Donny Kristanto Mulyantoro
Balai Litbang GAKI

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Hubungan Tingkat Pengetahuan Ibu tentang GAKI, Sikap dan Praktek dengan Kualitas Garam Beriodium di Rumah Tangga

Media Gizi Mikro Indonesia Vol 5, No 2 (2014)
Publisher : Media Gizi Mikro Indonesia

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Abstract

ABSTRACT The use of iodized salt for prevention programs of Iodine Deficiency Disorders (IDD) was still facing many obstacles. Poor quality of iodized salt and non iodized salt was still circulating in the market. The level of knowledge, attitudes and practices of consumers on IDD prevention can influence both selection and purchase of standardized iodized salt which in turn will affect the supply of iodine at household level. This research was conducted in District Pakis of Magelang regency with cross sectional design. Samples of eligible women aged between 18-45 years were selected at random. The level of knowledge was measured using a structured questionnaire. Attitudes were measured using the statement of attitude scale. Iodine content in salt was measured using the iodometric method. The purpose of the study was to determine the relationships between the level of knowledge, attitudes and practices on the quality of iodized salt consumed in the household. The results of this study indicate that there is no relationships between the level of knowledge and attitudes to the quality of household iodized salt. Good level of knowledge obtained from the study subjects only simple knowledge of the term and how prevent IDD use iodized salt instead of how to perform the selection of iodized salt by iodine content in the salt test.The level of a good knowledge of IDD not guarantee a salt containing iodine consumption according to standard ISO. This happens because there are still many low quality iodized salt and non iodized salt sold in the market. Keywords: iodized salt, practice, attitude, level of knowledge.   ABSTRAK Program garam beriodium untuk penanggulangan GAKI masih banyak menemui kendala. Kualitas garam beriodium yang jelek dan garam non iodium masih banyak beredar di pasaran. Tingkat pengetahuan, sikap dan praktek konsumen tentang upaya penanggulangan GAKI dapat mempengaruhi pemilihan dan pembelian garam beriodium sesuai SNI yang pada gilirannya akan mempengaruhi penyediaan sumber iodium di rumah tangga. Penelitian ini dilaksanakan di Kecamatan Pakis, Kabupaten Magelang dengan disain cross sectional. Sampel wanita usia subur berumur antara 18-45 tahun yang dipilih secara random. Tingkat pengetahuan diukur menggunakan kuesioner terstruktur. Sikap diukur menggunakan daftar pernyataan sebagai skala sikap. Kadar iodium dalam garam diukur menggunakan metode iodometri. Tujuan penelitian adalah untuk mengetahui hubungan antara tingkat pengetahuan, sikap dan praktek terhadap kualitas garam beriodium yang dikonsumsi di rumah tangga. Hasil penelitian ini menunjukkan bahwa tidak ada hubungan antara tingkat pengetahuan dan sikap dengan kualitas garam beriodium di rumah tangga. Tingkat pengetahuan yang baik dari responden hanya diperoleh dari pengetahuan sederhana tentang istilah GAKI dan cara penanggulangannya menggunakan garam beriodium dan bukan dari bagaimana cara melakukan pemilihan garam beriodium dengan melakukan tes kandungan iodium dalam garam. Tingkat pengetahuan yang baik tentang GAKI dan upaya penanggulanggannya tidak menjamin mendapatkan garam konsumsi mengandung iodium sesuai standar SNI. Hal ini terjadi karena masih banyak ditemukan garam beriodium dengan kualitas rendah dan garam non iodium dijual di pasaran. Kata kunci: garam beriodium, praktek, sikap, tingkat pengetahuan.

Suplementasi Besi Mampu Memperbaiki Kadar Hormon TSH Anak Sekolah di Daerah Endemik GAKI

Media Gizi Mikro Indonesia Vol 5, No 2 (2014)
Publisher : Media Gizi Mikro Indonesia

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Abstract

ABSTRACT Multiple nutritional and environmental influences contribute to the prevalence and severity of IDDs in iodine deficient areas, including iron. In many developing countries, children are at high risk of both goiter and iron deficiency anemia. Iron deficiency adversely affects thyroid metabolism and may reduce the efficacy of iodized salt. The aim of this study was to investigate whether iron supplementation can improve thyrothrophin hormone in school children in iodine deficient areas. A trial of iron supplementation was carried out in an area of endemic goiter in Kertek Wonosobo (n = 35), another group given placebo (n = 35). At baseline, anthropometri, TSH, ferritin, urinary iodine excretion and level of iodized salt were measured. After 13 weeks supplementation, the same data collecting was conducted. Supplement’s compliance during the study reached 100%. Two subject were excluded from from the analysis because they have extreme bio chemical data than the overall average. Statistical test showed no differences in age and gender proportion between groups. There were no significant difference in nutritional status, level of EIU, and level of iodine in salt between groups after the intervention, but there was a significant increase in ferritin level in the iron group (31.0 vs 44.8 μg/l, p<0.05). There were a significant difference in protein and iron intake, but no significant different in energy intake.These two group did not differ in TSH level change. After taking into account the modification variable effect of adequate protein > 70% RDA, the effect of iron supplementation was proved to be effective in changing TSH level (p <0.05). Our result indicate that increase in iron status can improve TSH hormone after considering adequate protein intake (RDA). Keywords : IDD, iron supplementation, thyroid function.   ABSTRAK Di daerah yang kekurangan iodium, pengaruh gizi dan lingkungan berkontribusi pada prevalensi dan tingkat keparahan GAKI, termasuk defisiensi mikronutrien lain diantaranya zat besi. Di negara berkembang, banyak anak-anak menderita GAKI dan defisiensi besi secara bersamaan. Defisiensi besi dapat mengganggu metabolisme tiroid dan mengurangi efektivitas garam beriodum. Penelitian ini bertujuan mempelajari pengaruh suplementasi besi dosis 60 mg/minggu terhadap hormon tiroid pada anak sekolah di daerah endemik GAKI. Suplementasi besi diberikan pada anak sekolah dasar umur 9-12 tahun di daerah dengan kasus kretin, di Kertek Wonosobo (n = 35) dan kelompok lainnya mendapatkan plasebo (n = 35). Awal penelitian dilakukan pengukuran antropometri, kadar TSH, ferritin, UIE dan kadar garam. Setelah 13 minggu suplementasi dilakukan pengukuran yang sama. Tingkat kepatuhan subyek mengonsumsi bahan intervensi 100%, tetapi 2 orang dikeluarkan dari analisis karena data biokimia yang ekstrim dibandingkan rerata keseluruhan. Umur dan jenis kelamin subyek tidak berbeda secara statistik. Setelah suplementasi, status gizi, kadar UIE dan kadar iodium dalam garam tidak berbeda nyata, tetapi ada peningkatan kadar ferritin yang signifikan pada kelompok Fe (31.0 menjadi 44.8 μg/l, p <0.05). Ada perbedaan asupan protein dan zat besi yang signifikan (p <0.05) antara kelompok Fe dan plasebo, tetapi tidak pada asupan energi. Tidak ada perbedaan perubahan kadar TSH yang signifikan antara kelompok Fe dan plasebo. Setelah memperhitungkan efek modifikasi (kecukupan protein >70% AKG), terbukti suplementasi besi berpengaruh terhadap perubahan TSH (p <0.05). Peningkatan status besi dapat memperbaiki hormon TSH setelah memperhitungkan tingkat kecukupan protein (AKG). Kata kunci: GAKI, suplementasi besi, fungsi tiroid.

Hubungan Kadar Iodium dalam Garam Beriodium di Rumah Tangga dengan Kecukupan Iodium Berdasarkan Nilai Ekskresi Iodium Urin (EIU) pada Wanita Usia Subur

Media Gizi Mikro Indonesia Vol 5, No 1 (2013)
Publisher : Media Gizi Mikro Indonesia

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Abstract

ABSTRACT Iodine Deficiency Disorder (IDD) was one of the nutrition problems in Indonesia that causes decrease of human resource quality. The main cause of iodine deficiency was the environmental factors where land and water in that area were poor of iodine. Childbearing age woman was one of the most vulnerable group to have IDD. Iodine fortification in salt was one of the approach to control iodine deficiency problem. The aim of this study was to measure the relationship between iodine level of iodized salt in the household with the iodine allowance based on Urinary Excretion of Iodine (UEI) value. This was an observational study with cross sectional design and conducted in Kragilan village, Pakis sub district, Magelang. A total of 68 women age 18 – 45 years was measured for iodine level of iodized salt in the household, UEI which reflect iodine allowance, the amount of iodine comsumption dan recall for iodine contained food consumtion. The result of this study showed that median UEI was 124.6 μg/L, among subject of this study, the proportion who had iodine deficiency was 41.1% and excess 5.9%. Mean iodine level of iodized salt in the household was 19.58 ppm and 52.9% had ≥ 30 ppm KIO3. The pearson correlation statistic analysis showed there was a significant relationship between iodine level of iodized salt in the houshold with the iodine allowance based on urinary excretion of iodine (UEI) value (rho=0,5 p<0,01). Based on multi variable analysis, the regression equation was Y = 22.199 + 6.076 X1. With that equation, the level of iodine in the salt for sufficient allowance of iodine should be in the range of 13 – 29 ppm iodine or 22 – 49 ppm KIO3. Keywords: iodine, iodized salt, allowance of iodine, UEI, women.   ABSTRAK Gangguan Akibat Kekurangan Iodium (GAKI) adalah salah satu masalah gizi di Indonesia yang akan mengakibatkan penurunan kualitas sumber daya manusia. Kekurangan iodium terutama disebabkan karena faktor lingkungan di mana tanah dan air setempat kurang mengandung iodium. Pada daerah tersebut Wanita Usia Subur (WUS) adalah segmen penduduk yang rawan mengalami GAKI. Sebagai upaya penanggulangan, saat ini dilakukan fortifikasi iodium pada garam. Tujuan penelitian ini untuk mengukur hubungan antara kadar iodium dalam garam beriodium di rumah tangga dengan kecukupan iodium berdasarkan nilai ekskresi iodium urin (EIU). Penelitian ini merupakan penelitian observasional dengan desain potong lintang. Lokasi penelitian di Desa Kragilan, Kecamatan Pakis, Kabupaten Magelang. Sebanyak 68 wanita usia 18 – 45 tahun terlibat dalam penelitian ini, yang diukur kadar iodium dalam garam yang digunakan di rumah tangga, kecukupan iodium berdasarkan kadar iodium urin (EIU), konsumsi garam beriodium dan makanan sumber iodium. Hasil penelitian menunjukkan bahwa median EIU sebesar 124,6 μg/L, proporsi subyek penelitian mengalami defisiensi iodium sebesar 41,1%, dan mengalami excess sebesar 5,9%. Rata-rata kadar iodium dalam garam beriodium di rumah tangga sebesar 19,6 ppm dan proporsi garam beriodium memenuhi syarat (≥ 30 ppm KIO3) sebesar 52,9%. Hasil analisis korelasi pearson menunjukkan ada hubungan bermakna antara kadar iodium dalam garam beriodium di rumah tangga dengan kecukupan iodium berdasarkan nilai EIU (rho = 0,5, p < 0,01). Hasil analisis multi variabel diperoleh persamaan Y = 22,199 + 6,076 X1. Dengan persamaan tersebut, untuk memenuhi kebutuhan iodium, kadar iodium dalam garam beriodium berkisar antara 13 – 29 ppm iodium atau 22 – 49 ppm KIO3. Kata kunci: iodium, garam beriodium, kecukupan iodium, EIU, wanita.

The design of radiology viewing box using light emitting diode and potentiometer

Global Health Management Journal Vol 1, No 1 (2017)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Abstract

Background: In the process of work to gain the maximum results, a radiologist needs a viewing box tool to read radiographs. Therefore, the authors want to develop a viewing box tool, which in general the work if this tool resembles the factory manufactured tool. The viewing tool box made can adjust the intensity of the light produced.Objective: to create a viewing box tool by using a potentiometer system.Methods: This study used applied research method by creating and using the design of viewing box tool by using a potentiometer system and testing the viewing box tool created by using a Lux meter and 15 respondents consisting of five radiologists and 10 radiographers who should fulfill the questionnaire form.Results: The mean of viewing box illumination reached 220 lux. The results of the questionnaire showed that 100% radiologist gave an A (excellent) and expressed that the viewing box tool created could be used properly and 90% radiographers provided an A (excellent) and expressed that the viewing box tool created could be used properly, while 10% radiographer gave a value of B (moderate).Conclusion: viewing box tool created could be used properly and obtained optimal results as a tool in reading radiographs. Potentiometer system contained in the viewing box was very helpful in reading radiographs because it allowed to adjust the light intensity according to user needs.Keywords       :  Viewing box, Potentiometer Bibliography   : 1980-2011

Pengaruh Suplementasi Ganda Iodium dan Zat Besi (Fe) terhadap Kadar Tsh, Ft4, T3 dan Ferritin Anak Sekolah Dasar

Media Gizi Mikro Indonesia Vol 6, No 2 (2015)
Publisher : Balai Penelitian dan Pengembangan Gangguan Akibat Kekurangan Iodium

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PENGARUH SUPLEMENTASI GANDA IODIUM DAN ZAT BESI (Fe) TERHADAP KADAR TSH, fT4, T3 DAN FERRITIN ANAK SEKOLAH DASAR   Effect of Iodine and Iron (Fe) Dual Supplementation on The Levels of TSH, fT4, T3 and Ferritin in Primary School Children ABSTRACT Background. Intercorrelations between iodine and iron (Fe) on the function of the thyroid gland and the status of iron (Fe) affects the effectiveness of Iodine deficiency disorders (IDD) prevention and anemia programs. Communities group prone to nutritional problems are school age children who are in growth period. Objective. This study aims to compare the effect of iodine iron (I+Fe) double supplementation with single supplementation of iodine (I) and single supplementation of iron (Fe) on the function of the thyroid gland and the status of iron (Fe). Method. The study was a randomized double-blind controlled trial. Provision of interventions done by randomization with block permutations dividing study subjects into four groups: Iodine+iron (I+Fe) dual supplement group, iodine (I) only supplement group, iron (Fe) only suplement group and placebo group. Subjects were primary school children aged 9-12 years. Interventions conducted for 13 weeks and thyroid function measured by serum levels of TSH, fT4 and T3, while the iron status based on ferritin levels. Results. Supplementation of Iodine and Iron can increase ferritin and T3 levels, while supplementation of I+FeI, I or Fe can increase levels of fT4 although it is not statistically significant. Ancova showed there is a mechanism of mutual influence between ferritin, fT4 and T3. Conclusion. There is no differences between dual supplementation of iodine and iron with single supplementation of iodine or iron in alteration of ferritin, TSH, fT4, and T3 serum. Keywords: iodine, iron, supplementation.   ABSTRAK Latar belakang. Interkorelasi antara iodium dan zat besi (Fe) terhadap fungsi kelenjar tiroid dan status zat besi (Fe) mempengaruhi efektifitas program penanggulangan Gangguan Akibat Kekurangan Iodium (GAKI) dan anemia. Kelompok masyarakat yang rawan terhadap kedua masalah gizi tersebut adalah anak usia sekolah yang sedang dalam masa pertumbuhan. Tujuan. Analisis ini bertujuan untuk membandingkan pengaruh suplementasi ganda iodium zat besi (Fe) dengan suplementasi tunggal iodium dan suplementasi tunggal zat besi (Fe) terhadap fungsi kelenjar tiroid dan status zat besi (Fe). Metode. Desain penelitian adalah randomized double blind contolled trial. Pemberian intervensi dilakukan dengan cara randomisasi dengan blok permutasi yang membagi partisipan penelitian ke dalam 4 kelompok yaitu kelompok suplementasi ganda iodium+zat besi (I+Fe), kelompok suplementasi tunggal iodium (I), kelompok suplementasi tunggal zat besi (Fe) dan kelompok placebo. Partisipan penelitian adalah anak sekolah dasar umur 9 – 12 tahun. Intervensi dilakukan selama 13 minggu dan fungsi tiroid diukur berdasarkan kadar TSH, fT4 dan T3 serum, sedangkan status besi berdasarkan kadar feritin serum. Hasil. Pemberian suplementasi Iodium dan Fe (I+Fe) dapat meningkatkan kadar feritin dan T3. Pemberian suplementasi Fe+I, I atau Fe dapat meningkatkan kadar fT4 walaupun secara statistik tidak bermakna. Uji ancova menunjukkan adamekanisme saling mempengaruhi antara feritin, fT4 dan T3. Kesimpulan. Tidak ada perbedaan nyata antara suplementasi ganda iodium zat besi (Fe) dengan suplementasi tunggal iodium atau zat besi (Fe) terhadap perubahan ferritin, TSH, fT4, dan T3 serum. Kata kunci: iodium, zat besi, suplementasi.

THE IMPACT OF COMBINATION OF ROLLING AND OKETANI MASSAGE ON PROLACTIN LEVEL AND BREAST MILK PRODUCTION IN POST-CESAREAN SECTION MOTHERS

Belitung Nursing Journal Vol 3, No 4 (2017): July-August 2017
Publisher : Belitung Nursing Journal

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Abstract

Background: Normal childbirth or cesarean section has an effect on the initiation of early breastfeeding. Thus, rolling massage and oketani massage are considered helpful for milk production. However, little is known about the combination of rolling and oketani massage.Objective: To examine the effect of combination of rolling and oketani massage on the levels of prolactin and milk production in post-cesarian section mothers.Methods: A quasy-experimental study with pretest-posttest control group design. Thirty six samples were selected using consecutive sampling, with 18 each assigned to an experiment and control group. Breast milk production was measured based on the baby's weight, while prolactin levels were measured using ELISA method. Data were analyzed using univariate and bivariate analysis.Results: Results showed that there was a statistically significant difference of prolactin levels after intervention in the experiment and control group with p-value 0.035 (<0.005), and significant difference in breast milk production in both groups in posttest 1 and posttest 2 with p-value 0.000 (<0.05).Conclusion: There was statistically significant effect of the combination of rolling and oketani massage on the increase of prolactin levels and breast milk production. It is suggested that this intervention can be applied in midwifery care in post-cesarean section mothers.

EFFECT OF COMBINATION OF OXYTOCIN MASSAGE AND HYPNOBREASTFEEDING ON UTERINE INVOLUTION AND PROLACTIN LEVELS IN POSTPARTUM MOTHERS

Belitung Nursing Journal Vol 3, No 3 (2017): May-June 2017
Publisher : Belitung Nursing Journal

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Abstract

Background: The absence of contractions after childbirth can lead to a slow-running uterine involution process. Thus, the effort to maintain and accelerate the process is needed. Oxytocin massage and hypnobreastfeeding are considered as an alternative treatment, but the effect of the combination of the two treatments have not yet been examined.Objective: To examine the effect of combination of oxytocin massage and hypnobreastfeeding on uterine involution and prolactin levels in post partum.Methods: A Quasy experimental study with pretest posttest control group design. a total of 40 respondents were recruited using simple random sampling, with 20 respondents assigned in the treatment and control group. Metline and ELISA methods were used to measure uterine involution prolactin levels. Paired t-test and independent t-test were used to analyze the data.Results: There was a significant decrease of uterine involution in the experiment group and control group after intervention with p-value 0.000 (<0.05), and it can be seen that the uterine involution in the experiment group (6.05) was faster than uterin involution in the control group (7.00).  Findings also showed that the prolactin level in the experiment group (273.53) was higher than the prolactin level in the control group (209.37).Conclusion: There was statistically significant effect of the combination of oxytocin massage and hypnobreastfeeding on the uterine involution and prolactin level in postpartum mothers in the General Hospital of Semarang. It is expected that the combination of oxytocin massage and hypnobreastfeeding can be used as consideration and references in providing postpartum midwifery care.

EFFECT OF CONSUMING PAPAYA (CARICA PAPAYA LINN.) ON THE LEVEL OF HEMOGLOBIN AND HEMATOCRIT IN PREGNANT WOMEN WITH ANEMIA

Belitung Nursing Journal Vol 3, No 2 (2017): March-April 2017
Publisher : Belitung Nursing Journal

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Abstract

Background: The prevalence of anemia among pregnant women was still high in Indonesia, especially in Bengkulu. Consuming papaya is considered as one of the solutions to increase hemoglobin and hematocrit level.Objective: This study aims to examine the effect of consuming papaya on the level of hemoglobin and hematocrit in pregnant women.Methods: This study employed a true experiment with randomized pretest and posttest design with control group. There were 42 respondents recruited in this study using simple random sampling. Randomization was performed to divide the samples into two groups, namely 21 respondents in the treatment group and 21 respondents in the control group. A total of 110 grams of papaya was given to the intervention group every day for 14 days.  Data were analyzed using dependent t-test and independent t-test.Result: There was a significant effect of consuming papaya on the hemoglobin and hematocrit level with p-value 0.000 (< .05). The mean difference between two groups showed that hemoglobin level (control group 10.010 gr/dL; intervention group 10.838 gr/dL) and hematocrit level (control group 27.43 %; intervention group 30.10 %).Conclusion: Consuming papaya has a significant effect on changes in hemoglobin and hematocrit levels. It is suggested that consuming papaya should be one of alternative treatment for midwives to prevent anemia in pregnant women.

EFFECT OF CARICA PAPAYA L LEAF ON MENSTRUAL PAIN AND PROSTAGLANDIN LEVEL IN ADOLESCENT WITH PRIMARY DYSMENORRHEA: A TRUE EXPERIMENT

Belitung Nursing Journal Vol 3, No 3 (2017): May-June 2017
Publisher : Belitung Nursing Journal

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Abstract

Background: Primary dysmenorrhea occurs because of the excessive amount of prostaglandins in the blood. Papaya leaf extract is considered to be able to reduce prostaglandin and menstrual pain.Objective: This study aims to prove that papaya leaf extract (Carica Papaya L.) can decrease the level of menstrual pain and prostaglandin levels in primary dysmenorrhea.Methods: A true experimental study with randomized pretest posttest control group design. There were 32 samples recruited using simple random sampling, with 16 each assigned to an experiment and control group. Numerical Rating Scale (NRS) was used to measure menstrual pain, and the level of prostaglandin was measured using the enzyme-linked immunosorbent assay (ELISA) method. Independent t-test and paired t-test were performed for data analysis.Results: There was statistically significant differencec of menstrual pain and prostaglandin level before and after intervention with p-value 0.000 (<0.005), which indiciated that papaya leaf extract had a significant effect on reducing menstrual pain. The decrease of menstrual pain in the experimental group was -3.375 and in the control group was -3.438; while the decrease of prostaglandin level in the experimental group was -56.971 and in the control group was -57.557.Conclusion: Provision of papaya leaf extract (Carica Papaya L.) significantly decreased the level of menstrual pain and prostaglandin levels in primary dysmenorrhea. Papaya leaf extract can be used as a safe and effective herbal medicine for primary dysmenorrhoea which has almost the same efficacy as mefenamic acid.

EFFECTIVENESS OF BREASTFEEDING AND NON-NUTRITIVE SUCKING ON PAIN RELIEF IN INFANT IMMUNIZATION

Belitung Nursing Journal Vol 3, No 2 (2017): March-April 2017
Publisher : Belitung Nursing Journal

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Abstract

Background:Immunization in infants is an action that can cause trauma due to injection of the immunization that can cause pain. Breastfeeding and non-nutritive sucking are considered to be non-pharmacologic strategy of pain management.Objective: This study aims to investigate the effectiveness of breastfeeding and non-nutritive sucking on pain relief in infant immunizationMethods: This was a quasy experimental study with posttest only control group.  This study was conducted on 26 October till 30 November 2016 at hree Community Health Centers (Puskesmas), namely Puskesmas Cilacap Utara I, Puskesmas Cilacap Tengah, and Puskesmas Cilacap Selatan I. The population was infants aged 2-4 months who got immunization of DPT-HB-Hib 1. Samples were recruited using consecutive sampling technique. There were 69 samples in this study, which were divided into three groups. 1) The group was given a breastfeeding intervention (23 respondents), 2) The second group was given a non Nutritive sucking intervention (23 respondents), and 3) The control group (23 respondents). Data were analyzed using ANOVA.Results: The pain response of the three groups was groups was 2.74 in breastfeeding group, 1.87 in non-nutritive sucking group, and 3.26 in control group. There was a significant difference between non-nutritive sucking and control group with p-value = 0,000, and also the significant difference between breastfeeding and non-nutritive sucking with p-value = 0.016. However, there was no difference between breastfeeding and control group with p value = 0.142.Conclusion: Breastfeeding and non-nutritive sucking were effective in reducing pain during infant immunization. It is suggested that midwives could administer these interventions to reduce pain in infant immunization, and it could be applied as non-pharmacological strategy in pain management in the Community Health Center in Indonesia.