The Effectiveness of Small Frequent Feedings on the Frequency of Nausea and Vomiting in Pregnant Women with Hyperemesis Gravidarum at the Vina Primary Care Clinic in Medan / Efektivitas Small Frequent Feedings terhadap Frekuensi Mual dan Muntah pada Ibu Hamil dengan Hiperemesis Gravidarum di Klinik Pratama Vina, Kota Medan

Background: Small frequent feedings (SFF) is a dietary approach intended to improve food tolerance in pregnant women experiencing nausea and vomiting. Objective: To assess changes in symptom severity following SFF at Vina Primary Care Clinic, Medan. Methods: A single-group pretest–posttest study included 36 pregnant women with a clinical diagnosis of hyperemesis gravidarum. The protocol prescribed six to eight small meals daily, supported by food diaries and WhatsApp monitoring. Symptoms were assessed on days 1 and 3 using the 24-hour Pregnancy-Unique Quantification of Emesis and Nausea (PUQE-24) scale. Paired scores were compared using the Wilcoxon signed-rank test. Results: Mean PUQE-24 scores decreased from 9.28 ± 3.248 to 6.83 ± 3.140, with a mean paired reduction of 2.44 points (Z = −5.103; p < 0.001; r = 0.85). Median scores decreased from 9.0 to 6.0. The proportion with mild symptoms increased from 25.00% to 61.11%, while the proportion with severe symptoms decreased from 22.22% to 8.33%. Scores decreased in 34 participants, remained unchanged in one, and increased by one point in one. Twenty participants (55.56%) met the reported adherence threshold. Conclusion: SFF accompanied by education and monitoring was associated with lower PUQE-24 scores during short-term observation. The uncontrolled design precludes causal attribution; controlled studies are needed before its specific effectiveness can be established.

Latar belakang: Small frequent feedings (SFF) merupakan pengaturan makan dalam porsi kecil dan frekuensi sering untuk membantu toleransi asupan pada ibu hamil yang mengalami mual dan muntah. Tujuan: Menilai perubahan keparahan gejala setelah penerapan SFF di Klinik Pratama Vina, Medan. Metode: Penelitian satu kelompok dengan pengukuran sebelum–sesudah melibatkan 36 ibu hamil dengan diagnosis klinis hiperemesis gravidarum. Protokol mencakup enam hingga delapan kali makan dalam porsi kecil setiap hari, disertai catatan makan dan pemantauan melalui WhatsApp. Gejala dinilai pada hari pertama dan ketiga menggunakan Pregnancy-Unique Quantification of Emesis and Nausea 24 jam (PUQE-24). Perbedaan skor berpasangan dianalisis dengan uji Wilcoxon. Hasil: Rerata skor PUQE-24 menurun dari 9,28 ± 3,248 menjadi 6,83 ± 3,140, dengan penurunan rerata berpasangan sebesar 2,44 poin (Z = −5,103; p < 0,001; r = 0,85). Median skor menurun dari 9,0 menjadi 6,0. Proporsi gejala ringan meningkat dari 25,00% menjadi 61,11%, sedangkan gejala berat menurun dari 22,22% menjadi 8,33%. Skor menurun pada 34 responden, tetap pada satu responden, dan meningkat satu poin pada satu responden. Sebanyak 20 responden (55,56%) memenuhi ambang kepatuhan yang dilaporkan. Kesimpulan: Penerapan SFF yang disertai edukasi dan pemantauan berkaitan dengan penurunan skor PUQE-24 selama pengamatan singkat. Tanpa kelompok kontrol, perubahan tersebut belum dapat diatribusikan secara kausal kepada SFF; efektivitas spesifiknya memerlukan pengujian terkontrol.