Pediatric And Family Care Journal (PFCJ)

Pesticide exposure increases the incidence of low birth weight in agricultural areas

Fajar Dini Hariyanti — 2025-12-01

The widespread use of pesticides in agriculture and households poses serious health risks, especially in low-income countries with weak regulatory enforcement. Pregnant women are particularly vulnerable, as prenatal pesticide exposure is linked to low birth weight (LBW) through hormonal and neurotoxic effects. Socioeconomic challenges and proximity to agricultural areas further increase these risks, making it essential to address this issue to improve maternal and neonatal health in farming communities. This study analyzes the incidence of LBW according to levels of prenatal pesticide exposure among pregnant women in agricultural communities by examining environmental exposure patterns and birth outcome data. A literature review was conducted for 2019–2025 using PubMed, ScienceDirect, SSRN, Wiley Online Library, and ProQuest, and from an initial pool of 142,730 records, filters for research articles, full-text availability, and topic relevance yielded 14 studies for final analysis. Across the 14 studies, prenatal pesticide exposure was consistently associated with an increased risk of LBW and fetal growth restriction. Key factors influencing this risk included low socioeconomic status, pesticide type (organophosphates, fumigants), and timing of exposure—particularly during the second trimester. Living near agricultural areas also correlated with higher exposure levels, which may impair placental function, disrupt hormonal balance, and interfere with fetal tissue development. Some studies additionally reported long-term developmental problems. Prenatal pesticide exposure significantly increases the risk of LBW. Reducing maternal pesticide exposure and strengthening protective health interventions are crucial to improving agricultural communities' birth outcomes.

The application of facilitated tucking in premature infants on pain response during care procedures

Isna Zukhrofa — 2025-12-01

Premature infants have a lower pain threshold due to the immaturity of their nervous system, making them more sensitive to invasive procedures during hospitalization. Repeated pain responses can have long-term impacts on neurological development. One non-pharmacological technique proven effective in reducing pain in neonates is facilitated tucking. This study aimed to analyze the effectiveness of facilitated tucking in reducing pain responses in premature infants during invasive care procedures. This study is a qualitative case study conducted at Jember regional hospital. Samples were selected using purposive sampling. Pain responses were measured using the Premature Infant Pain Profile-Revised (PIPP-R) instrument, before, during, and after the procedure. The facilitated tucking intervention showed a reduction in Premature Infant Pain Profile-Revised (PIPP-R) scores across all observed procedures. Facilitated tucking performed before, during and after the procedure was associated with improved physiological and behavioural stability, as indicated by PIPP-R (lower heart rate and respiratory rate, increased oxygen saturation, nasolabial furrow, eyes squeeze, and brow bulge), compared to when the intervention was not applied or the baseline condition. On average, infants returned to their baseline condition within one minute after the procedure. Facilitated tucking is effective in reducing pain responses in premature infants during invasive procedures such as blood sampling, intravenous insertion and OGT, this pain management can be utilized as a non-pharmacological intervention.

Nursing care of aloe vera compress in a hyperthermia patient with dengue hemorrhagic fever at dr. Haryoto Hospital of Lumajang

Amirotul Zahro — 2025-12-01

Dengue Hemorrhagic Fever (DHF) is an acute infectious disease caused by the dengue virus, which is generally transmitted through the bite of the Aedes aegypti mosquito. One of the main symptoms in the early phase is high fever, which often leads to hyperthermia, especially in pediatric patients. Uncontrolled hyperthermia can result in serious complications, including dehydration, febrile seizures, and neurological problems. This study aims to describe a nursing care intervention using aloe vera compresses to manage hyperthermia in children diagnosed with DHF. This case study was conducted at the Bougenville Ward, Dr. Haryoto Regional General Hospital, Lumajang, from December 15 to 18, 2024. The intervention consisted of applying aloe vera compresses twice daily for three days, with each session lasting 15–20 minutes. The effectiveness of the intervention was assessed by measuring the patient's body temperature before and after each session using a thermometer. The results showed a significant average temperature decrease of 1.5°C over three days, indicating a positive effect of the aloe vera compresses. Aloe vera contains active compounds such as natural saponins and salicylates, which function as antipyretic and anti-inflammatory agents, helping to reduce fever by inhibiting prostaglandin synthesis. This analysis confirms that aloe vera compresses are an effective complementary nursing intervention for managing hyperthermia in pediatric dengue fever patients. Based on these findings, it is recommended that aloe vera compresses be considered as a non-pharmacological option in clinical practice to support temperature regulation in febrile children.

The application of the quarter-prone position to improve oxygen saturation in patients with respiratory distress syndrome at dr. Haryoto General Hospital

Ahmad Ruslan — 2025-12-01

Respiratory distress syndrome (RDS) was a syndrome that occurred in premature or less than full-term infants with immature lungs and surfactant deficiency. The corrected position of the baby was very important to noted. This could have a negative impact, namely increased breathed, heart rate, oxygen saturation and impaired comfort and slept quality. The purpose of this studied was to determine the increased in the provision of Quarter prone positions in infants with RDS. This studied began on January 11 to January 13, 2025. The sample of this studied was Mrs. AVE with a medical diagnosis of premature neonates, RDS and BBLSR who treated in the NICU room of Dr. Haryoto Lumajang Hospital. This studied took the diagnosis of ineffective breathed patterns, the desired outcome criteria improved breathed patterns by lifted airway management interventions and focusing interventions on the used of accessory respiratory muscles decreased and increased breathed depth. the intervention given was the Quarter prone position. Provided a Quarter prone position to RDS patients with observation after 15 minutes, 30 minutes and 60 minutes twice a day. Gave this position could increased oxygen saturation and stabilize breathing and pulse. Therefore, there is an increase in the provision of prone quarter position in infants with RDS.

The application of nesting therapy on physiological changes (body temperature, respiratory rate, heart rate, and oxygen saturation) in low-birth-weight infants in the perinatology unit

Riza Rohmatul Maulidia — 2025-12-01

Infants with low birth weight (LBW) are at high risk of experiencing physiological adaptation disorders due to the immaturity of their organs, requiring close monitoring of physiological parameters such as body temperature, respiratory rate, heart rate, and oxygen saturation. Nesting therapy is one form of developmental care intervention aimed at stabilizing the baby's position and enhancing comfort to achieve stability in vital functions. This study aims to analyze the effect of nesting therapy on physiological changes in LBW infants in the Perinatology Unit of Dr. Soebandi General Hospital, Jember. The study design used a descriptive case study with a qualitative approach. The research subject was one LBW infant who met the inclusion criteria. Data collection was conducted through direct observation with measurements of physiological parameters before and after the administration of nesting therapy every 15 minutes over a one-hour period for three consecutive days. The results of the study showed positive changes in the infant's physiological parameters after nesting therapy was administered. Body temperature increased from 35.4°C to 36.3°C on the third day. Respiratory rate decreased from 75 breaths per minute to 58 breaths per minute. Heart rate decreased from 189 beats per minute to 122 beats per minute, and oxygen saturation increased from 94% to 99%. These findings indicate that nesting therapy is effective in helping to stabilize the physiological condition of LBW infants. The nesting position also makes the baby feel more comfortable, the baby's position is awake, the baby's sleep time is more effective, so that the baby's energy is used optimally in growth and development and can affect the baby's physiological functions. Given its non-invasive and safe nature, this therapy is recommended for routine application as part of the care of LBW infants in the perinatal unit.

Differences in pain intensity of mothers during labor with endorphin massage techniques

Chusnul Khotimah — 2025-12-01

Labor pain is a common yet significantly discomforting experience for women, especially during the first stage of labor. Based on field observations, most patients choose cesarean section due to their inability to endure labor pain. Out of approximately 10 patients, around 5 to 6 request a cesarean delivery, with the majority being primigravida mothers. This phenomenon indicates that the inability to manage labor pain, particularly among women giving birth for the first time, is one of the contributing factors to the increasing rate of cesarean deliveries. Furthermore, if labor pain is not properly managed, it can cause physical and emotional stress in the mother that interferes with her ability to push, breathe, and progress during labor, increases sympathetic responses and the risk of psychological trauma, reduces oxygen supply to the fetus which may lead to fetal distress, asphyxia, and other complications, as well as prolongs labor due to ineffective contractions, while also raising the risk of medical interventions and postpartum hemorrhage. This study aimed to determine the difference in pain intensity among mothers in the first stage of labor before and after the application of the Endorphin Massage technique. A quantitative research design was used, employing a pre-experimental method with a one-group pretest-posttest design. The sample consisted of 20 respondents selected through purposive sampling. The research instruments included the Standard Operating Procedure (SOP) for Endorphin Massage and a pain measurement sheet using the Numeric Rating Scale (NRS). The research results show a decrease in pain intensity, as indicated by a reduction in the incidence of pain from 70% of respondents experiencing moderate pain before the intervention to 60% of respondents after the intervention. The Paired Samples Test revealed a t-value of 17.085 with a significance level of 0.0001 (p < 0.05), indicating a statistically significant difference in pain intensity before and after the Endorphin Massage. The mean difference of 2.189 also demonstrated a substantial reduction in pain intensity following the intervention. These findings support existing theories that Endorphin Massage can stimulate the body's natural endorphin release, which acts as a natural analgesic. Therefore, this technique can be considered an effective alternative for labor pain management.

Case study of a 16-year-old pregnant woman (G1P0A0) with high-risk pregnancy due to early maternal age at Pujon Community Health Center, Central Kapuas Regency

Evy Kasanova — 2025-12-01

The researcher chose Mrs. I to be a comprehensive patient because when the study was carried out, the condition of pregnant women who were too young <20 years old was obtained, which was very risky to cause various complications in the mother and fetus in the womb that could cause death to the mother and fetus. This study aimed to carry out comprehensive obstetric care for Mrs. "I" continuously from pregnancy, childbirth, BBL, postpartum to neonatal and family planning. By using an obstetric management approach on Mrs. I aged 16 years with a pregnancy too young at the Pujon Health Center, Central Kapuas Regency using 7-step midwifery management varney and soap. Using a case study by conducting comprehensive midwifery care in Mrs. I at the age of 16 pregnant women in the third trimester. The subject of the study is Mrs. I, conducted at the Pujon Health Center, Central Kapuas Regency on February 04 - April 05, 2025. The results were analyzed using 7-step varney and soap management. Midwifery care for Mrs. I aged 16 years with too young pregnancy was carried out from the third trimester of pregnancy, with 4 pregnancy visits, first delivery assistance lasted 4 hours and 35 minutes. At 3 neonatal visits, 4 postpartum visits, and 1 maternal birth control visit, the mother decided to use 3 months of injectable birth control. Comprehensive obstetric care for Mrs. I at the age of 16 years G1P0A0 starting from pregnancy, childbirth, BBL, postpartum period, neonates, and birth control was physiological, a gap was found between facts and theories, there were no complications in the mother or baby. This is because midwifery care for mothers and babies has been carried out according to standards.

Case study of comprehensive midwifery care for Mrs. R, 28 years old, G2P1A0 with anemia at Ketapang I Community Health Center, Ketapang Subdistrict, Kotawaringin Timur

Neneng Safitri — 2025-12-01

On February 17, during the second antenatal visit, it was found that Mrs. R was experiencing anemia. Anemia, one of the indirect causes of maternal mortality, remains a significant global health problem, particularly in developing countries. This condition frequently occurs due to an increase in blood volume of up to 50% during pregnancy, which gradually returns to normal as gestational age advances, provided the mother maintains a healthy lifestyle and adequate nutritional intake. However, if left untreated, anemia in pregnancy may lead to serious complications. The aim of this case study was to provide comprehensive midwifery care for Mrs. R, a 28-year-old pregnant woman with anemia, at Ketapang I Community Health Center, Ketapang Subdistrict, East Kotawaringin. This case study was conducted at the same facility from February to April 2025. The research subject was Mrs. R, aged 28 years, at 35 weeks of gestation with a live, singleton intrauterine fetus in cephalic presentation. The instruments used in this study included the comprehensive midwifery care format, observation sheets, screening forms, and partograph. Data collection techniques consisted of both primary and secondary data sources. The results indicated that the provision of comprehensive midwifery care proceeded smoothly. All clinical assessments were within normal limits. Based on the findings, no discrepancies were observed between theory and actual practice because the researcher implemented comprehensive midwifery care according to established service standards. All examination results were documented thoroughly using the seven-step Varney management approach and SOAP documentation. The comprehensive midwifery care provided to Mrs. R, a 28-year-old pregnant woman at Ketapang I Community Health Center, East Kotawaringin, was successfully implemented. All examination findings were within normal physiological limits, no complications were identified, and the care delivered adhered to professional midwifery standards.

Comprehensive midwifery care for Mrs. W, 23 years old, G2P1A0 with mild anemia at Pujon Community Health Center, Central Kapuas Regency

Evy Kasanova — 2025-12-01

Anemia in pregnancy is defined as a hemoglobin level below 11 g/dL. Hemoglobin is an iron-rich protein responsible for transporting oxygen to maternal and fetal tissues. Anemia during pregnancy may result from iron or vitamin B12 deficiency, poor dietary intake, bleeding, or immune disorders, and it can adversely affect maternal and fetal outcomes. This case study aimed to provide comprehensive midwifery care for Mrs. W, 23 years old, with mild anemia, covering pregnancy, childbirth, newborn care, postpartum care, and family planning services. The case study was conducted at Pujon Community Health Center, Central Kapuas Regency, from February to April 2025. The subject was a 23-year-old pregnant woman at 34 weeks of gestation with a single live intrauterine fetus in cephalic presentation. Instruments included midwifery care forms, observation sheets, screening sheets, and a partograph. Data collection comprised primary data (physical examination, interviews, observation) and secondary data (medical records, ANC registers, and the maternal KIA book). Comprehensive midwifery care for Mrs. W proceeded smoothly. She completed four ANC visits in the third trimester. Labor progressed normally, with the second stage lasting 30 minutes. She received three neonatal visits, four postpartum visits, and one family planning visit, ultimately selecting a 3-month injectable contraceptive. No maternal or neonatal complications were identified. All assessments and interventions were documented using Varney’s 7-Step Management and SOAP. This study highlights the importance of early detection of anemia, routine hemoglobin monitoring, balanced nutrition counseling, adherence to iron and vitamin supplementation, regular ANC attendance, and the consistent application of comprehensive midwifery care standards.

Analysis of tactile-kinesthetic stimulation in babies with asphyxia and a nursing care diagnosis of the risk of aspiration in the perinatal unit

Azhari Trisna — 2025-12-01

Infants with a low birth weight (LBW) are those born with a weight of less than 2500 grams, and they are predisposed to a range of health complications, including neonatal asphyxia. This condition has been shown to have a detrimental effect on oromotor functions, such as sucking and swallowing. These functions are of crucial importance in the initiation of effective oral feeding. Impairment in these reflexes has been demonstrated to directly influence nutritional intake and may have a detrimental effect on long-term neurological outcomes. The present study was conducted with the objective of examining the effect of tactile–kinesthetic stimulation on improving sucking and swallowing reflexes in low birth weight (LBW) infants who have experienced asphyxia. The Early Feeding Skills (EFS) tool was utilized to assess the infants' development. A qualitative descriptive design with a case study approach was applied over a period of three consecutive days in the Perinatology Unit of RSUD dr. Soebandi Jember. The intervention comprised structured tactile and kinesthetic stimulation, administered twice daily. The findings revealed a progressive improvement in oromotor readiness, with EFS scores increasing from 79.1% on the first day (partial readiness) to 91.7% on both the second and third days (independent feeding readiness with minimal risk). The results of this study indicate that tactile–kinesthetic stimulation is a safe and beneficial nursing intervention to enhance functional feeding readiness in LBW infants with asphyxia. This method has the potential to function as a complementary strategy in neonatal care, with the aim of supporting the recovery of oral feeding abilities and reducing reliance on enteral nutrition.