ENGLISH PAPERS

"THE TREATMENT OF FAMILY MEMBERS

WITH A TODDLER LESS NUTRIENTS IN THE HOUSE "

LECTURER : ROTTU MADASIH SS

ARRANGED BY : GROUP 11

1. AYUNG WIJI UTAMI (201601006)

2. ENDAH APRILIANI (201601021)
3. JAKA SULISTIA (201601029)
4. LUKMAN FATKHUL AZIZ (201601034)
5. NANIK LESTARI (201601045)

PRODI DIII KEPERAWATAN

AKADEMI KEPERAWATAN PEMERINTAH

KABUPATEN PONOROGO

Jl. Ciptomangunkusumo No.82 A ponorogo

Academic Year 2017/2018

 FOREWORD

Praise and our thanks to God Almighty who gave the mercy and his grace
so that we can finish this paper with the title "The treatment of family members
with a toddler less nutrients in the House". These papers are arranged in order
to meet assignment group English courses.
In compiling this paper we received help and guidance from the various
parties. Therefore, we would like to convey my thanks to :
1. Language courses United Kingdom Lecturer, Mrs. Rottu Madasih, SS has
many take the time to give us guidance in the preparation of this paper.

2. Both of our parents who always give support either in moral or material
during the making of this paper.

3. All classmates IIA in DIII Akademi Keperawatan Pemerintah Kabupaten

Ponorogo 2016/2017 which always provide support and advice as well as
the sharing of knowledge for the sake of tersusunnya this paper.

This paper is not a perfect piece of work because it still has many
shortcomings, both in terms of content as well as systematic and technical writing.
Therefore, we expect the criticisms and suggestions of its nature is build in order
to perfect the paper. We hope that this paper can be useful, especially for authors
and readers in General.

Ponorogo, 25 July 2017

Authors
 TABLE OF CONTENTS

FOREWORD ...................................................................................................
TABLE OF CONTENTS .................................................................................
CHAPTER I INTRODUCTION
1.1 Background ...........................................................................................
1.2 Formulation of the problem ..................................................................
1.3 Purpose .................................................................................................
CHAPTER II DISCUSSION
2.1 The sense of lack of nutrients on a toddler ...........................................
2.2 Cause ....................................................................................................
2.3 Signs and symptoms .............................................................................
2.4 Management .........................................................................................
2.5 The task of family against family members who are sick ....................
CHAPTER III CONCLUSION AND SUGGESTION

3.1 Conclusion ...........................................................................................

3.2 Suggestion ............................................................................................
REFERENCES.................................................................................................
 CHAPTER I
INTRODUCTION

1.1 Background
Toddler Age is the age of the very important in physical growth and
psychology of a child. Infancy is a critical period in an attempt to create a
quality resource. This period is called the golden era (goldenages) in which
brain cells are experiencing growth and development of the optimal.
Nutritional problems are primary concerned with Toddlers according to
Atmarita (2005) that is hard packed, which have become a common
phenomenon in society, so that it will lead to the problem of malnutrition
result from hard packed (Nurhayati & Sudewi, 2009)
Nutrition problems less on toddlers, bringing negative impact on
physical or mental growth, lowering the body's resistance, causing loss of life
healthy toddlers, even cause disability, increasing numbers of pain as well as
mortality (uterus, 2014). In less nutrition is not handled well, it will evolve
into malnutrition and serious nutrition deficiencies can cause death in
children (Helmi, 2013).
The nutrition figures less in Indonesia are still far above the target of
2014 years RPJMN i.e. by 15%, the number of nutrition less of 18.4% in
2007 and 17.9% in 2010 but has increased in the year 2013 to 19.6%
(Riskesdas, 2013). Nutritional status is a State body as a result of the
consumption of food and the use of nutritional substances. Nutritional status
can be known through the assessment of pangannya consumption based on
quantitative as well as qualitative data (Health RI, 2012).
Two factors affecting nutritional problems less on toddlers, namely
direct and indirect causes. The direct cause of nutrition status factors less
adekuatnya the intake of foods containing protein and calories needed by the
body, the social and cultural differences about the eating habits that affect
nutrition, lack of knowledge about nutrition, excess food in terms of both the
quality of which is not required by the body, the presence of diseases that
 accompany such as digestion, food absorspi, failed to build a menu based on
the level of activity and rest (Purwaningrum & Wardani , 2011). While the
indirect cause factor, among others, knowledge of mother, mother's
education, family income, childcare and a history of exclusive breast feeding.
The factors of the knowledge of the mother, the mother's education, family
income, history of breast feeding, the completeness of immunization and a
history of BBLR has an impact on the incidence of nutritional toddler less
(Lastanto dkk, 2014). (Nuzula, Oktaviana, & Anggari)

1.2 Formulation of the problem

Based on the above background, then the author can formulate some
problems in the care of family members with a toddler less nutrition at home.

1.3 The purpose of

1. To know the sense of lack of nutrients on a toddler
2. To find out the cause of the lack of nutrients in toddlers
3. To know the signs and symptoms of lack of nutrients on a toddler
4. To know the management less nutrients in toddlers
5. To know the family tasks against the sick family members
 CHAPTER II
DISCUSSION

2.1 Definition of less nutrition

Less nutrition is a situation caused by the consumption of food protein
source, the less the bad absorption or loss of nutrients in excess. Less
nutrition food shortage caused by a source of energy in General and less
protein source. (Almatsier,2002),
Less nutrition is a condition where the nutrition intake less than the
needs so that it can interfere with the growth and development of toddlers. The
State of malnutrition due to less nutritious food consume or suffer pain for a
long time (Ilham, 2009).
Less nutrition is a disorder of health due to a deficiency or an imbalance
of nutrients necessary for growth, activity of thought, and all things
associated with life. Nutrition deficiencies are mild to severe many occur in
older toddlers.
To find out the nutritional status on a toddler has adekuat needs to be
done in monitoring growth as an indicator of nutrition status. Growth is the
end result of a balance between intake and nutrition needs. Growth is the
increasing physical size over time. Example: the child grew older, her weight
gain is high. Child growth will be well balanced its nutrition value whereas a
child that its nutrition value of balance then growth will be interrupted.

2.2 Etiology
UNICEF in Soekirman (2002) has also been introduced and are already
used internationally on a variety of factors cause the onset of nutrition less on
toddlers, namely :
1. The direct cause
a. The incidence of infection
Infectious diseases will cause disorders of nutrition through
some way eliminate foodstuffs through vomiting and diarrhea.
 Besides infectious diseases such as respiratory tract infections can also
decrease appetite (Arisman, 2004).
Some infectious diseases that affect the occurrence of
malnutrition are upper respiratory tract infections (ISPA) and diarrhea.
(Iqbal Kabir, et al. 1994). According to Gordon, and Ezzel (2000)
chronic lung disease can also lead to malnutrition.
ISPA (infections of the upper respiratory tract) is a disease with
symptoms of cough, secretes mucus, fever, and without shortness of
breath (Priyanti Z, 1996).
Diarrhea is a disease with symptoms of bowel = 4 times a day
with liquid consistency with or without vomiting (Suandi, 1998).
(Ernawati, 2003)
b. The level of consumption of nutrients
Less nutrition is unhealthy state for not eating enough in a
certain period (Winarto, 1990). According to Arnelia & Sri Muljati
(1991), the lack of the amount of food consumed either in quality or
quantity dapatmenurunkan nutritional status. Children are not enough
food then the durability of his body will be weakened and susceptible
to infection. (Ernawati, 2003)
c. Affordability Of Basic Medical Services
Nutritional status of the child with regard to affordability against
basic medical services. Child toddler hard to reach by many activities
of other nutrition and health improvement as it cannot come in person
to the gathering place is specified without a transfer out (Sediaoetama,
2000).
Some aspects of basic medical services related to the nutritional
status of the child such as: immunization, childbirth aid, weighing
children, children's health, education as well as health facilities such
as posyandu, clinics, hospitals, the practice of midwives and doctors.
The higher the reach of society against the means of basic medical
 services, fewer risks of disease occurrence less nutrition. (Ernawati,
2003)
d. The Availability Of Food
The cause of the issue nutrition is a staple in place for at least
two-thirds of the world is less enough food for normal growth, health,
and normal activities. Less enough food related to the availability of
food in the family. The unavailability of food in the family happens
continuously will cause the occurrence of diseases of malnutrition
(Ernawati, 2003)
e. Environmental Sanitation Facility
Environmental sanitation is bad will cause children more
susceptible to infectious diseases that can eventually affect nutritional
status (Poedjiadi, 1994). Environmental sanitation is very related to
the availability of clean water, the availability of toilets, the type of
floor and the cleanliness of the tableware in every family. The more
available fresh water for daily needs, fewer risks of children affected
is undernourished (Ernawati, 2003)
f. The economic crisis, social and political
The economic crisis, social and political since the year 1997 is
the root of the problem of nutrition. The crisis caused a decline in
purchasing power. This led to a decrease in food consumption and
nutritional status eventually society society experience a decrease
(Aritonang, 2002). (Ernawati, 2003)
2. An indirect cause of
a. Patterns Of Parenting
Patterns of parenting is the ability of families and communities
to provide the time, attention, and support for the child to be able to
grow and develop well physically, mentally, and socially. Concrete
form the pattern of childrearing attitudes and behavior in the form of
the mother or other caregivers in terms of proximity to the child,
providing meals, take care of, keep clean, give love, and so on. It is so
 related to the health of the mother, the mother's nutritional status,
education, knowledge, and customary (Soekirman 2000). (Ernawati,
2003)
b. Educational Level Of Mother
Education greatly influences the reception of information about
nutrition. Communities with low education will further sustain the
traditions associated with difficult makanansehingga received
information recently in the field of nutrition (Suharjo, 1992). In
addition to this level of education also determines whether someone
receives an easy knowledge. The higher the level of education a
person is, the more easily he absorbs information received includes a
nutrition education and information which the nutrition education are
expected to be created by the pattern of good habits and healthy
(Handayani, 1994). (Ernawati, 2003)
c. Mother's level of knowledge about nutrition
The mother is a person who plays an important role in the
determination of food consumption in keluaga especially in older
toddlers. Knowledge of mother food consumption patterns affect
family (Khumaidi, 1994). Mother's lack of knowledge about nutrition
leads to low budget shopping for food and the quality and diversity of
food is lacking. More families buy the stuff because of the influence
of custom, ad, and the environment. In addition, the nutritional
disorder also caused due to the lack of the ability of the mother to
apply information about nutrition in everyday life (Winarno, 1990).
(Ernawati, 2003)
g. Income Level
Poverty as a cause of nutrition less occupied the first position on
the General conditions in the community. The main problem of the
poor population in general highly dependent on revenue per day are
generally unable to fullfill the basic needs normally. The poor tend to
have no food reserves due to low purchasing power. In 1998, there
 were 51.0% of households in urban areas and 47.5% of households in
rural areas are experiencing shortages of food consumption (Dini
Latief, et al 2000).
Poor according to BPS criteria for rural areas are Rp 72,780.00/
kapita/bulan as for the urban area of Rp 96,959.00/kapita/bulan
(Iravan, 2000). (Ernawati, 2003)
h. The Number Of Family Members
Poor families will more easily meet the needs of the food if it is
fed the numbers a bit. Food available on a large family may be just
enough for the family that the magnitude of half of the family.
Children who grow up in a poor family is the group most prone to
malnutrition among members of his family. Most small children
usually most affected by food shortages. If family members are
increased, then the food for each child. 1 -6 age years is the period
most prone. Less energy protein weight will be a bit of a family found
in the number of members of his family are smaller (Winarno, 1990).
The results of research conducted by Dini Latief, et al (2000)
showed a decrease in the average intake of energy and protein during
the monetary crisis. The distribution of the food that is consumed
increasingly deteriorated in the household has a member that is large
enough. In households with 6 or more indicate the level of food
consumption to deteriorate. In households with 3 – 5 people average
intake of energy and protein is still approaching the recommended
values.
In addition many inventions which States that culture is very
instrumental in process of occurrence of nutritional problems in
different communities and countries. Elements of human culture is
creating a population of eating habits that are sometimes at odds with
the principles of nutrition.
In terms of food, there is a culture that prioritize certain families
to consume the family dishes have been prepared that is head of the
 family. Other family members occupy the next priority and the most
common get last priority is a housewife. In such case it is still
embraced by a culture, then it may happen that food distribution is not
good between family members. If the situation lasts for a long time
may result in the onset of less nutritional problems in the family are
concerned. When the family was composed of individuals that include
nutrition-prone dalamgolongan such as pregnant women, nursing
mothers, infants and toddlers then the condition would be more
supportive of the incidence of nutrition less (Sayogjo, 1978; Steven
Tabor, S, et al, 2000; Oakley, CB, 1997). (Ernawati, 2003)
The factors of the knowledge of the mother, the mother's education,
family income, history of breast feeding, the completeness of immunization
and history BBLR has an impact on the incidence of nutritional toddler less
(Lastanto dkk, 2014). Other studies mention that parenting family had a
significant relationship of events nutritional problems in toddlers (Mustapa
dkk, 2013). (Ernawati, 2003)

2.3 Signs and symptoms

Signs and symptoms of malnutrition are as follows :
1. Weight toddler who is always decreasing
2. Weight not up for 3 months and under normal line on KMS
3. Child's condition is weak.
4. Pale Face.
5. Stunted growth
6. Whiny and fussy Children
7. Development of toddlers not in accordance with age
(Soetjiningsih, 1998)

2.4 Management
Nutrition is the total process involved in the consumption and use of
food substances.
 Triguna foods are :
1. Contain a power: carbohydrates, staple food (rice, corn , sago and
others).
2. Contains: Protein builders, zar side dishes (meat, eggs, fish tofu,
tempeh, and others)
3. Contain substances: vitamins and minerals (vegetables and fruit)
A. How to make food for the families of sufferers less nutrition

1. Serve meals daily based on triguna food.

2. Provide diverse food and unique presentation.
3. Provide diverse food in small portions but often.
4. Give foods that are easy to digest.
5. Use iodized salt.
B. Types of food 1-2 years of age
1.Provide the boiled rice Plus/ ayam/ eggs fish/ tempeh/ tofu/ meats/
carrot/ spinach/ green beans
2. Give the food 3 times a day.
3. Give also the food interludes 2 times a day like pureed green beans,
bananas, crackers and fruit.
4. Fill a balanced nutrition
5. Diversify the menu correspond to the favourite
C. Daily Menu
1. Morning: rice, vegetables, soups, and fish/chicken.
2. Lunch: rice, vegetables, spinach, 1 cut the tofu/tempeh, and fruit.
3. Afternoon/evening: rice, 1 egg, and vegetables.
The following average number of nutrition needs of toddlers who needed each day
based on the Food Guide Pyramid on toddlers ages 2-3 years :
No. Seeds and grains
1. The amount required per day on toddlers age 2 years: 3 ounces (85 grams)
2. The amount required per day at toddler age 3 years: 4-5 ounces (110-140
grams)
 No. Vegetables
1. The amount required per day on toddlers age 2 years: 1 measure out the
glass
2. The amount required per day at toddler age 3 years: 1.5 glasses measure
out

No. Fruits
1. The amount required per day on toddlers age 2 years: 1 measure out the
glass
2. The amount required per day at toddler age 3 years: 1.5 glasses measure
out

No. Milk
1. The amount required per day on toddlers age 2 years: 2 cups (400 ml)
2. The amount required per day at toddler age 3 years: 2 cups (400 ml)

No. Meat and beans

1. The amount required per day on toddlers age 2 years: 2 oz (65 g)
2. The amount required per day at toddler age 3 years: 3-4 ounces (85-115
grams)

2.5 Family Tasks against the sick family members

Efforts should be made by families is to increase the appetite. In
increasing appetite toddlers is to perform the massage. According to Roesli
(2008), massage can increase appetite, weight loss, and the intelligence of
infants and toddlers. Research conducted Field (1986, in C 2008) shows that
on 20 premature babies (weight-1,280 and 1,176 g), which is massaged 3 x 15
minutes over 10 days, experiencing weight gain 20%-47% per day than not
massaged. Being in infants aged 1 month enough – a 3bulan massage 15
minutes, twice a week for 6 weeks experienced a weight gain that was higher
than the control group.
The effort that has been made in addressing childhood nutrition with
less need to be further enhanced, especially in terms of the principle of the
feeding strategies and conducted to meet the needs of toddlers nutrition.
Support system obtained by the family in the form of social support family
can be used as the power in an attempt to meet the needs of toddlers with
nutrients are lacking. Such behaviour can be strengthened by health workers
and can also be used for other families, so that the independence of the
community in terms of achievement of the nutrition needs on a toddler can
do.
Efforts and strategies that family has done is an attempt is good. Family
support system includes the family social support i.e. There is a source of
support was obtained from family, community, and media. Forms of support
obtained, namely in the form of information and is instrumental to the
strengthening families in an attempt to resolve the problem of nutrition less
on toddlers. (Fitriyani, Sahar, & Wiarsih)
 REFERENCES

Ernawati, a. (2003). HUBUNGAN FAKTOR SOSIAL EKONOMI, HIGIENE SANITASI

LINGKUNGAN, TINGKAT KONSUMSI DAN INFEKSI DENGAN STATUS GIZI ANAK
USIA 2-5 TAHUN DI KABUPATEN SEMARANG TAHUN 2003. 39-45.

Fitriyani, P., Sahar, J., & Wiarsih, W. (t.thn.). PENGALAMAN KELUARGA MEMENUHI
KEBUTUHAN NUTRISI BALITA GIZI KURANG. 154-155.

Nurhayati, A., & Sudewi. (2009). REKA CIPTA MENU BALITA SEBAGAI UPAYA
MENGATASI SULIT MAKAN DAN KURANG GIZI PADA BALITA . Media Pendidikan,
Gizi dan Kuliner. Vol.1, No.1 , 1.

Nuzula, F., Oktaviana, M. N., & Anggari, R. S. (t.thn.). ANALISIS TERHADAP FAKTOR-
FAKTOR PENYEBAB GIZI KURANG PADA BALITA DI DESA BANYUANYAR
KECAMATAN KALIBARU BANYUWANGI. 360.

Soetjiningsih. (1998). Tumbuh Kembang Anak. Jakarta: EGC.

https://www.scribd.com/doc/134841000/Materi-Kurang-Gizi

https://www.scribd.com/document/286428426/SAP-Gizi-Kurang