Abstract
BackgroundDespite the increasing rate of exclusive breastfeeding in Indonesia, there is still a need for supportive interventions. The breastfeeding self-efficacy of mothers is a key factor positively associated with optimum breastfeeding practices. Our analysis aims to assess the determinants of low breastfeeding self-efficacy amongst a sample of women with children aged under 6 months in Malang and Sidoarjo Districts, East Java, Indonesia.MethodsWe used information from 1210 mothers of children aged < 6 months recruited in the BADUTA study conducted in 2015–2016 in Malang and Sidoarjo Districts. The outcome variable in this analysis was mothers’ self-efficacy for breastfeeding using the 14 statements in the Breastfeeding Self-Efficacy-Short Form. We evaluated 17 potential predictors of breastfeeding self-efficacy, organized into six sub-groups of variables: (1) context/demographic; (2) household factors; (3) maternal characteristics; (4) child characteristics; (5) breastfeeding practices; and (6) antenatal and delivery care. Logistic regression analyses were employed to examine factors associated with mothers’ self-efficacy with breastfeeding.ResultsMore than half of the women in this study had a low level of self-efficacy. One of the factors associated with low breastfeeding self-efficacy found in this study was mothers’ problems related to breastfeeding. Mothers who had problems with breastfeeding not related to illness (adjusted odds ratio [aOR] 3.27; 95% CI 2.45, 4.36) or problems related to both illness and non-illness conditions (aOR 3.57; 95% CI 1.37, 9.33) had higher odds of low breastfeeding self-efficacy than those who did not have any problems. Compared to mothers who completed university education, there was a significantly higher odds of low breastfeeding self-efficacy in mothers who completed primary school or lower (aOR 1.88; 95% CI 1.16, 3.05); completed junior high school (aOR 2.27; 95% CI 1.42, 3.63); and completed senior high school (aOR 1.94; 95% CI 1.29, 2.91). Other significant predictors of low breastfeeding self-efficacy were mothers not exposed to any breastfeeding interventions (aOR 1.87; 95% CI 1.09, 3.22); working outside the house (aOR 1.69; 95% CI 1.23, 2.32); not obtaining any advice on breastfeeding (aOR 1.40; 95% CI 1.08, 1.82); with low knowledge of breastfeeding (aOR 1.38; 95% CI 1.03, 1.84); and delivered by Caesarean section (aOR 1.34; 95% CI 1.05, 1.70).ConclusionsMultipronged breastfeeding education programs and support are required to improve women’s self-efficacy with breastfeeding. Improved access to breastfeeding counselors, active support for mothers following cesarean delivery, and increased supporting facilities at workplaces are essential to improve self-efficacy with breastfeeding.
Highlights
Despite the increasing rate of exclusive breastfeeding in Indonesia, there is still a need for supportive interventions
In Indonesia, the rate of exclusive breastfeeding is increasing, and contributing to this change is the Decree of the Minister of Health of the Republic of Indonesia No.450/ MENKES/SK/IV/2004 concerning exclusive breastfeeding for infants, which contains the ten steps towards successful breastfeeding [9]
Almost 31% of mothers had problems with breastfeeding: 16.9% of mothers had problems not related to illness; 11.3% had problems related to illness or anatomical condition, and 2.5% had both types of problems
Summary
Despite the increasing rate of exclusive breastfeeding in Indonesia, there is still a need for supportive interventions. Our analysis aims to assess the determinants of low breastfeeding self-efficacy amongst a sample of women with children aged under 6 months in Malang and Sidoarjo Districts, East Java, Indonesia. Exclusive breastfeeding is strongly recommended in their first 6 months of life to provide the ideal nutrition for optimal growth and development [2, 3]. After this period, infants should continue to receive breast milk and appropriate complementary feeding until reaching at least 2 years of age [4]. Malang District, located in the center-south region of East Java Province, has an estimated total population in 2017 of 2,576,596 people [23]. Sidoarjo District, located north of Surabaya City, has an estimated total population in 2017 of 2,207,600 people [24]
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