CARE OF NEW BORN INFANTS ACCORDING TO THE CULTURAL PERSPECTIVE OF THE BATAK TOBA TRIBE IN HUTA BAYU RAJA DISTRICT

Newborn (neonatal) is the first 28 days of human life. At this time there is a process of adjusting the baby's body system from intra-uterine life to extra-uterine life. This is the period that needs extra attention and care because this is the period when the mortality rate is the highest. The culture of the Toba Batak tribe has certain traditions that have been applied from generation to generation until now in terms of caring for newborns. This study uses a qualitative phenomenological design which aims to find out and dig deeper about newborn care according to the cultural perspective of the Toba Batak tribe in Huta Bayu Raja District, Simalungun Regency. Data collection was carried out from January 10 2014 to March 28 2014 using purposive sampling with a sample of five participants. The data collection process was carried out by in-depth interviews using a tape recorder. The results showed that care for newborns according to the Toba Batak cultural perspective consisted of organ care, umbilical cord care, hygiene and skin care, gastrointestinal care, maintaining temperature and warming the baby's body, fulfillment of nutrition, giving immunity, and other special care, namely marempas, maresek-esek and giving small amounts (blessings). The results of this study are expected to be used as knowledge and information material for nurses in getting to know the culture of the Toba Batak tribe and planning comprehensive nursing care related to newborn care. This culture must also be filtered because there is a culture that has a negative impact on the health of the baby, and it is necessary to provide counseling related to the care of newborns.

Some communities run different strategies in dealing with various health problems including caring for their babies. Through all of their cultural potential, people develop health behaviors that are considered capable of overcoming various health problems they face in their environment (Swasono, 1998).
Knowledge of cultural aspects is important for health workers to know in order to make it easier to approach and provide health services, because not all treatments based on ancestral heritage can be fully accepted, it is possible that these treatments will have an unfavorable health impact for mother and baby. This of course requires special attention to overcome it (Swasono, 1998).
The culture of the Toba Batak tribe has its own culture in living life. All behaviors are influenced by culture that has been passed down from generation to generation. In dealing with health problems, the Toba Batak tribe uses many cultural practices, as well as newborn care. The culture of the Toba Batak tribe has certain traditions that have been applied from generation to generation until now (BPS Sumut, 2010).
According to the culture of the Toba Batak tribe, the teachings of the ancestors must be maintained and good to follow because of the many benefits. It is these things that encourage researchers to conduct research on newborn care according to the culture of the Toba Batak tribe in the Huta Bayu Raja area.

1.1.Research question
The research question is how to care for newborns according to the cultural perspective of the Toba Batak tribe in Huta Bayu Raja District, Simalungun Regency?

2.RESEARCH METHOD 2.1.Research design
The research design used is qualitative research with a phenomenological approach. Qualitative research is research that intends to understand phenomena about the things experienced by research subjects, for example behavior, perceptions, motivations, or actions that are seen as a whole and by means of descriptions in the form of words and language in special natural contexts using various natural methods ( Moleong, 2005). The purpose of qualitative research is to understand phenomena through a holistic picture and increase in-depth understanding (Moleong, 2005).

2.2.Population
The population in this study were all Toba Batak mothers who had given birth who lived in Huta Bayu Raja District, Simalungun Regency.

2.3.Sample
The sample in this study is referred to as the participant. Sampling was carried out by purposive sampling, which in this case met the sample criteria and according to research needs. The criteria for the sample taken were that the original Toba Batak tribe, had given birth, stated that they were still practicing BBL care based on the Toba Batak tradition, and were willing to be interviewed or become participants.

2.4.Location and time of Research
The research was conducted in Huta Bayu Raja District, Simalungun Regency. This research was conducted from January 10 2014 to March 28 2014.

2.5.Data analysis
Data analysis was carried out at the same time as the first data transcript. The analytical method used is the fixed comparison method. In this method data are compared with one another regularly, as well as other categories. In general, the data analysis process includes data reduction, categorization, synthesis, and developing working hypotheses.

3.RESULTS AND DISCUSSION
Newborns go through various biological changes during the first hours and days after birth. Although most babies can make the adjustments needed to live outside the womb without much difficulty, their health depends on the care they receive (Bobak, 2005). Newborn care carried out by the Toba Batak tribe in this study included care for the baby's organs, care for the umbilical cord, care for hygiene and skin, care for the gastrointestinal tract, warming the baby's body, fulfillment of nutrition, provision of immunity, and other special care.

3.1.Organ Treatment
Every organ of the baby's body must be treated to maintain the baby's health and prevent the onset of a disease. Based on interviews with the five participants, every organ of the baby's body is important to treat. Caring for the organs of the body consists of caring for the head, nose, ears, mouth, hands, nails and feet.

3.2.Head Care
The head treatment is started by shaping the head using a pillow called sigundal bolon or a cloth filled with rice. The pillow aims to make a good woman's head wear a bun (bun) and shape the head so it doesn't tilt. The baby's head is also sprayed with hazelnut, betel and pepper to protect the baby's fontanel and baby's fontanel.
A newborn's head may appear unbalanced and oval like a melon due to pressure in the birth canal. Big head looks disproportionate to the body. The clay membrane covers the two nonscapular points called fontanels, which are the bones of the skull that have not yet fused.

3.3.Nose and Ear Care
Baby care can also be done on the baby's nose and ears. Nose and ears can be formed with dipohol (massage with warm palms). This works so that the baby's nose becomes sharp and good at wearing earrings. Natural touch to the baby actually means the act of massaging or massaging. If this action is done regularly and in accordance with the procedures and techniques for baby massage, then it can be a therapy to get many benefits for the baby.
According to Rene Spitz (2005) babies who get a lot of touch rarely experience symptoms of hospitalimus (disturbances such as inflammation of the middle ear, measles, and intestinal disorders). Massaging the baby can also be squeezed. According to Ahr, squeezing is efficacious in determining muscle flexibility which is located in the muscle tissue spindles. In other words, squeezing can make the baby's muscles stronger, as well as improve blood circulation. The squeezing technique is done on the legs or arms compacted using the inner side of the hand and a slight squeezing motion.

3.4.Oral Care
A baby's mouth, like the rest of his body, should always be cleaned, even though his teeth haven't grown yet. In the baby's mouth, whitish spots are usually found, which are traces of mother's milk (ASI). To prevent this, according to the Toba Batak tribe, the baby's mouth is cleaned with the mother's hair or chicken feathers by wiping it over the baby's mouth until it is clean. Before carrying out the action, the mother's hair or chicken feathers must be ensured that they are clean.
According to Ladewig, et al (2006) white spots on the mucous membranes that look like a buildup of milk and this could indicate a fungus (Candida albicans). To prevent this from happening, you have to clean the baby's mouth. If the baby's mouth is always clean, the baby will feel comfortable so that the baby's oral health is maintained.

3.5.Hand and Foot Care
The results of the study stated that the hands and feet were swaddled using cloth so that the baby could not move around. This way of swaddling can make the hands skilled at dancing and the feet avoiding feet O. The arms and legs are also tied up so that the baby is good at climbing/tapping sap (maragar). Umbilical cord care aims to prevent and identify bleeding or infection early. If there is bleeding from the umbilical cord blood vessels, then the condition of the ties must be checked (Bobak, 2005).

CARE OF NEW BORN INFANTS ACCORDING TO THE CULTURAL PERSPECTIVE OF THE BATAK TOBA TRIBE IN HUTA BAYU RAJA DISTRICT
Based on the interview, the baby's umbilical cord was cut using a bamboo base with cassava/turmeric and tied with thread, either ordinary thread or Manalu thread. In China and Japan, a bamboo knife is also used to cut the umbilical cord at birth.
Bamboo has parts, namely the base, nodes, middle, and ends. At the base and the book has a higher starch content than the middle or tip. In addition to starch, bamboo is a cellulose-based material which is prone to fungal attack. Bamboo is also in contact with the ground. Even though soil is one of the growing media for mold and staining fungi (Duryatmo, 2000).

3.7.Hygiene Care and Skin Care
Hygiene care starts with bathing the baby and keeping the baby clean. Babies should be bathed at least six hours after birth and before bathing, it must be ensured that the body temperature is stable (axillary temperature 36.50C-37.50C). If the baby's body temperature is below normal, bathing the baby is postponed (Rukiyah, 2010). On the other hand, according to the Toba Batak tribe, after a baby is born, they must be washed immediately because babies are considered dirty.
According to the Toba Batak tribe, babies are bathed in warm water with a mixture of candlenut, Sona leaves or Leung leaves. As explained hazelnut has a natural content that is very beneficial, especially for the skin. Candlenut contains protein and unsaturated fat. Pecans also contain vitamin B6 and thiamin. In addition, hazelnuts are rich in vitamin E, dietary fiber, minerals and phenolic antioxidants. One cup of hazelnut flour (237ml) has 20 grams of carbohydrates and 12 grams of fiber. Candlenut is also used as a toner and is proven to be effective in tightening the skin. In fact, it can help regenerate cells and strengthen capillaries

3.8.Gastrointestinal Treatment
Full-term newborns are able to swallow, digest, metabolize, and absorb proteins and simple carbohydrates, and emulsify fats. Characteristics of enzymes and digestive juices have been found in newborns. The newborn's ability to digest carbohydrates, fats and proteins is regulated by certain enzymes. Most of these enzymes are functioning when the baby is born, except for the enzyme amylase, which is produced by the salivary glands after three months and by the pancreas at around six months of age (Bobak, 2005).

3.9.Warms the Baby's Body
Warming the baby's body in Toba Batak culture can be done by martataring (fireplace) with the baby in the mandarbagashon (put in the mother's sarong) and followed by mamoholi (massaging the baby with warm hands). Fire is the main capital for newborns and is used to mamoholi babies so that the baby's body is healthier, stronger and protected from disease and colds. Mamoholi can also function to shape the baby's body parts so that they are more ideal, for example the nose, ears, feet, hands, and so on. Fire is used to keep the baby warm so that the baby will feel comfortable and not cold so that the baby can sleep soundly. Fire is also used to ward off winds that can cause death to babies in special rituals. The mechanism for regulating the temperature of newborns does not function perfectly, therefore if heat loss is not prevented, the baby will experience hypothermia (Rukiyah, 2010). Infants with hypothermia are at high risk of experiencing severe pain or even death. Hypothermia very easily occurs in babies whose bodies are wet or are not immediately dried and covered even though they are in a warm room (JNPK-KR, 2007in Rukiyah, 2010.

3.10.Nutrition Fulfillment
The main nutrition for babies is Mother's Milk (ASI) because it contains almost all the nutrients with a composition according to the baby's needs but the composition is sufficient only until the age of four months (The Children Indonesia, 2009). Breast milk is the main food choice for babies. Breastfeeding provides many benefits: nutritional, immunological, and psychological (Bobak, 2005). The principle of breastfeeding is as early as possible and exclusive. Newborns must receive breast milk within one hour after birth (Rukiyah, 2010).

3.11.Granting Immunity
Newborns must immediately get immunized because the body's immune system is not yet adequate. The immune system is a system in the body consisting of cells and the products of the substances they produce, which work together collectively and in a coordinated way to fight foreign bodies such as disease germs or their poisons that enter the body. Immunization is an action to provide protection (immunity) in the body of infants and children so that they are protected and protected from infectious and dangerous diseases for infants and children (Anwar in Rukiyah, 2010).

4.CONCLUSION
Based on the results of the study, it can be concluded that care for newborns according to the cultural perspective of the Toba Batak tribe in Huta Bayu Raja District, Simalungun Regency, namely: 1. Caring for the organs of the body, which includes the head, nose, ears, mouth, hands, nails, hands and feet. 2. Treatment of the umbilical cord is cutting the umbilical cord with bamboo (sambilu) ground sweet potato/turmeric and the medicine is the ashes left over from burning black cloth. Improper care of the umbilical cord can cause infection and slow down the discharge of the umbilical cord. 3. Hygiene and skin care starts with bathing and grooming baby hygiene and spray hazelnut all over the skin. 4. Treatment of the gastrointestinal tract is by giving hazelnut which has been crushed by the mother to the baby so that the bowel movements run smoothly. 5. Warming the baby's body, namely martataring (fireplace) and dimandarbagashon (putting it in the mother's sarong). This concept is almost the same as the kangaroo method, where it is very beneficial for babies, but the use of fire is bad for babies. 6. Fulfillment of nutrition is by providing breast milk and additional food. Breast milk was given from the first time the milk came out and never wasted milk, this shows that colostrum was given, but did not do IMD because breastfeeding was not given immediately after birth. Babies are not given exclusive breastfeeding because of the provision of additional food, namely giving candlenuts, starch water, and rice porridge before the baby is six months old. The baby's nutrition also depends on the food consumed by the mother, so the mother consumes palm wine and dark beer. 7. Providing immunity, namely by giving necklaces or bracelets made of jerango and spraying the baby's body with jerango so that the baby avoids disease and colds. This shows that immunization is not given to babies, because they only give necklaces or bracelets as baby guards.