data used chi square test with p value: 0.05. The results in this study were toddlers who were not exclusively breastfeeding who experienced more stunting, namely 52 respondents. Statistical test results obtained P Value <α = 0.05 which is 0,000. The conclusion of the study is the relationship between exclusive breastfeeding and stunting in the Kampung Tapung District with a P value of 0,000.


INTRODUCTION
Stunting is defined as a chronic malnutrition problem caused by feeding that is not in accordance with nutritional needs so that nutrient intake is lacking in a long time (Millennium Challenga Account Indonesia, 2014). Based on the 2013 Basic Health Research (RISKESDAS), Short Toddler is one of the health problems of toddlers in Indonesia. According to WHO, short toddlers will become a public health problem if the prevalence is more than 20%, in Indonesia, the prevalence of short toddlers in 2013 was 37.2% so this problem must be addressed. Based on the 2013 Basic Health Research (RISKESDAS), the prevalence of short toddlers also increased compared to neighboring countries such as Malaysia (17%), Myanmar (35%), Vietnam (23%), and Thailand (16%).
Stunting is influenced by several factors, including factors before birth such as maternal nutrition during pregnancy and factors after birth such as exclusive breastfeeding, nutritional intake of children during growth, infectious diseases, socio-economic, health services, and various other factors that collaborate at the level and a certain degree so that it ultimately leads to failure of linear growth (Fikrina, 2017). Although exclusive breastfeeding is strongly associated with reduced risk of Stunting, it has not been able to completely change people's perceptions regarding the importance of exclusive breastfeeding during the first 6 months of life (Victoria C et al, in Paramashanti et al, 2015). This is indicated by the low percentage of babies who are breastfed in Indonesia. In 2016 the percentage of babies getting ASI based on age group was 54% while in 2017, babies got Exclusive ASI according to their age of 46.7%.

A. Exclusive Breast Milk
Breast milk has many benefits for babies. Breast milk can reduce the risk of lack of various nutrients because breast milk can reduce the risk of lack of various nutrients because milk contains protein, fat, vitamins, minerals, water and enzymes needed by infants (Mufidah et al., 2015). Research that proves that exclusive breastfeeding in developing countries has succeeded in saving about 1.5 million babies per year is one of the basic recommendations for exclusive breastfeeding until six months old by WHO, UNICEF, and the Minister of Health of the Republic of Indonesia (Mamonto, 2015).

B. Stunting
Short toddler (Stunting) is a chronic malnutrition problem caused by a lack of nutritional intake in a long time due to food that is not in accordance with nutritional needs (Amaliah N, K and B.Ch.Rosha, 2012). Human growth is the result of interactions between genetic factors, hormones, nutrients, and energy with environmental factors (Oktarina, Z and T. Sudiarti, 2013). Stunting is a chronic condition that describes stunted growth due to long-term malnutrition. Stunting according to WHO Child Growth Standard is based on body length index by age (PB / U) or height by age (TB / U) with a limit (z-score) <-2 SD (Ministry of PDTT, 2017).
Stunting in infants is a consequence of several factors that are often associated with poverty including nutrition, health, sanitation and the environment (Ministry of PDTT, 2017). The main factors causing stunting are: Food intake, infectious diseases and Health and Environmental Health Services. Stunting is a chronic malnutrition that occurs in the womb and during the first two years of a child's life can result in low intelligence and decreased physical capacity which ultimately leads to decreased productivity, slowing economic growth, and prolongation of poverty (Amaliah, N., K. Sari., And B.Ch. Rosha. 2012).  2018) stated that there was a significant relationship between exclusive breastfeeding and the incidence of stunting in infants aged 6-23 months in Lampung Province, where infants who did not receive exclusive breastfeeding were at risk of being stunted 2,808 times compared to infants who received exclusive breastfeeding.

III. RESEARCH METHODS
This research uses observational analytic method with a case control research design. The place of research is in Tapung, Kampar Regency. The population in this study are mothers who have toddlers aged 6-24 months in Tapung, Kampar District. The sample in this study were all mothers who had toddlers aged 6-24 months in Tapung, Kampar District., totaling 132 people with inclusion criteria for toddlers with normal gestational age and weight. The independent variable in this study is the history of exclusive breastfeeding. While the dependent variable is a stunting event. The research instrument used was Microtoise (a tool to measure height) and a questionnaire. Data analysis was performed using the chi square statistic test.

IV. RESEARCH RESULTS AND DISCUSSION
The results of research conducted in 2020 with 132 respondents using a questionnaire in Kampung Tapar, Riau Province, can be seen in the  Growth and development in infancy requires balanced and relatively large amounts of nutrients. However, a baby's ability to eat is limited by the condition of the digestive tract which is still in the maturing stage. The only food that suits the condition of the baby's digestive tract and meets the needs during the first months is breast milk. Children who do not get exclusive breast milk are at higher risk for nutrient deficiencies needed for the growth process. Growth disturbance will result in stunting in children (Soetjiningsih, 2015).

V. CONCLUSION
The results of a study conducted in 2020 in Tapung, Kampar Regency, Riau Province, about the Relationship of Exclusive Asi Giving to Stunting Events in Baduta in Tapung, Kampar District, are the relationship between exclusive breastfeeding incidents towards stunting in Tapung, Kampar Regency, with a P value of 0,000.