Community Tradition about Center Rope Care Using Powder and Oil For New-Born Babies

Newborn care is a process of deeds, ways of caring for and nurturing. The most important care of the umbilical cord is to make sure the umbilical cord and the area around it is always clean and dry and avoid infection. Always wash your hands using clean water and soap, before cleaning the umbilical cord. This study aims to analyze in depth the care of the umbilical cord using powder and oil in newborns in the Ajangale Community Health Center, Bone Regency. This type of research used in this research is qualitative research. Qualitative research is a study aimed at describing and analyzing phenomena, events, social activities, attitudes, beliefs, perceptions, thoughts of people individually or in groups. This research was conducted in the work area of ​​Arenaale Public Health Center, Bone District. The number of research subjects was 10 people. The results showed that the people of Ajangale Subdistrict in the care of newborns, especially the tradition of umbilical cord care using powder, were still practiced by several people who were believed to be able to accelerate dryness and detachment of the umbilical cord. There are still people in Ajangale who perform umbilical cord care using powder and oil which are considered to be able to accelerate the dryness of the umbilical cord and quickly release it.


Introduction
Newborn care is a process of deeds, ways of caring for and nurturing. The most important care of the umbilical cord is to make sure the umbilical cord and the area around it is always clean and dry and avoid infection. Always wash your hands using clean water and soap, before cleaning the umbilical cord. Newborn care is also influenced by the traditional and cultural background of the mother, as many myths from certain traditions and cultures are incompatible with the proper way of caring for a newborn. (Antini, et al, 2012).
Tradition is a description of human behavior and behavior that has been processed for a long time and has been carried out from generation to generation starting from the ancestors. (Coomans, 2011). Culture is the whole system of ideas, actions, and the work of humans in the context of community life which belongs to humans. (Koentjaraningrat, 2015).
Baby care is carried out by the community in Ajangale District, Bone Regency with very strong traditions including: umbilical cord care using white powder or pifa powder and oil, traditional massage for the baby by traditional healers, bathing the baby by mixing natural ingredients (stones). alum and langsat leaves) which are believed to be able to whiten baby's skin, people believe that by connecting a pin that has been put in onions and panini which is believed to protect babies from bad things. Of the 4 traditions, what the Ajangale people still do is the tradition of treating the umbilical cord using powder and oil. (Data from UPT Puskesmas (Community Health Center) Ajangale. 2020).
Powder or powder is a powder that is used as a cosmetic to beautify the face or as a skin medicine. Oil is a general term for all organic liquids that do not dissolve in water but dissolve in organic solvents. There is another additional property that the layman knows about: it feels slippery when held. In a narrow sense, the word "oil" usually refers to petroleum or its processed product: kerosene. (KBBI).
The World Health Organization (WHO) said that in 2017 an estimated 29.3% (3.9 million) of newborns had complications. In 2018, approximately 5% (7 million) of 140 babies had complications. Meanwhile, in 2019 it is estimated that 29.4% (3.5 million) of newborns will experience complications. Based on data from the World Health Organization (WHO), it shows that the main causes of infant mortality are asphyxia (32%), LBW (28%), and asphyxia (18%).
Based on the results of the Indonesian Demographic and Health Survey (SDKI), the Infant Mortality Rate (IMR) in Indonesia in 2017 reached 31/1000 KH (live births) when compared to the target in the 4th Millennium Development Goals (MDGs) in 2018, namely 17 / 1000 KH (live birth), in 2019 the IMR in Indonesia is still very high, and the birth rate of BBL in Indonesia ranges from 10-20%. Based on data from the Indonesian Health Demographic Survey (IDHS), the main causes of early neonatal mortality are LBW (35%), asphyxia (33.6%). This figure is sufficient to provide a large enough contribution to the morbidity and mortality of newborns. (IDHS, 2020  Based on research conducted by Finulia Sri Surjati (2013). That the behavior of mothers in umbilical cord care from 30 respondents obtained results, namely 5 respondents (16.7%) had behaviors that understood correct umbilical cord care, 22 respondents (73.3%) were knowledgeable enough, 3 respondents (10% ) knowledgeable less well.
Based on data obtained from several sources above, both from the World Health Organization (WHO), the Indonesian Demographic and Health Survey (SDKI), the South Sulawesi Health Office, the Bone District Health Office, the UPT Puskesmas Ajangale, and the Research Journal it can be concluded that the percentage of babies newborns in every year have increased and the still high infant mortality rate and based on the results of interviews with the Ajangale Health Center Midwife Coordinator, that there are still some residents or residents of Ajangale District who care for their baby's umbilical cord using powder and oil on newborns. As obtained in the science of midwifery, it is very contradictory to the umbilical cord care performed by the Ajangale Community. This study aims to analyze in depth the care of the umbilical cord using powder and oil in newborns in the Ajangale Community Health Center, Bone Regency.

Methods
This research is a qualitative research. Qualitative research. The research site was conducted in the Work Area of the Ajangale Health Center, Bone Regency. The exclusion criteria were eliminating or removing subjects who did not meet the inclusion criteria. The research inclusion criteria included: (1) Parents of newborns who were unwilling to become respondents in Ajangale District, Bone Regency.
(2) Midwives on duty in Ajangale District, Bone Regency who are not willing to be interviewed.
(3) Shaman who is domiciled in Ajangale District, Bone Regency who is not willing to be interviewed. In addition, the researcher was also assisted by an observation guide and interview guide. This was done to sharpen and complete the results of observations, interviews and documentation. Steps in data analysis according to Milles Matthew and Michael Huberman (1992), namely data collection, data reduction, data presentation and conclusions.

Result and Discussion
Based on the results of research on Community Traditions Regarding Umbilical Cord Care Using Powder and Oil on Newborns in the Work Area of the Ajangale Community Health Center, Bone Regency, 2020 which was held on May 4 to September 10, 2020. The population in this study were all post mothers. partum for the period August-September 2020, totaling 10 post partum mothers. The number of samples is 6 respondents.
The type of research used is qualitative research, where data collection is by means of interviews. During the continuation of the interview, the place and environmental conditions have been selected based on the agreement of the researcher and the informant, an agreement is requested for additional interviews if the required informant requires improvement.
Care of the umbilical cord with white powder or viva powder. People have long been familiar with white powder and viva powder, it is very easy to find and is widely sold in markets or stalls that are usually used by people in everyday life such as for facial beauty. Based on the results of an interview with the informant "S", at the age of 35, one of the mothers gave birth in Tonrong Alau Hamlet, Welado Village, on August 24, 2020, which explained that: Furthermore, the results of an interview with Informant "I", age 27, one of the village midwives in the Pompanua Village on September 7, 2020, which explained that: "Today's mothers rarely give anything to the umbilical cord, because it has been conveyed before, but there are still some people who don't practice it because they still really believe in the customs or traditions that they have been passed down from generation to generation from their ancestors to the present".
Based on some of the opinions above, it can be explained that the people of Ajangale District in the care of newborns, especially the tradition of umbilical cord care using powder, are still practiced by several people who are believed to be able to accelerate dryness and detachment of the umbilical cord. Usually the powder used is viva powder.
From a health perspective Powder is a solid / solid vehicle (an inactive / inert substance used in topical preparations as a drug / active substance in contact with the skin) which has a cooling effect, absorbs liquid and reduces friction in the application area (Surber, 2007). Powder or powder is a powder that is used as a cosmetic to beautify the face or as a skin medicine. However, now using or sprinkling powder on the baby's umbilical cord is not recommended because it can cause infection. This is due to the increase in moisture due to absorption by these materials, thus creating ideal conditions for the growth of bacteria. The importance of telling the mother not to give anything to the umbilical cord, it should be left open and not giving anything to keep the umbilical cord dry.
Umbilical cord care using pure coconut oil, the community previously processed coconut into pure coconut oil by means of grated coconut and then milk it into coconut milk which is stored in a frying pan and cooked until the coconut milk actually turns into oil that people usually use in daily life.
Based on the results of an interview with informant "J", at the age of 34, one of the mothers gave birth in Dusun Sepe'e Desa Opo on August 27, 2020, which explained that: Based on some of the opinions above, it can be explained that the people of Ajangale District in the care of newborns, especially the tradition of caring for the umbilical cord using oil, are still practiced by several people who are believed to be able to accelerate dryness and detachment of the umbilical cord. Usually the oil used is virgin coconut oil.
In terms of health, oil is a general term for all organic liquids which are insoluble / mixed in water but soluble in organics. In a narrow sense, the word "oil" usually refers to petroleum or its processed product: kerosene. (KBBI). Pure coconut oil is made from fresh coconut meat. The processes are all carried out at relatively low temperatures. The flesh of the fruit is squeezed with the coconut milk, then this coconut milk is further processed by heating at a relatively low temperature, fermentation, cooling, adding enzymes, mechanical pressure or centrifuge. Research and clinical trials have proven the efficacy and efficacy of virgin coconut oil to cure various diseases such as: hepatitis, chickenpox, urinary tract infections, food poisoning etc. However, it is not recommended to give or rub virgin coconut oil on the umbilical cord because it can cause infection in the umbilical cord.
From several results of interviews with respondents, both main respondents and supporting respondents as well as key respondents in the Ajangale Community Health Center Work Area, the results obtained from the respondents are as follows: (a) There are still some people who use white powder or viva powder which is believed to accelerate dryness and detachment of the umbilical cord. (b) There are still some people who use virgin coconut oil or telon oil which is believed to accelerate the release of the umbilical cord.
People nowadays we rarely encounter using powder to dry the umbilical cord in babies, although there are still some people who use powder and oil for the treatment of the baby's umbilical cord, because mothers who want to give birth are required to go to health services to give birth, that's where we give understanding to mothers regarding good and proper umbilical cord care and it is not recommended to give anything to the baby's umbilical cord.
In the care of the umbilical cord carried out by the Ajangale community, namely conducting treatment using viva powder or powder and virgin coconut oil or telon oil which they think can make the baby's umbilical cord dry and loose quickly, but some people no longer use powder or oil anymore, because of the information obtained from health workers, namely midwives, that using powder or sprinkling anything on the baby's umbilical cord can cause infection of the umbilical cord. The treatment that is usually done by the community is to only clean the umbilical cord from the remains of the blood using boiled water. And there are those who don't sprinkle or put anything on the baby's umbilical cord, they just wait until the baby's umbilical cord is dry and loose.
After the researcher analyzed, in this case it shows that it is rare for people to do their previous habitual habits. People are now starting to trust health workers (i.e. midwives)

Care of the Umbilical Cord with White Powder or Viva Powder
People have long been familiar with white powder and viva powder, it is very easy to find and is widely sold in markets or stalls that are usually used by people in everyday life such as for facial beauty.
The results showed that the people of Ajangale Subdistrict in the care of newborns, especially the tradition of umbilical cord care using powder, were still practiced by several people who were believed to be able to accelerate dryness and the puput of the umbilical cord. Usually the powder used is viva powder.
The use of powder is not recommended in umbilical cord care because it raises pros and cons. This is because the talc content in talcum powder which basically contains asbestos is considered a danger to babies. So in fact, asbestos is a kind of microscopic fiber-shaped mineral that can injure the lungs when inhaled.
The World Health Organization (WHO) found the number of infant deaths of 560,000 / 1000 live births, caused by umbilical cord infection. In Indonesia, the incidence rate of tetanus in urban areas is around 6-7 / 1000 live births, while in rural areas the rate is around 2-3 times higher, namely 11-23 / 1000 live births with the number of deaths of approximately 60,000 babies each year (MOH RI , 2010).

Care of the Umbilical Cord With Oil
Treatment of the umbilical cord using murrni coconut oil, the community previously processed coconut into pure coconut oil by means of grated coconut then milked into coconut milk which is stored in a frying pan and cooked until the coconut milk actually turns into oil that people usually use in life. daily.
The results showed that the people of Ajangale Subdistrict in the care of newborns, especially the tradition of maintaining the umbilical cord using oil, were still practiced by several people who were believed to be able to accelerate dryness and detachment of the umbilical cord.
Usually the oil used is virgin coconut oil.
This was confirmed by health workers that there are still some people who perform umbilical cord care using white powder and oil, which are considered to be able to dry the umbilical cord quickly and the umbilical cord falls off quickly.
Mother's knowledge of umbilical cord care can be influenced by several factors including age, parity and education. From the factor of maternal age, which is 20-35 years, the knowledge tends to be high in knowing umbilical cord care. The education factor of mothers who are only low-educated or have graduated from elementary school (SD) causes mothers to not know umbilical cord care, while mothers with high education tend to know umbilical cord care.
From the parity factor, primiparous mothers usually tend not to know umbilical cord care due to their inexperience in caring for the umbilical cord, while multiparous mothers tend to know umbilical cord care. The level of knowledge of mothers about baby umbilical cord care at BPM H. Sukabumi, West Java, most of the respondents' knowledge about umbilical cord care in this study were mostly with a low level of knowledge, namely 29 people (84.9%), while respondents who had a level of knowledge good only 4 people (12.1%), this indicates that not all post partum mothers have good knowledge about umbilical cord care (Reni et al., 2018).
According to WHO in developing countries every year there are four million babies die in the neonatal period. Reportedly 300,000 babies died from tetanus, and another 460,000 died due to severe infection with umbilical cord infection (omphalitis) as an important predisposition. The umbilical cord infection rate in developing countries varies from 2 per 1000 to 54 per 1000 live births with a case fatality rate of 0-15%. Factors that play a role in the incidence of umbilical cord infection in developing countries include untrained labor and some traditional methods of treating unsterile umbilical cords (WHO, 2009 rarely mothers who do aseptic cord care will have a negative impact, namely the baby will experience tetanus and can cause death. The treatment of the umbilical cord that is currently being developed is with open care. WHO (2007) recommends umbilical cord care based on aseptic and dry principles and alcohol use is no longer recommended. The umbilical cord also should not be tightly covered with anything, as this will cause it to become damp. In addition to slowing down the release of the umbilical cord, it also raises the risk of infection (Taylor et al, 2010).
Infection of the umbilical cord can occur due to several factors. The factors that cause umbilical cord infection in newborns are germs, childbirth, and traditional factors. Umbilical cord care for newborns is by not wrapping the umbilical cord stump or the baby's stomach and not applying any fluids or materials to the umbilical cord stump in an effort to prevent umbilical cord infection from occurring in the baby. (JNPK-KR, 2012).
Efforts to prevent infection of the baby's cord means keeping the wound clean, free of urine, baby feces or soil. The baby's diaper is placed under the umbilical cord. If the umbilical cord is dirty, wash the umbilical cord with clean running water with soap, immediately dry it with dry gauze and wrap it in sterile, dry gauze. It is prohibited to apply or apply ingredients, kitchen ash and so on to the umbilical cord wound, because it will cause infection and tetanus which can lead to neonatal death. Signs of umbilical cord infection to watch out for include reddish skin around the umbilical cord, pus or pus and a foul odor. Monitor and immediately report to the doctor if the umbilical cord is found bleeding, swelling, discharge, looks red / smells bad (Yana & Desmiati, 2020).
There have been many clinical trials to compare how to treat the umbilical cord so that infection does not increase, namely by leaving the umbilical cord wound open and cleaning the wound only with water (Yana & Desmiati, 2020).
Countries with tropical climates need to be aware of the use of alcohol which was once popular and effective for cleaning the umbilical cord because alcohol will actually evaporate young in hot areas and thus its effectiveness will decrease. Likewise with antiseptic powder. So the most effective way is to leave the umbilical cord open, dry out and only clean it daily with clean water. Nurses and midwives need to provide this information to each mother so that infection does not occur due to increased moisture on the baby's skin (Yana & Desmiati, 2020).
Apriyanti's research (2012) The knowledge of postpartum mothers about umbilical cord care is mostly lacking (53, 85%). Most of them are 20-35 years old, mostly primary school education, and most of the respondents are housewives (IRT). This is in accordance with the theory of Wawan and Dewi (2010) that the factors that influence knowledge include age, education, occupation and tradition.
Indriyani (2014) states that the relationship between culture, rituals and health is very closely related, as an example of a simple village community that can survive certain methods of treatment according to their traditions. Culture or traditions can shape habits and responses to health and disease in all societies regardless of level. That is why it is important for health workers not only to promote health, but also to help people understand the process of disease occurring and how to correct beliefs or cultures related to health.According to Hamilton (2014), the baby's umbilical cord is generally bluish in color and 2.5 cm to 5 cm long after being cut.
A cord clamp will be placed to stop bleeding. The cord clamp is removed when the umbilical cord is dry. Babies who have not removed the umbilical cord, can be bathed using warm water and try not to bathe the baby in a soaking position. Before doing treatment on the umbilical cord must wash hands thoroughly. Cleaning the remaining umbilical cord, especially the base, is done carefully if the umbilical cord is still red. The goal of cord care is to prevent and identify bleeding or infection early. Every day should be checked for signs of infection.