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rscalex100 {Areola}\par\pard\li3760\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3760
\ri0\sl-440\slmult0 \fs24\cf0\f0\charscalex100 {Gambar 2.1 : Struktur Makroskopi
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li5453\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li5453\ri0\sl-466\slmult0 \fs24\cf0
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charscalex100 {tengah kira-kira 2,5 cm.}\tab \fs24\cf0\f0\charscalex100\i {Areol
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6\slmult0 \fs24\cf0\f0\charscalex100 {3).}{ }\fs24\cf0\f0\charscalex100\i {Papil
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sl-346\slmult0 \fs24\cf0\f0\charscalex100\i {Papilla mammae}\i0 { }\fs24\cf0\f0\
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costa}\i0 \fs24\cf0\f0\charscalex100 {)}\par\pard\li2720\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li2720\ri0\sl-333\slmult0 \*\tx3680\fs22\cf0\f0\charscalex100 {ke
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rscalex100 {merupakan suatu tonjolan dengan panjang}\par\pard\li2720\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100
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i0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-320\slmult0 \fs24\cf0\f0\char
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pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {berlubang-lubang beru
pa}{ }\fs24\cf0\f0\charscalex100\i {ostium papillare}\i0 { }\fs24\cf0\f0\charsca
lex100 {kecil-kecil yang merupakan}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0
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f0\f0\charscalex100\i {ductus lactifer}\i0 \fs24\cf0\f0\charscalex100 {.}\par\pa
cf0\f0\charscalex100 {b. Struktur Mikroskopis}\par\pard\li2573\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li2573\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Payud
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pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2160\ri0\sl-346\slmult0 \fs2
4\cf0\f0\charscalex100 {kelenjar ini dibagi menjadi kira-kira 18 lobus yang dipi
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sl-346\slmult0 \fs24\cf0\f0\charscalex100 {sempurna satu sama lain oleh lembaran
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00 {memproduksi hormon yang menstimulasi munculnya ASI dalam sistem}\par\pard\li
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tab \fs24\cf0\f0\charscalex100 {diperlukan faktor-faktor pendukung yang}\par\par
f0\f0\charscalex100 {terus-menerus mengupayakan keberhasilan menyusui, yang anta
ra lain}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-346
\slmult0 \fs24\cf0\f0\charscalex100 {bergantung pada peran yang dilakukan oleh :
peran petugas kesehatan, peran}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li1973\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {rumah sakit dan pem
erintah, peran fisik dan psikis ibu, faktor keluarga, faktor}\par\pard\li1973\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\chars
calex100 {masyarakat dan faktor bayi (Saleha, 2009).}\par\pard\li2320\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li2320\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100
{a. Produksi Air Susu Ibu}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2720\ri0\sl-346\slmult0 \*\tx8680\fs24\cf0\f0\charscalex100 {Prolaktin merup
akan suatu hormon yang disekresi oleh}\tab \fs24\cf0\f0\charscalex100\i {glandul
a}\i0 \par\pard\li2360\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2360\ri0\sl-346\s
lmult0 \fs24\cf0\f0\charscalex100\i {pituitaria anterior}\i0 \fs24\cf0\f0\charsc
alex100 {, penting untuk produksi air susu ibu, tetapi walaupun}\par\pard\li2360
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2360\ri0\sl-333\slmult0 \*\tx6613\*\tx7
680\fs22\cf0\f0\charscalex100 {kadar hormon ini di dalam sirkulasi}\tab \fs22\cf
0\f0\charscalex100\i {maternal}\i0 \tab \fs22\cf0\f0\charscalex100 {meningkat se
lama}\par\pard\li5520\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li5520\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li5520\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li5520\ri0
li5520\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {9}\par\pard\sect\sectd\sbk
page\pgwsxn11893\pghsxn16840\marglsxn666\margrsxn133\margtsxn666\margbsxn173\par
360\ri0\sl-386\slmult0 \*\tx7800\fs24\cf0\f0\charscalex100 {kehamilan, kerja hor
mon ini dihambat oleh hormon}\tab \fs24\cf0\f0\charscalex100\i {plasenta}\i0 \fs
24\cf0\f0\charscalex100 {. Dengan}\par\pard\li2360\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li2360\ri0\sl-346\slmult0 \*\tx4480\*\tx5400\fs22\cf0\f0\charscalex100
{lepas atau keluarnya}\tab \fs22\cf0\f0\charscalex100\i {plasenta}\i0 \tab \fs22
\cf0\f0\charscalex100 {pada akhir proses persalinan, maka kadar}\par\pard\li2360
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2360\ri0\sl-333\slmult0 \fs24\cf0\f0\ch
arscalex100 {estrogen dan progesteron berangsur-angsur turun sampai tingkat pada
}\par\pard\li2360\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2360\ri0\sl-346\slmult
0 \fs24\cf0\f0\charscalex100 {dilepaskannya dan diaktifkannya}{ }\fs24\cf0\f0\ch
arscalex100\i {prolaktin}\i0 { }\fs24\cf0\f0\charscalex100 {(Verralls, 1997).}\p
fs24\cf0\f0\charscalex100 {b. Pengeluaran Air Susu (Sarwono, 2005)}\par\pard\li2
533\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2533\ri0\sl-346\slmult0 \*\tx2853\fs
24\cf0\f0\charscalex100 {1)}\tab \fs24\cf0\f0\charscalex100\i {Reflek Produksi}\
i0 \par\pard\li2920\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2920\ri0\sl-346\slmu
lt0 \fs24\cf0\f0\charscalex100 {Hisapan bayi pada payudara merangsang produksi h
ormon}{ }\fs24\cf0\f0\charscalex100\i {prolaktin}\i0 \par\pard\li2920\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li2920\ri0\sl-333\slmult0 \*\tx8133\*\tx9000\fs22\cf
0\f0\charscalex100 {yang akan menyebabkan sel-sel sekretori dan}\tab \fs22\cf0\f
0\charscalex100\i {alveoli}\i0 \tab \fs22\cf0\f0\charscalex100 {untuk}\par\pard\
li2920\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2920\ri0\sl-346\slmult0 \*\tx4533
\*\tx5266\*\tx6026\*\tx6773\*\tx8000\*\tx8880\fs22\cf0\f0\charscalex100 {memprod
uksi}\tab \fs22\cf0\f0\charscalex100 {susu}\tab \fs22\cf0\f0\charscalex100 {yang
}\tab \fs22\cf0\f0\charscalex100 {akan}\tab \fs22\cf0\f0\charscalex100 {disiapka
n}\tab \fs22\cf0\f0\charscalex100 {dalam}\tab \fs22\cf0\f0\charscalex100\i {lume
n}\i0 \fs22\cf0\f0\charscalex100 {.}\par\pard\li2920\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li2920\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {Pembendungan AS
I yang terjadi dalam}{ }\fs24\cf0\f0\charscalex100\i {alveolus}\i0 { }\fs24\cf0\

f0\charscalex100 {akan menyebabkan}\par\pard\li2920\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li2920\ri0\sl-346\slmult0 \*\tx3853\*\tx5146\*\tx5866\*\tx7093\*\tx794
6\*\tx9066\fs24\cf0\f0\charscalex100 {adanya}\tab \fs24\cf0\f0\charscalex100 {pe
nekanan}\tab \fs24\cf0\f0\charscalex100 {pada}\tab \fs24\cf0\f0\charscalex100 {p
embuluh}\tab \fs24\cf0\f0\charscalex100 {darah,}\tab \fs24\cf0\f0\charscalex100
{sehingga}\tab \fs24\cf0\f0\charscalex100 {akan}\par\pard\li2920\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2920\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {men
yebabkan penurunan prolaktin dalam darah sehingga sekresi}\par\pard\li2920\ri0\s
ex100 {ASI juga berkurang (Mommies, 2006).}\par\pard\li3280\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li3280\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Untuk me
ngetahui banyaknya produksi ASI, beberapa kriteria}\par\pard\li2920\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li2920\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {
yang dapat digunakan sebagai patokan jumlah ASI cukup atau tidak}\par\pard\li292
0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2920\ri0\sl-346\slmult0 \fs22\cf0\f0\c
harscalex100 {adalah : ASI yang banyak dapat merembes keluar melalui puting,}\pa
s22\cf0\f0\charscalex100 {sebelum disusukan payudara terasa tegang, jika ASI cuk
up setelah}\par\pard\li2920\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2920\ri0\sl333\slmult0 \fs22\cf0\f0\charscalex100 {menyusu bayi akan tertidur/tenang selama
3 sampai 4 jam dan bayi}\par\pard\li2920\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li2920\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {akan sering berkemih sekit
ar 8 kali sehari (Saleha, 2009).}\par\pard\li3280\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li3280\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {Produksi ASI yang
rendah adalah akibat dari kurang seringnya}\par\pard\li2920\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li2920\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {menyusui
atau memerah payudara, bayi tidak bisa menghisap secara}\par\pard\li2920\ri0\sl
x100 {efektif, dan kurangnya gizi ibu. Sedangkan faktor-faktor yang}\par\pard\li
0\charscalex100 {mempengaruhi produksi ASI antara lain adalah frekuensi pemberia
n}\par\pard\li5453\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li5453\ri0\sl-213\slmul
453\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {10}\par\pard\sect\sectd\sbkpa
ge\pgwsxn11893\pghsxn16840\marglsxn666\margrsxn133\margtsxn666\margbsxn173\pard\
\par\pard\li2920\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2920\ri0\sl-213\slmult0
0\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {susu, berat bayi saat lahir, us
ia kehamilan saat melahirkan, usia ibu}\par\pard\li2920\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li2920\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {dan paritas,
stres dan penyakit akut, merokok, mengonsumsi}\par\pard\li2920\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li2920\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {alko
hol, dan penggunaan pil kontrasepsi (Saleha, 2009).}\par\pard\li2533\ri0\sl-213\
calex100 {2)}\tab \fs24\cf0\f0\charscalex100\i {Reflek Let Down}\i0 \par\pard\li
0\charscalex100 {Hisapan bayi pada payudara dapat merangsang produksi hormon}\pa
s22\cf0\f0\charscalex100 {oksitosin yang akan menyebabkan kontraksi sel yang ter
dapat dalam}\par\pard\li2920\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2920\ri0\sl
-346\slmult0 \*\tx3653\*\tx5413\*\tx6760\*\tx7800\*\tx8600\fs22\cf0\f0\charscale
x100\i {lumen,}\i0 \tab \fs22\cf0\f0\charscalex100 {masuk ke dalam}\tab \fs22\cf
0\f0\charscalex100\i {sinus lacteal}\i0 \tab \fs22\cf0\f0\charscalex100 {di daer
ah}\tab \fs22\cf0\f0\charscalex100\i {areola}\i0 \fs22\cf0\f0\charscalex100 {.}\
tab \fs22\cf0\f0\charscalex100\i {Reflek let}\i0 \par\pard\li2920\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li2920\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100\i {
down}\i0 { }\fs24\cf0\f0\charscalex100 {ini sangat sensitif terhadap faktor keji

waan ibu dan proses}\par\pard\li2920\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li292
0\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {produksinya dapat terhambat apa
bila ibu lelah, merasa malu, atau}\par\pard\li2920\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li2920\ri0\sl-320\slmult0 \fs22\cf0\f0\charscalex100 {tidak pasti. Prod
uksi ASI akan lancar apabila ibu merasa bangga dan}\par\pard\li2920\ri0\sl-213\s
yakin akan kemampuannya menyusui.}\par\pard\li3280\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li3280\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Faktor-faktor yan
g meningkatkan reflek}{ }\fs24\cf0\f0\charscalex100\i {let down}\i0 { }\fs24\cf0
\f0\charscalex100 {antara lain :}\par\pard\li2920\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li2920\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {melihat bayi, mend
engarkan suara bayi, mencium bayi dan}\par\pard\li2920\ri0\sl-213\slmult0 \fs18\
cf0\par\pard\li2920\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {memikirkan un
tuk menyusui bayi (Saleha, 2009).}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\
\fs18\cf0\par\pard\li1973\ri0\sl-453\slmult0 \fs24\cf0\f0\charscalex100\b {3. Ma
salah Yang Sering Timbul Dalam Masa Laktasi}\b0 \par\pard\li2560\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2560\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {Mas
alah-masalah yang biasanya terjadi dalam pemberian ASI yang}\par\pard\li1973\ri0
alex100 {disebabkan karena masalah pada payudara antara lain : puting susu rata,
0 \fs24\cf0\f0\charscalex100 {puting susu lecet, bendungan payudara (}\fs24\cf0\
f0\charscalex100\i {engorgement}\i0 \fs24\cf0\f0\charscalex100 {), saluran ASI t
ersumbat,}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-3
20\slmult0 \fs24\cf0\f0\charscalex100 {mastitis dan abses payudara. Dan masalah
yang sering timbul dari faktor bayi}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {antara lain : b
ayi bingung puting dan bayi enggan menyusu. Sedangkan}\par\pard\li1973\ri0\sl-21
0 {masalah lain yang sering timbul adalah adanya sindrom ASI kurang dan ibu}\par
24\cf0\f0\charscalex100 {bekerja (Sarwono, 2005).}\par\pard\li5453\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li5453\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li5453\ri0
\f0\charscalex100 {11}\par\pard\sect\sectd\sbkpage\pgwsxn11893\pghsxn16840\margl
sxn666\margrsxn133\margtsxn666\margbsxn173\pard\li2560\ri0\sl-213\slmult0 \fs18\
lt0 \fs18\cf0\par\pard\li2560\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2560\ri0\s
0\charscalex100 {Untuk dapat mencegah dan menangani masalah}{ }\fs24\cf0\f0\char
scalex100\i {engorgement}\i0 { }\fs24\cf0\f0\charscalex100 {maka ibu}\par\pard\l
f0\charscalex100 {memerlukan pengetahuan tentang bendungan ASI sehingga ibu memp
unyai}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-333\s
lmult0 \*\tx3213\*\tx4080\*\tx5173\*\tx6000\*\tx7333\*\tx8746\fs24\cf0\f0\charsc
alex100 {kesadaran}\tab \fs24\cf0\f0\charscalex100 {dalam}\tab \fs24\cf0\f0\char
scalex100 {bersikap}\tab \fs24\cf0\f0\charscalex100 {untuk}\tab \fs24\cf0\f0\cha
rscalex100 {melakukan}\tab \fs24\cf0\f0\charscalex100 {pencegahan}\tab \fs24\cf0
\f0\charscalex100 {masalah}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100\i {engorgement.}\i0 \par\
pard\li2560\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2560\ri0\sl-320\slmult0 \*\t
x3733\*\tx5093\*\tx6586\*\tx7506\*\tx8866\fs24\cf0\f0\charscalex100 {Sebagian}\t
ab \fs24\cf0\f0\charscalex100 {perempuan}\tab \fs24\cf0\f0\charscalex100 {mengan
ggap}\tab \fs24\cf0\f0\charscalex100 {bahwa}\tab \fs24\cf0\f0\charscalex100 {mas
a-masa}\tab \fs24\cf0\f0\charscalex100 {setelah}\par\pard\li1973\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {mel
ahirkan adalah masa-masa sulit yang akan menyebabkan mereka}\par\pard\li1973\ri0

alex100 {mengalami tekanan secara emosional. Gangguan-gangguan psikologis yang}\
\fs24\cf0\f0\charscalex100 {muncul akan mengurangi kebahagiaan yang dirasakan, d
an sedikit banyak}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\
ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {mempengaruhi penerimaan ibu terha
dap bayi baru lahir, yaitu dalam hal}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li1973\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {perawatan anak
.}\par\pard\li2560\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2560\ri0\sl-346\slmul
t0 \fs24\cf0\f0\charscalex100 {Sikap ibu terhadap bayi akan lebih menyenangkan j
ika pengalaman}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0
\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {melahirkan relatif lebih mudah darip
ada pengalaman melahirkan yang lama,}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li1973\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {sulit, dan dis
ertai dengan komplikasi fisik, dan semakin cepat kesehatan ibu}\par\pard\li1973\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\cha
rscalex100 {pulih setelah melahirkan semakin menyenangkan sikapnya terhadap bayi
dan}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-320\sl
mult0 \fs24\cf0\f0\charscalex100 {semakin ia yakin pada kemampuannya untuk melak
sanakan peran ibu secara}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {memuaskan. Robert A. Hinde
(1974) dalam Saleha (2009) menyatakan bahwa}\par\pard\li1973\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {semaki
n baik perawatan yang diterima ibu selama kehamilan, akan semakin}\par\pard\li19
73\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-333\slmult0 \fs24\cf0\f0\
charscalex100 {baik pula perlakuan ibu tersebut kepada bayinya.}\par\pard\li1973
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\p
\cf0\par\pard\li1973\ri0\sl-266\slmult0 \fs24\cf0\f0\charscalex100\b {4. Engorge
ment}\b0 \par\pard\li2213\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2213\ri0\sl-32
0\slmult0 \fs24\cf0\f0\charscalex100 {a. Pengertian}\par\pard\li2720\ri0\sl-213\
calex100\i {Engorgement}\i0 \tab \fs24\cf0\f0\charscalex100 {yang biasa disebut
dengan payudara bengkak (}\fs24\cf0\f0\charscalex100\i {Breast}\i0 \par\pard\li2
160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2160\ri0\sl-333\slmult0 \fs24\cf0\f0
\charscalex100\i {engorgement}\i0 \fs24\cf0\f0\charscalex100 {) disebabkan penge
luaran ASI yang tidak lancar karena bayi}\par\pard\li5453\ri0\sl-213\slmult0 \fs
calex100 {12}\par\pard\sect\sectd\sbkpage\pgwsxn11893\pghsxn16840\marglsxn666\ma
rgrsxn133\margtsxn666\margbsxn173\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\p
lex100 {tidak sering menyusu atau terlalu cepat disapih. Dapat pula disebabkan}\
\fs24\cf0\f0\charscalex100 {adanya gangguan}{ }\fs24\cf0\f0\charscalex100\i {let
down reflex}\i0 { }\fs24\cf0\f0\charscalex100 {(Sarwono, 2005).}\par\pard\li216
harscalex100 {b. Gejala}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\l
i2720\ri0\sl-346\slmult0 \*\tx6213\*\tx7640\fs22\cf0\f0\charscalex100 {Gejala ya
ng biasa muncul bila}\tab \fs22\cf0\f0\charscalex100\i {engorgement}\i0 \tab \fs
22\cf0\f0\charscalex100 {terjadi antara lain}\par\pard\li2160\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2160\ri0\sl-320\slmult0 \fs22\cf0\f0\charscalex100 {payuda
ra terasa penuh, panas, berat dan keras, tidak terlihat mengkilat,}\par\pard\li2
160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2160\ri0\sl-346\slmult0 \*\tx2933\fs
24\cf0\f0\charscalex100\i {edema}\i0 \tab \fs24\cf0\f0\charscalex100 {atau merah
. ASI biasanya mengalir lancar dan kadang-kadang}\par\pard\li2160\ri0\sl-213\slm

ult0 \fs18\cf0\par\pard\li2160\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {me
netes keluar secara spontan, namun ada pula payudara yang terbendung}\par\pard\l
f0\charscalex100 {membesar, membengkak, dan sangat nyeri. Ibu kadang-kadang menj
adi}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2160\ri0\sl-346\slm
ult0 \fs24\cf0\f0\charscalex100 {demam, namun biasanya akan hilang dalam 24 jam
(Tanaya, 2006).}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2160\ri
0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {c. Penyebab}\par\pard\li2360\ri0\sl
x100 {1). Faktor Hormon}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\l
i2720\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {Proses pembentukan ASI dan
pengeluaran ASI dipengaruhi oleh}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li2720\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {hormon oksitosin d
an hormon prolaktin. Ketika payudara mulai}\par\pard\li2720\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {digunaka
n untuk menyusui, dibawah areola terdapat saluran yang}\par\pard\li2720\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-320\slmult0 \*\tx5333\*\tx7173\fs24\
cf0\f0\charscalex100 {melebar yang disebut}\tab \fs24\cf0\f0\charscalex100\i {si
nus laktiferus}\i0 \tab \fs24\cf0\f0\charscalex100 {yang berfungsi untuk}\par\pa
cf0\f0\charscalex100 {menampung air susu (Rianto, 2009).}\par\pard\li3280\ri0\sl
x100 {Setelah bayi lahir dan plasenta keluar, kadar estrogen dan}\par\pard\li272
harscalex100 {progesteron turun dalam dua sampai tiga hari. Dengan ini fungsi da
ri}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-346\slmu
lt0 \*\tx4133\*\tx7480\fs24\cf0\f0\charscalex100\i {hipotalamus}\i0 \tab \fs24\c
f0\f0\charscalex100 {yang menghalangi keluarnya}\tab \fs24\cf0\f0\charscalex100\
i {pituitary lactogenic}\i0 \par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li2720\ri0\sl-320\slmult0 \*\tx3760\fs24\cf0\f0\charscalex100\i {hormone}\i0
\tab \fs24\cf0\f0\charscalex100 {(prolaktin) waktu hamil dan sangat dipengaruhi
oleh}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-346\sl
mult0 \fs24\cf0\f0\charscalex100 {estrogen, tidak dikeluarkan lagi dan terjadi s
ekresi prolaktin oleh}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2
720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {hipofisis. Hormon ini menyeba
bkan}{ }\fs24\cf0\f0\charscalex100\i {alveolus}\i0 { }\fs24\cf0\f0\charscalex100
{kelenjar}{ }\fs24\cf0\f0\charscalex100\i {mammae}\i0 { }\fs24\cf0\f0\charscale
x100 {terisi}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\s
l-333\slmult0 \fs24\cf0\f0\charscalex100 {dengan air susu, tetapi untuk megeluar
kannya dibutuhkan reflek yang}\par\pard\li5453\ri0\sl-213\slmult0 \fs18\cf0\par\
8\cf0\par\pard\li5453\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li5453\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li5453\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {1
3}\par\pard\sect\sectd\sbkpage\pgwsxn11893\pghsxn16840\marglsxn666\margrsxn133\m
argtsxn666\margbsxn173\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\
lt0 \fs18\cf0\par\pard\li2720\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {men
yebabkan kontraksi sel-sel}{ }\fs24\cf0\f0\charscalex100\i {mioepiteal}\i0 { }\f
s24\cf0\f0\charscalex100 {yang mengelilingi}{ }\fs24\cf0\f0\charscalex100\i {alv
eolus}\i0 \par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-3
46\slmult0 \fs24\cf0\f0\charscalex100 {dan duktus kecil kelenjar-kelenjar terseb
ut (Sarwono, 2005).}\par\pard\li2360\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li236
0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {2). Hisapan Bayi}\par\pard\li27
charscalex100 {Proses menyusui tergantung 2 reflek (Sarwono, 2005), yaitu :}\par
24\cf0\f0\charscalex100 {a) Reflek Produksi}\par\pard\li3480\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li3480\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Hisapan

bayi pada payudara merangsang produksi hormon}\par\pard\li3093\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li3093\ri0\sl-346\slmult0 \*\tx8880\fs22\cf0\f0\charscalex
100 {prolaktin yang akan menyebabkan sel-sel sekretori dan}\tab \fs22\cf0\f0\cha
rscalex100\i {alveoli}\i0 \par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li3093\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {untuk memproduksi susu ya
ng akan disiapkan dalam lumen.}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {b) Reflek Let Down}\
\fs22\cf0\f0\charscalex100 {Hisapan bayi pada payudara dapat merangsang produksi
0 \fs22\cf0\f0\charscalex100 {hormon oksitosin yang akan menyebabkan kontraksi s
el yang}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3093\ri0\sl-346
\slmult0 \*\tx7240\*\tx8600\fs22\cf0\f0\charscalex100 {terdapat dalam lumen, mas
uk ke dalam}\tab \fs22\cf0\f0\charscalex100\i {sinus lacteal}\i0 \tab \fs22\cf0\
f0\charscalex100 {di daerah}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li3093\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100\i {areola}\i0 \fs22\cf0\
f0\charscalex100 {.}{ }\fs22\cf0\f0\charscalex100\i {Reflek let down}\i0 { }\fs2
2\cf0\f0\charscalex100 {ini sangat sensitif terhadap faktor kejiwaan}\par\pard\l
f0\charscalex100 {ibu dan proses reproduksinya dapat terhambat apabila ibu lelah
,}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3093\ri0\sl-320\slmul
t0 \fs24\cf0\f0\charscalex100 {merasa malu, atau tidak pasti. Produksi ASI akan
lancar apabila}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3093\ri0
\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {ibu merasa bangga dan yakin akan kem
ampuannya menyusui.}\par\pard\li2360\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li236
0\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {3). Pengosongan Payudara}\par\p
\cf0\f0\charscalex100 {Ketika susu mulai masuk menggantikan kolostrum pada hari
setelah}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-346
\slmult0 \fs24\cf0\f0\charscalex100 {persalinan, payudara akan menjadi lebih bes
ar, lebih berat dan lebih}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li2720\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {empuk karena bertambahnya
getah bening dan suplai darah. Pada saat}\par\pard\li2720\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {ini akan
terjadi bendungan ASI apabila ibu tidak cukup sering}\par\pard\li2720\ri0\sl-213
{menyusui bayinya dalam jarak waktu yang lama dan jika}\par\pard\li5453\ri0\sl213\slmult0 \fs18\cf0\par\pard\li5453\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li54
lmult0 \fs24\cf0\f0\charscalex100 {14}\par\pard\sect\sectd\sbkpage\pgwsxn11893\p
ghsxn16840\marglsxn666\margrsxn133\margtsxn666\margbsxn173\pard\li2720\ri0\sl-21
ult0 \fs24\cf0\f0\charscalex100 {menghentikan penyusuan secara mendadak atau pay
udara tidak}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl
-346\slmult0 \fs24\cf0\f0\charscalex100 {dikosongkan secara memadai (Nellson,199
5).}\par\pard\li3280\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3280\ri0\sl-333\slm
ult0 \fs22\cf0\f0\charscalex100 {Apabila ASI berlebihan sampai keluar memancar,
maka sebelum}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\s
l-346\slmult0 \fs22\cf0\f0\charscalex100 {menyusui diusahakan ASI dikeluarkan te
rlebih dahulu, untuk}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li27
20\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {menghindari bayi tersedak atau
enggan menyusu. Pengeluaran ASI}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li2720\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {dapat dilakukan de
ngan cara : Pengeluaran ASI dengan tangan dan}\par\pard\li2720\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {penge

luaran ASI dengan pompa.}\par\pard\li2360\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li2360\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {4). Cara Menyusui}\par\par
f0\f0\charscalex100 {Menyusui merupakan proses ilmiah dan kadang terlihat amat s
angat}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-320\s
lmult0 \fs24\cf0\f0\charscalex100 {sederhana, namun bila dilakukan dengan cara y
ang salah akan}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0
\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {menyebabkan terjadinya puting susu l
ecet, air susu tidak keluar}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {dengan sempurna sehingg
a akan terjadi pembendungan air susu}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li2720\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {(Inggrid, 2006
).}\par\pard\li3280\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3280\ri0\sl-346\slmu
lt0 \fs24\cf0\f0\charscalex100 {Seorang ibu dengan bayi pertamanya mungkin akan
mengalami}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-3
20\slmult0 \fs22\cf0\f0\charscalex100 {berbagai masalah, hanya karena tidak meng
etahui cara-cara yang}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2
720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {sebenarnya sangat sederhana,
seperti caranya menaruh bayi pada}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {payudara ketika m
enyusui, hisapan bayi yang mengakibatkan puting}\par\pard\li2720\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2720\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {ter
asa nyeri, dan masih banyak lagi masalah yang lain. Terlebih pada}\par\pard\li27
charscalex100 {minggu pertama setelah persalinan seorang ibu lebih peka dalam}\p
fs24\cf0\f0\charscalex100 {emosi. Untuk itu seorang ibu butuh seseorang yang dap
at}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-346\slmu
lt0 \fs24\cf0\f0\charscalex100 {membimbingnya dalam merawat bayi termasuk dalam
menyusui.}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-3
46\slmult0 \fs24\cf0\f0\charscalex100 {Orang yang dapat membantunya terutama ada
lah orang yang}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0
\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {berpengaruh besar dalam kehidupannya
atau orang yang disegani,}\par\pard\li5453\ri0\sl-213\slmult0 \fs18\cf0\par\par
t0 \fs18\cf0\par\pard\li5453\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {15}\
par\pard\sect\sectd\sbkpage\pgwsxn11893\pghsxn16840\marglsxn666\margrsxn133\marg
tsxn666\margbsxn173\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0
\fs18\cf0\par\pard\li2720\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {sepert
i suami, keluarga/ kerabat terdekat atau kelompok-kelompok ibu}\par\pard\li2720\
rscalex100 {pendukung ASI dan dokter/ tenaga kesehatan (Christine, 2005).}\par\p
\cf0\f0\charscalex100 {Saat kembali bekerja, usahakan memerah ASI dari kedua bel
ah}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-346\slmu
lt0 \fs22\cf0\f0\charscalex100 {payudara minimal empat jam sekali sebanyak tiga
kali selama jam}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri
0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {kerja (Saleha, 2009).}\par\pard\li2
\charscalex100 {a). Posisi Menyusui}\par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li3480\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Posisi yang nya
man untuk menyusui sangat penting. Lecet}\par\pard\li3093\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li3093\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {pada putin
g susu dan payudara merupakan kondisi tidak normal}\par\pard\li3093\ri0\sl-213\s
dalam menyusui, tetapi penyebab lecet yang paling umum adalah}\par\pard\li3093\r

scalex100 {posisi dan perlekatan yang tidak benar pada payudara (Varney,}\par\pa
cf0\f0\charscalex100 {2007).}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li3093\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {(1). Posisi Madona (at
au \uc1\u8221Xmenggendong\uc1\u8221X)}\par\pard\li3480\ri0\sl-213\slmult0 \fs18\
cf0\par\pard\li3480\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {Bayi berbarin
g miring, menghadap ibu. Kepala, leher,}\par\pard\li3480\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li3480\ri0\sl-346\slmult0 \*\tx8893\fs24\cf0\f0\charscalex100 {pu
nggung atas bayi diletakkan pada lengan bawah}\tab \fs24\cf0\f0\charscalex100\i
{lateral}\i0 \par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\s
l-320\slmult0 \fs22\cf0\f0\charscalex100 {payudara. Ibu menggunakan tangan sebel
ahnya untuk}\par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl
-346\slmult0 \fs24\cf0\f0\charscalex100 {memegang payudara jika diperlukan.}\par
24\cf0\f0\charscalex100 {(2). Posisi Menggendong-Menyilang}\par\pard\li3480\ri0\
lex100 {Bayi berbaring miring, menghadap ibu. Kepala, leher, dan}\par\pard\li348
0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-346\slmult0 \*\tx9200\fs22
\cf0\f0\charscalex100 {punggung atas bayi diletakkan pada telapak}{ }\fs22\cf0\f
0\charscalex100\i {kontralateral}\i0 \tab \fs22\cf0\f0\charscalex100 {dan}\par\p
\cf0\f0\charscalex100 {sepanjang lengan bawahnya. Ibu menggunakan tangan}\par\pa
cf0\f0\charscalex100 {sebelahnya untuk memegang payudara jika diperlukan.}\par\p
\fs24\cf0\f0\charscalex100 {16}\par\pard\sect\sectd\sbkpage\pgwsxn11893\pghsxn16
840\marglsxn666\margrsxn133\margtsxn666\margbsxn173\pard\li3093\ri0\sl-213\slmul
s24\cf0\f0\charscalex100 {(3). Posisi}{ }\fs24\cf0\f0\charscalex100\i {football}
\i0 { }\fs24\cf0\f0\charscalex100 {(atau \uc1\u8221Xmengempit\uc1\u8221X)}\par\p
\cf0\f0\charscalex100 {Bayi berbaring miring atau punggung melingkar antara leng
an}\par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-333\slmu
lt0 \fs22\cf0\f0\charscalex100 {dan samping dada ibu. Lengan bawah dan tangan ib
u}\par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-346\slmul
t0 \fs24\cf0\f0\charscalex100 {menyangga bayi, dan ia menggunakan tangan sebelah
nya}\par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-320\slm
ult0 \fs24\cf0\f0\charscalex100 {untuk memegang payudara jika diperlukan.}\par\p
\cf0\f0\charscalex100 {(4). Posisi Berbaring Miring}\par\pard\li3480\ri0\sl-213\
{Ibu dan bayi berbaring miring saling berhadapan. Posisi ini}\par\pard\li3480\ri
calex100 {merupakan posisi paling nyaman bagi ibu yang menjalani}\par\pard\li348
harscalex100 {penyambuhan setelah melahirkan melalui operasi (Murkoff,}\par\pard
0\f0\charscalex100 {2002).}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {b). Lama dan Frekuensi M
enyusui}\par\pard\li3480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3480\ri0\sl-346
\slmult0 \fs24\cf0\f0\charscalex100 {Rentang frekuensi menyusui yang optimal ada

lah antara 8}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3093\ri0\s
l-333\slmult0 \fs24\cf0\f0\charscalex100 {sampai 12 kali setiap hari. Meskipun m
udah untuk membagi 24}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3
093\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {jam menjadi 8 hingga 12 kali
menyusui dan menghasilkan}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li3093\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {perkiraan jadwal, cara in
i bukan merupakan cara makan sebagian}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\
cf0\par\pard\li3093\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {besar bayi (V
arney, 2007). Sebaiknya menyusui bayi tanpa}\par\pard\li3093\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li3093\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {dijadwa
l (}\fs24\cf0\f0\charscalex100\i {on demand}\i0 \fs24\cf0\f0\charscalex100 {), k
arena bayi akan menentukan sendiri}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li3093\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {kebutuhanya. Ibu
harus menyusui bayinya bila bayi menangis}\par\pard\li3093\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li3093\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {bukan ka
rena sebab lain (kencing, dsb.) atau ibu sudah merasa}\par\pard\li3093\ri0\sl-21
0 {ingin menyusui bayinya. Bayi yang sehat dapat mengosongkan}\par\pard\li3093\r
scalex100 {satu payudara sekitar 5-7 menit dan ASI dalam lambung bayi akan}\par\
4\cf0\f0\charscalex100 {kosong dalam waktu 2 jam (Inggrid, 2006).}\par\pard\li54
0\sl-466\slmult0 \fs24\cf0\f0\charscalex100 {17}\par\pard\sect\sectd\sbkpage\pgw
sxn11893\pghsxn16840\marglsxn666\margrsxn133\margtsxn666\margbsxn173\pard\li3480
sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Untuk menjaga keseimbangan kedua payu
dara diusahakan}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3093\ri
0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {sampai payudara terasa kosong, agar
produksi ASI tetap baik.}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li3093\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Setiap menyusui dimulai d
engan payudara yang terakhir}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li3093\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {disusukan. Selama masa
menyusui sebaiknya ibu menggunakan}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li3093\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {BH yang dapat m
enyangga payudara, tetapi tidak terlalu ketat.}\par\pard\li2360\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li2360\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {5).
Kelainan Puting Susu}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li21
60\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {d. Pencegahan dan Penatalaksan
aan}{ }\fs24\cf0\f0\charscalex100\i {Engorgement}\i0 \par\pard\li2720\ri0\sl-213
{Sekitar hari ketiga setelah melahirkan, seringkali payudara terasa}\par\pard\l
i2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2160\ri0\sl-346\slmult0 \*\tx5946\
fs24\cf0\f0\charscalex100 {penuh, tegang dan nyeri. Kondisi}\tab \fs24\cf0\f0\ch
arscalex100 {tersebut disebabkan karena adanya}\par\pard\li2160\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li2160\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {bend
ungan pada pembuluh getah bening. Ini merupakan tanda bahwa ASI}\par\pard\li2160
arscalex100 {mulai banyak disekresi. Jika keadaan ini berlanjut, maka kulit payu
dara}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2160\ri0\sl-346\sl
mult0 \fs24\cf0\f0\charscalex100 {akan tampak lebih mengkilat dan sering ibu sam
pai mengalami demam}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li216
0\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {(Suradi, 2008).}\par\pard\li232

harscalex100 {1). Pencegahan}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li2720\ri0\sl-320\slmult0 \*\tx5720\*\tx7133\fs24\cf0\f0\charscalex100 {Untu
k mencegah terjadinya}\tab \fs24\cf0\f0\charscalex100\i {engorgement}\i0 \tab \f
s24\cf0\f0\charscalex100 {apabila memungkinkan,}\par\pard\li2720\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {sus
ukan ASI pada bayi segera setelah lahir dengan posisi yang benar,}\par\pard\li27
charscalex100 {menyusui bayi tanpa dijadwal, keluarkan ASI dengan tangan atau}\p
fs24\cf0\f0\charscalex100 {pompa bila produksi ASI melebihi kebutuhan bayi, mela
kukan}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-346\s
lmult0 \fs22\cf0\f0\charscalex100 {perawatan payudara pasca melahirkan (}\fs22\c
f0\f0\charscalex100\i {postpartum}\i0 \fs22\cf0\f0\charscalex100 {) secara terat
ur, ibu}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-320
\slmult0 \fs22\cf0\f0\charscalex100 {merasa yakin akan kemampuannya menyusui bay
inya dan hanya}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0
\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {memberikan ASI pada bayinya.}\par\pa
fs24\cf0\f0\charscalex100 {18}\par\pard\sect\sectd\sbkpage\pgwsxn11893\pghsxn168
40\marglsxn666\margrsxn133\margtsxn666\margbsxn173\pard\li2320\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li2320\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2320\ri0\sl213\slmult0 \fs18\cf0\par\pard\li2320\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li23
24\cf0\f0\charscalex100 {2). Penatalaksanaan}\par\pard\li2720\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Penata
laksanaan yang dilakukan pada ibu yang mengalami}\par\pard\li2720\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li2720\ri0\sl-333\slmult0 \*\tx4120\fs24\cf0\f0\charscal
ex100\i {engorgement}\i0 \tab \fs24\cf0\f0\charscalex100 {antara lain adalah : k
eluarkan sedikit ASI sebelum}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {menyusui agar payudara
lebih lembek, sehingga lebih mudah}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li2720\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {memasukkannya k
e dalam mulut bayi, bila bayi belum dapat}\par\pard\li2720\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {menyusu,
ASI dikeluarkan dengan tangan atau pompa dan diberikan}\par\pard\li2720\ri0\sl-2
00 {pada bayi dengan cangkir/ sendok, menyusui lebih sering dan lebih}\par\pard\
\f0\charscalex100 {lama pada payudara yang mengalami bendungan ASI untuk}\par\pa
cf0\f0\charscalex100 {melancarkan aliran ASI dan menurunkan tegangan payudara. U
ntuk}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-320\sl
mult0 \fs24\cf0\f0\charscalex100 {mengurangi rasa sakit dapat diberi kompres din
gin, kompres panas}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720
\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {untuk melancarkan aliran aliran
darah payudara dan bila ibu demam}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {dapat diberikan o
bat penurun demam dan pengurang sakit.}\par\pard\li2560\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li2560\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {Apabila bayi
belum menyusu dengan baik atau kelenjar-kelenjar tidak}\par\pard\li1973\ri0\sl213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-346\slmult0 \*\tx7120\*\tx8493\fs24
\cf0\f0\charscalex100 {dikosongkan dengan sempurna maka akan terjadi}\tab \fs24\
cf0\f0\charscalex100\i {engorgement}\i0 \tab \fs24\cf0\f0\charscalex100 {(Hamilt
on,}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-320\slm
ult0 \fs24\cf0\f0\charscalex100 {1999). Sesuai dengan pendapat Macklin (1988) da
lam Subekti (2005)}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973
\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {mengatakan bahwa pasangan yang b
ekerja cenderung melakukan pembagian}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {tugas-tugas ke
wanitaan tradisional daripada melakukan pembagian tugas-}\par\pard\li1973\ri0\sl
x100 {tugas keluarga dimana salah satu pasangan atau keduanya bekerja, khususnya
0 \fs24\cf0\f0\charscalex100 {dalam bidang perawatan anak. Dari pernyataan terse
but dapat disimpulkan}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1
973\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {bahwa dengan adanya kesibukan
keluarga dalam pekerjaan akan menurunkan}\par\pard\li1973\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {tingkat p
erawatan dan perhatian dalam keluarga, maka dengan adanya}\par\pard\li1973\ri0\s
ex100 {kesibukan menurunkan tingkat perawatan dan perhatian ibu dalam melakukan}
3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li5453\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li5453\ri0\sl-466\slmult0 \fs24\cf0\f0\charscalex100 {19}\par\pard\sect\sec
td\sbkpage\pgwsxn11893\pghsxn16840\marglsxn666\margrsxn133\margtsxn666\margbsxn1
73\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\
rd\li1973\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {perawatan payudara sehi
ngga akan cenderung mengakibatkan terjadinya}\par\pard\li1973\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {pening
katan angka kejadian kasus}{ }\fs24\cf0\f0\charscalex100\i {engorgement.}\i0 \pa
s22\cf0\f0\charscalex100 {Kebutuhan yang harus dapat dipenuhi selama masa nifas
(menyusui)}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl346\slmult0 \fs22\cf0\f0\charscalex100 {antara lain : yang pertama adalah kebutu
han fisik. Ibu yang menyusui harus}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li1973\ri0\sl-320\slmult0 \fs22\cf0\f0\charscalex100 {cukup istirahat,
memakan makanan yang bergizi, sering meghirup udara segar,}\par\pard\li1973\ri0
alex100 {dan lingkungan yang bersih. Yang kedua adalah kebutuhan psikologi, stre
s}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-346\slmul
t0 \fs22\cf0\f0\charscalex100 {setelah persalinan dapat segera distabilkan dari
dukungan keluarga yang}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
1973\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {menunjukkan rasa simpati, me
ngakui dan menghargai ibu. Kebutuhan yang}\par\pard\li1973\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {ketiga ad
alah kebutuhan sosial, seringkali ibu yang berpengalaman dapat}\par\pard\li1973\
rscalex100 {memberikan informasi konkret yang sangat berharga kepada ibu-ibu yan
g lain}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-346\
slmult0 \fs24\cf0\f0\charscalex100 {dan ibu yang kurang atau bahkan tidak berpen
galaman mungkin akan meniru}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {tindakan ibu yang lain
yang dianggap baik, dan kebutuhan yang terakhir}\par\pard\li1973\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li1973\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {ada
lah kebutuhan psikososial (Saleha, 2009).}\par\pard\li1973\ri0\sl-213\slmult0 \f
i0\sl-266\slmult0 \fs24\cf0\f0\charscalex100\b {5. Perilaku Kesehatan}\b0 \par\p

\cf0\f0\charscalex100 {Perilaku kesehatan adalah suatu respon seseorang terhadap
stimulus}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\sl-3
46\slmult0 \fs24\cf0\f0\charscalex100 {atau obyek yang berkaitan dengan sakit da
n penyakit, sistem pelayanan}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li1973\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {kesehatan, makanan dan
minuman, serta lingkungan (Notoatmodjo, 2003).}\par\pard\li1973\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Per
ilaku kesehatan dapat diklasifikasikan menjadi 3 kelompok, yaitu :}\par\pard\li2
\charscalex100 {a. Perilaku pemeliharaan kesehatan (}\fs24\cf0\f0\charscalex100\
i {Health maintenance}\i0 \fs24\cf0\f0\charscalex100 {)}\par\pard\li2720\ri0\sl213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex
100 {Perilaku pemeliharaan kesehatan adalah perilaku atau usaha-usaha}\par\pard\
\f0\charscalex100 {seseorang untuk memelihara atau menjaga kesehatan agar tidak
sakit dan}\par\pard\li2360\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2360\ri0\sl-3
33\slmult0 \fs24\cf0\f0\charscalex100 {usaha untuk penyembuhan apabila sakit.}\p
fs18\cf0\par\pard\li5453\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li5453\ri0\sl-213
ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {20}\par\pard\sect\sectd\sbkpage\p
gwsxn11893\pghsxn16840\marglsxn666\margrsxn133\margtsxn666\margbsxn173\pard\li23
0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {b. Perilaku pencarian pengobatan (}
\fs24\cf0\f0\charscalex100\i {Health seeking behavior}\i0 \fs24\cf0\f0\charscale
x100 {)}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-346
\slmult0 \fs24\cf0\f0\charscalex100 {Perilaku ini adalah menyangkut upaya atau t
indakan seseorang pada}\par\pard\li2360\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
2360\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {saat menderita penyakit atau
kecelakaan.}\par\pard\li2360\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2360\ri0\s
l-346\slmult0 \fs24\cf0\f0\charscalex100 {c. Perilaku kesehatan lingkungan}\par\
2\cf0\f0\charscalex100 {Adalah bagaimana seseorang merespon lingkungan, baik lin
gkungan}\par\pard\li2360\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2360\ri0\sl-346
\slmult0 \fs24\cf0\f0\charscalex100 {fisik maupun lingkungan sosial budaya. Deng
an perkataan lain, bilamana}\par\pard\li2360\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li2360\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {seseorang mengelola lin
gkungannya sehingga tidak mengganggu}\par\pard\li2360\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li2360\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {kesehatannya s
endiri, keluarga, atau masyarakat.}\par\pard\li2560\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li2560\ri0\sl-346\slmult0 \*\tx3626\*\tx4853\*\tx5933\*\tx7160\*\tx801
3\*\tx8933\fs24\cf0\f0\charscalex100 {Perilaku}\tab \fs24\cf0\f0\charscalex100 {
seseorang}\tab \fs24\cf0\f0\charscalex100 {menurut}\tab \fs24\cf0\f0\charscalex1
00 {Lawrence}\tab \fs24\cf0\f0\charscalex100 {Green}\tab \fs24\cf0\f0\charscalex
100 {(1980)}\tab \fs24\cf0\f0\charscalex100 {dalam}\par\pard\li1973\ri0\sl-213\s
Notoatmodjo (2003) dipengaruhi oleh faktor predisposisi (}\fs24\cf0\f0\charscale
x100\i {predisposing}\i0 \par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100\i {factor}\i0 \fs24\cf0\f0\
charscalex100 {), faktor pemungkin (}\fs24\cf0\f0\charscalex100\i {enabling fact
or}\i0 \fs24\cf0\f0\charscalex100 {), dan faktor penguat (}\fs24\cf0\f0\charscal
ex100\i {reinforcing}\i0 \par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100\i {factor}\i0 \fs24\cf0\f0\
charscalex100 {).}\par\pard\li2560\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2560\
ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Faktor predisposisi mencakup peng
etahuan dan sikap masyarakat}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {terhadap kesehatan, tr

adisi dan kepercayaan masyarakat terhadap hal-hal yang}\par\pard\li1973\ri0\sl-2
00 {berkaitan dengan kesehatan, tingkat pendidikan, tingkat sosial ekonomi dan}\
\fs24\cf0\f0\charscalex100 {sebagainya. Faktor pemungkin mencakup ketersediaan s
arana dan prasarana}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li197
3\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {atau fasilitas kesehatan bagi m
asyarakat, misalnya : puskesmas, poliklinik,}\par\pard\li1973\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1973\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {polind
es, pos obat desa, dokter atau bidan praktek swasta. Sedangkan faktor}\par\pard\
\f0\charscalex100 {penguat meliputi faktor sikap dan perilaku tokoh masyarakat,
tokoh agama,}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1973\ri0\s
l-320\slmult0 \fs24\cf0\f0\charscalex100 {sikap dan perilaku para petugas termas
uk petugas kesehatan, termasuk juga}\par\pard\li1973\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li1973\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {undang-undang,
peraturan-peraturan baik dari pusat maupun pemerintah}\par\pard\li1973\ri0\sl-21
0 {daerah yang terkait dengan kesehatan.}\par\pard\li5453\ri0\sl-213\slmult0 \fs
0\f0\charscalex100 {21}\par\pard\sect\sectd\sbkpage\pgwsxn11893\pghsxn16840\marg
lsxn666\margrsxn133\margtsxn666\margbsxn173\pard\li1973\ri0\sl-213\slmult0 \fs18
f0\charscalex100\b {6. Pengetahuan}\b0 \par\pard\li2160\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li2160\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {a. Pengertia
n}\par\pard\li2533\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2533\ri0\sl-333\slmul
t0 \fs24\cf0\f0\charscalex100 {Pengetahuan merupakan hasil tahu dan ini terjadi
setelah orang}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2160\ri0\
sl-346\slmult0 \fs22\cf0\f0\charscalex100 {melakukan penginderaan terhadap subye
k tertentu. Penginderaan terjadi}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li2160\ri0\sl-320\slmult0 \fs22\cf0\f0\charscalex100 {melalui panca inde
ra manusia yaitu penglihatan, pendengaran, penciuman,}\par\pard\li2160\ri0\sl-21
0 {rasa, dan raba (Notoatmodjo, 2003).}\par\pard\li2533\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li2533\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Untuk dapat
mencegah dan menangani masalah}{ }\fs24\cf0\f0\charscalex100\i {engorgement}\i0
{ }\fs24\cf0\f0\charscalex100 {maka ibu}\par\pard\li2160\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li2160\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {memerlukan
pengetahuan tentang payudara bengkak sehingga ibu}\par\pard\li2160\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li2160\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {m
empunyai kesadaran dalam bersikap untuk melakukan pencegahan}\par\pard\li2160\ri
calex100 {masalah}{ }\fs24\cf0\f0\charscalex100\i {engorgement.}\i0 \par\pard\li
0\charscalex100 {Pengetahuan responden yang baik tentu akan mempengaruhi sikap y
ang}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2160\ri0\sl-346\slm
ult0 \fs24\cf0\f0\charscalex100 {semakin positif, tetapi perlu diketahui juga ba
hwa pembentukan sikap}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2
160\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {seseorang sangat ditentukan o
leh kepribadian intelegensia, bakat, minat,}\par\pard\li2160\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2160\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {perasaa
n serta kebutuhan dan motivasi seseorang (Widayatun, 1999).}\par\pard\li2160\ri0
alex100 {Responden yang memiliki sikap negatif dapat disebabkan oleh beberapa}\p
fs24\cf0\f0\charscalex100 {faktor yaitu pengalaman pribadi, pengaruh media massa
, orang lain yang}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2160\
ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {dianggap penting, pengaruh kebuda
yaan, pengaruh pendidikan, pengaruh}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li2160\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {agama dan keper
cayaan, serta pengaruh emosional (Azwar, 2003).}\par\pard\li2533\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2533\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Men
urut Kamus Besar Bahasa Indonesia, pengetahuan adalah segala}\par\pard\li2160\ri
calex100 {sesuatu yang diketahui. Menurut Taksonomi Bloon, terdiri dari tiga kat
agori}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2160\ri0\sl-346\s
lmult0 \fs24\cf0\f0\charscalex100 {yaitu dikenal sebagai domain atau ranah kogni
tif, ranah efektif dan ranah}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li2160\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {psikomotorik. Pengetah
uan dalam domain mempunyai 6 tingkatan, yaitu :}\par\pard\li5453\ri0\sl-213\slmu
fs24\cf0\f0\charscalex100 {22}\par\pard\sect\sectd\sbkpage\pgwsxn11893\pghsxn168
40\marglsxn666\margrsxn133\margtsxn666\margbsxn173\pard\li2320\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li2320\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2320\ri0\sl213\slmult0 \fs18\cf0\par\pard\li2320\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li23
24\cf0\f0\charscalex100 {1). Tahu (}\fs24\cf0\f0\charscalex100\i {know}\i0 \fs24
\cf0\f0\charscalex100 {)}\par\pard\li2680\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li2680\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Tahu adalah mengingat suat
u materi yang telah dipelajari.}\par\pard\li2320\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li2320\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {2). Memahami (}\fs2
4\cf0\f0\charscalex100\i {comprehetion}\i0 \fs24\cf0\f0\charscalex100 {)}\par\pa
cf0\f0\charscalex100 {Memahami adalah merupakan kemampuan menjelaskan secara ben
ar}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-320\slmu
lt0 \fs22\cf0\f0\charscalex100 {tentang obyek yang diketahui dan dapat menginter
pretasikan materi}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\
ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {tersebut secara benar.}\par\pard\
\f0\charscalex100 {3). Aplikasi (}\fs24\cf0\f0\charscalex100\i {aplication}\i0 \
fs24\cf0\f0\charscalex100 {)}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li2720\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {Aplikasi diartikan kem
ampuan menggunakan materi yang telah}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {dipelajari pad
a kondisi dan situasi riil atau sebenarnya.}\par\pard\li2320\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2320\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {4). Ana
lisis}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-346\s
lmult0 \fs22\cf0\f0\charscalex100 {Kemampuan untuk menjabarkan materi atau obyek
ke dalam}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-3
46\slmult0 \fs22\cf0\f0\charscalex100 {komponen tetapi masih tetap berkaitan sat
u sama lainnya. Dengan}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
2720\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {analisis seseorang dapat mem
punyai pemahaman yang komprehensif.}\par\pard\li2320\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li2320\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {5). Sintesis (}
\fs24\cf0\f0\charscalex100\i {synthesis}\i0 \fs24\cf0\f0\charscalex100 {)}\par\p
ard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-320\slmult0 \*\tx
3746\*\tx4653\*\tx5440\*\tx6906\*\tx7733\*\tx9120\fs24\cf0\f0\charscalex100 {Sin
tesis}\tab \fs24\cf0\f0\charscalex100 {adalah}\tab \fs24\cf0\f0\charscalex100 {s
uatu}\tab \fs24\cf0\f0\charscalex100 {kemampuan}\tab \fs24\cf0\f0\charscalex100
{untuk}\tab \fs24\cf0\f0\charscalex100 {meletakkan}\tab \fs24\cf0\f0\charscalex1

00 {atau}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-34
6\slmult0 \fs22\cf0\f0\charscalex100 {menghubungkan bagian-bagian dalam suatu be
ntuk keseluruhan yang}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2
720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {baru.}\par\pard\li2320\ri0\sl
x100 {6). Evaluasi (}\fs24\cf0\f0\charscalex100\i {evaluation}\i0 \fs24\cf0\f0\c
harscalex100 {)}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri
0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {Evaluasi berkaitan dengan kemampuan
untuk melakukan penilaian}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2720\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {suatu materi atau obyek
(Notoatmodjo, 1997).}\par\pard\li5453\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li54
0\par\pard\li5453\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li5453\ri0\sl-306\slmult
0 \fs24\cf0\f0\charscalex100 {23}\par\pard\sect\sectd\sbkpage\pgwsxn11893\pghsxn
16840\marglsxn666\margrsxn133\margtsxn666\margbsxn173\pard\li2160\ri0\sl-213\slm
\fs24\cf0\f0\charscalex100 {b. Faktor \uc1\u8211X faktor yang Mempengaruhi Penge
tahuan}\par\pard\li2533\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2533\ri0\sl-346\
slmult0 \fs24\cf0\f0\charscalex100 {Menurut Notoatmodjo (2003), faktor-faktor ya
ng mempengaruhi}\par\pard\li2160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2160\ri
0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {pengetahuan yang dimiliki seseorang
dipengaruhi oleh faktor-faktor sebagai}\par\pard\li2160\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li2160\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {berikut :}\
\fs24\cf0\f0\charscalex100 {1). Faktor internal}\par\pard\li2720\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Mel
iputi :}\par\pard\li2880\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2880\ri0\sl-346
\slmult0 \fs24\cf0\f0\charscalex100 {a) Jasmani}\par\pard\li3293\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li3293\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {Fak
tor jasmani diantaranya adalah keadaan indera seseorang.}\par\pard\li2880\ri0\sl
x100 {b) Rohani}\par\pard\li3293\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3293\ri
0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {Faktor rohani diantaranya adalah ke
sehatan psikis, intelektual,}\par\pard\li3293\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li3293\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {psikomotor, serta kond
isi efektif dan kognitif individu.}\par\pard\li2320\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li2320\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {2). Faktor Ekste
rnal}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-333\sl
mult0 \fs24\cf0\f0\charscalex100 {Meliputi :}\par\pard\li2880\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li2880\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {a). Pe
ndidikan}\par\pard\li3280\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3280\ri0\sl-32
0\slmult0 \fs24\cf0\f0\charscalex100 {Tingkat pendidikan seseorang akan berpenga
ruh dalam}\par\pard\li3280\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3280\ri0\sl-3
46\slmult0 \fs24\cf0\f0\charscalex100 {memberikan respon terhadap sesuatu yang d
atang dari luar.}\par\pard\li3280\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3280\r
i0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Orang yang berpendidikan tinggi ak
an memberikan respon yang}\par\pard\li3280\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li3280\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {lebih rasional terhadap i
nformasi yang datang dan akan berpikir}\par\pard\li3280\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li3280\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {sejauh mana
keuntungan yang mungkin akan mereka peroleh}\par\pard\li3280\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li3280\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {dari ga

gasan tersebut.}\par\pard\li2880\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2880\ri
0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {b). Paparan media massa}\par\pard\l
f0\charscalex100 {Melalui bermacam-macam media baik cetak maupun elektronik}\par
24\cf0\f0\charscalex100 {berbagai informasi dapat diterima, sehingga seseorang y
ang}\par\pard\li5453\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li5453\ri0\sl-213\slm
i5453\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {24}\par\pard\sect\sectd\sbk
page\pgwsxn11893\pghsxn16840\marglsxn666\margrsxn133\margtsxn666\margbsxn173\par
280\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {lebih sering terpapar media m
assa akan memperoleh informasi}\par\pard\li3280\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li3280\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {yang lebih banyak di
banding dengan orang yang tidak terpapar}\par\pard\li3280\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li3280\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {informasi
media massa. Ini berarti paparan media massa}\par\pard\li3280\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li3280\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {mempen
garuhi tingkat pengetahuan yang dimiliki seseorang.}\par\pard\li2720\ri0\sl-213\
{c). Status ekonomi}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li309
3\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {Tingkat status ekonomi dapat me
mpengaruhi pengetahuan.}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard\l
i3093\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {Dimana dalam memenuhi kebut
uhan primer maupun sekunder,}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li3093\ri0\sl-333\slmult0 \fs22\cf0\f0\charscalex100 {keluarga dengan status
ekonomi baik akan lebih mudah tercukupi}\par\pard\li3093\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li3093\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {dibanding
keluarga dengan status ekonomi rendah. Hal ini juga}\par\pard\li3093\ri0\sl-213\
{berpengaruh dalam pemenuhan kebutuhan sekunder.}\par\pard\li2720\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li2720\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {d)
. Hubungan sosial}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3093\
ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {Manusia adalah makhluk sosial dim
ana dalam kehidupan saling}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li3093\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {berinteraksi satu sama l
ain. Individu yang dapat berinteraksi}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\
cf0\par\pard\li3093\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {secara kontin
yu akan dapat lebih biasa mendapatkan informasi.}\par\pard\li3093\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li3093\ri0\sl-320\slmult0 \*\tx4400\*\tx5280\*\tx6520\*\
tx7360\*\tx8080\fs24\cf0\f0\charscalex100 {Sementara}\tab \fs24\cf0\f0\charscale
x100 {faktor}\tab \fs24\cf0\f0\charscalex100 {hubungan}\tab \fs24\cf0\f0\charsca
lex100 {sosial}\tab \fs24\cf0\f0\charscalex100 {juga}\tab \fs24\cf0\f0\charscale
x100 {mempengaruhi}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3093
\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {kemampuan individu sebagai komun
ikan untuk menerima pesan}\par\pard\li3093\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li3093\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {menurut model komunikasi
media.}\par\pard\li2720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2720\ri0\sl-333\
slmult0 \fs24\cf0\f0\charscalex100 {e). Pengalaman}\par\pard\li3093\ri0\sl-213\s
Pengalaman individu tentang berbagai hal bisa diperoleh dari}\par\pard\li3093\ri
calex100 {tingkat kehidupan dalam proses perkembangannya. Misal sering}\par\pard
0\f0\charscalex100 {mengikuti kegiatan-kegiatan yang mendidik seperti seminar.}\
ult0 \fs24\cf0\f0\charscalex100 {25}\par\pard\sect\sectd\sbkpage\pgwsxn11893\pgh
sxn16840\marglsxn666\margrsxn133\margtsxn666\margbsxn173\pard\li2720\ri0\sl-213\
t0 \fs24\cf0\f0\charscalex100 {f). Akses layanan kesehatan}\par\pard\li3093\ri0\
lex100 {Mudah atau sulitnya mengakses layanan kesehatan tentunya akan}\par\pard\
\f0\charscalex100 {berpengaruh terhadap pengetahuan dalam hal kesehatan.}\par\pa
cf0\f0\charscalex100 {c. Pengukuran Pengetahuan}\par\pard\li2533\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li2533\ri0\sl-320\slmult0 \fs22\cf0\f0\charscalex100 {Pen
gukuran pengetahuan dapat dilakukan dengan wawancara atau}\par\pard\li2160\ri0\s
ex100 {angket yang menanyakan tentang isi materi yang ingin diukur dari subyek}\
\fs24\cf0\f0\charscalex100 {penelitian atau responden (Notoatmodjo, 2003).}\par\
2\cf0\f0\charscalex100 {Sesuai dengan pendapat Notoatmodjo (2003), bahwa pengeta
huan merupakan}\par\pard\li1600\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1600\ri0
\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {sebagian bentuk operasional dari per
ilaku seseorang yakni bersifat positif. Adanya}\par\pard\li1600\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li1600\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {peng
etahuan yang tinggi mengenai menyusui khususnya pada awal menyusui,}\par\pard\li
0\charscalex100 {selanjutnya dengan timbulnya sikap positif akan menimbulkan per
ilaku menyusui}\par\pard\li1600\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1600\ri0
\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {yang baik pula. Diharapkan bahwa sem
akin tinggi pengetahuan seseorang}\par\pard\li1600\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li1600\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {dimungkinkan akan
memberikan perilaku ke arah perubahan perilaku positif,}\par\pard\li1600\ri0\sl
x100 {dengan kata lain bahwa semakin ibu mengetahui tentang pengertian, gejala,}
\fs22\cf0\f0\charscalex100 {penyebab, pencegahan dan penatalaksanaan bendungan
ASI akan dapat}\par\pard\li1600\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1600\ri0
\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {meminimalkan terjadinya kemungkinan
kejadian bendungan ASI}\fs24\cf0\f0\charscalex100\i {.}\i0 { }\fs24\cf0\f0\chars
calex100 {Pengetahuan}\par\pard\li1600\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1
600\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {merupakan faktor penting dala
m menentukan perilaku seseorang karena}\par\pard\li1600\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li1600\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {pengetahuan
dapat menimbulkan perubahan persepsi dan kebiasaan masyarakat.}\par\pard\li1600\
rscalex100 {Perilaku yang didasari pengetahuan akan lebih langgeng daripada peri
laku yang}\par\pard\li1600\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1600\ri0\sl-3
20\slmult0 \fs24\cf0\f0\charscalex100 {tidak didasari pengetahuan.}\par\pard\li5

t0 \fs18\cf0\par\pard\li5453\ri0\sl-306\slmult0 \fs24\cf0\f0\charscalex100 {26}\
par\pard\sect\sectd\sbkpage
7;32768}}
7;32768}}
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7;32768}}
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7;32768}}

{\sp{\sn pVerticies}{\sv 8;13;(13,53);(2986,53);(3000,66);(3000,66);(13,66);(0,6
6);(13,53);(2973,0);(3093,66);(2973,120);(2973,0);(13,53);(13,53);}}
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn pVerticies}{\sv 8;13;(13,53);(920,53);(933,66);(933,66);(13,66);(0,66);
(13,53);(906,0);(1026,66);(906,120);(906,0);(13,53);(13,53);}}
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2720\ri0\sl-346\slmult0 \\tx6000\\tx7933\fs24\cf0\f0\charscalex100 {areola ini