Abstract
Introduction: Exclusive breastfeeding plays an important role in preventing morbidity and mortality in infants and young children. However, exclusive breastfeeding coverage remains low, especially among working mothers. This study aimed to examine the relationship between early initiation of breastfeeding and prevalence of exclusive breastfeeding among working mothers in Bantul District, Yogyakarta Special Region, Indonesia. 
 Methods: This study used a cross-sectional design. The population were all women in reproductive age who worked in middle and large companies. Samples included mothers whose infants were aged six to 12 months and were selected by probability proportional to size sampling technique. Main outcome was exclusive breastfeeding, while the independent variable was the early initiation of breastfeeding. Statistical analysis were descriptive statistics test, chi-square test, and multiple logistic regression at the level of significance of 0.05.
 Results: Exclusive breastfeeding coverage was around 22%, whilst the early initiation of breastfeeding coverage was 10%. Early initiation of breastfeeding was associated with exclusive breastfeeding practice (adjusted OR = 2.93; 95% CI: 1.04 - 8.28). Variables that were not significantly related to exclusive breastfeeding included being a first-time mother, maternal age, maternal educational level, breastfeeding counselling during antenatal visits, and delivery methods.
 Conclusions: Early initiation of breastfeeding is associated with higher prevalence of exclusive breastfeeding among working mothers. To increase exclusive breastfeeding coverage, particularly among employed women, it is highly recommended to enhance early initiation of breastfeeding program.
Highlights
Exclusive breastfeeding plays an important role in preventing morbidity and mortality in infants and young children
This study was a part of a larger study titled “Factors associated with exclusive breastfeeding among employed mothers in companies in Bantul District” with one of its findings published elsewhere.[16]
Mothers who initiated breastfeeding earlier were three times more likely to be successful in exclusive breastfeeding (COR = 3.17; 95% CI = 1.09 - 9.24)
Summary
Exclusive breastfeeding plays an important role in preventing morbidity and mortality in infants and young children. Exclusive breastfeeding coverage remains low, especially among working mothers. In order to reduce infant mortality and morbidity, UNICEF and WHO recommend providing exclusive breast feeding during the first six months of life and continued breastfeeding up to two years of age.[2] Exclusive breastfeeding is defined as providing only breast milk without additional food or liquid, including water. Various earlier studies in Indonesia have reported variable exclusive breastfeeding proportions in different regions.[5,6] One of the national efforts to improve exclusive breastfeeding coverage is through early initiation of breastfeeding program.[7] Early initiation of breastfeeding means breastfeeding within the first hour of birth.[8] In Indonesia, early initiation of breastfeeding remained low, ranging from 13 to 40%.9,10
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