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Less than half of Indonesian mothers follow the World Health Organization recommendation to provide exclusive breastfeeding practice. Exclusive breastfeeding is associated with reducing an infant’s risk of communicable and non-communicable diseases. Little is known about factors related to exclusive breastfeeding in Indonesia. This study examined the factors that predict exclusive breastfeeding in Indonesia by applying secondary analysis of data from the Indonesian Demographic Health Survey 2012, after relevant permission was given. The participants were women aged 15-49 years old, and the survey was implemented using multi-stage cluster random sampling. The sample of 1508 respondents was comprised of women who gave birth over the previous two years, were currently breastfeeding, and their baby was aged 0-5 months and living with mother. The IDHS survey provided three kinds of questionnaires: one for households, one for men, and one for women. The women’s questionnaire included questions about demographic characteristics, their reproductive history, pregnancy, antenatal and postnatal care, as well as immunization and nutrition. The data were analyzed using descriptive statistics and multiple logistic regression analysis.
The results revealed that only 40% of mothers breastfed exclusively. The multivariate logistic regression analysis indicated that three of ten factors could significantly predict exclusive breastfeeding, namely occupation, region and initiation of breastfeeding. This study has strong implications for health policy makers, and health professionals. Nurses should work with health systems and community to improve exclusive breastfeeding practice by increasing early breastfeeding initiation within an hour of delivery, and helping to sustain breastfeeding for at least six months. This can be done through health promotion and education by health workers. Health promotion activities should include the benefits of exclusive breastfeeding, and education on suitable nutrition during pregnancy and postpartum.
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2. Sonko A, Worku A. Prevalence and predictors of exclusive breastfeeding for the first six months of life among women in Halaba special woreda, Southern Nations, Nationalities and Peoples’ Region/SNNPR/, Ethiopia: a community based cross-sectional study. Archives of Public Health. 2015;73(1):53.
3. Neovita Study Group. Timing of initiation, patterns of breastfeeding, and infant survival: Prospective analysis of pooled data from three randomised trials. The Lancet Global Health. 2017;4(4):e266-e75.
4. Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. The Lancet. 2008;371(9608):243-260.
5. Victora CG, Bahl, R., Barros, A. D., Franca, G. A., Horton, S., Krasevec, J., & ... Rollins, N.C. . Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect Lancet. 2016;387(17):475-90.
6. Champeny M. Breastfeeding: a powerful tool to promote health equity [Internet]. New York City: Helen Keller International; 2017 [cited 2017 Jun 06].Available from: https://archnutrition.org/breastfeeding-health-equity/.
7. World Health Organization. Exclusive breastfeeding to reduce the risk of childhood overweight and obesity [Internet]. Swiss. 2014. [cited 2017 Jan 10]. Available from: https://www.who.int/elena/bbc/breastfeeding_ childhood_obesity/en/.
8. McIsaac KE, Moineddin R, Matheson FI. Breastfeeding as a means to prevent infant morbidity and mortality in Aboriginal Canadians: A population prevented fraction analysis. 2015;106(4): e217-22..
9. Al-Darweesh F, Al-Hendyani R, Al-Shatti K, Abdullah A, Taqi M, Abbas A, et al. Knowledge, intention, practice, and perceived barriers of breastfeeding among married working women in Kuwait. Int J Community Fam Med. 2016;1(108):1-6.
10. Government of United Kingdom. New survey of mums reveals perceived barriers to breastfeeding [Internet]. UK: Public Health England - Gov. UK; 2017 [cited 2017 Feb 12]. Available from: https://www.gov.uk/government/ news/new-survey-of-mums-reveals-perceived-barriersto-breastfeeding
11. World Health Organization: Indonesia’s breastfeeding challenge is echoed the world over [Internet]. Bulletin of the World Health Organization. 2014 [cited 2016 Sep 1]; Available from: https://www.who.int/bulletin/volumes/ 92/4/14-020414/en/.
12. National Statistic Office (BPS), Familty Planning Board (BKKBN), Ministry of Health, ICF International. Indonesia Demographic and Health Survey 2012. Jakarta, Indonesia: BPS, BKKBN, Kemenkes, and ICF International, 2013.
13. Barwick M, Barac R, Zlotkin S. Evaluation of effective implementation of exclusive breastfeeding in Ethiopia and Mali using the consolidated framework for implementation research. The Hospital for Sick Children Report [Internet]. 2015 [cited 2016 Jul 27]. Available from: https://www. can-mnch.ca/wp-content/uploads/2015/05/EBFResearch-Report-FINAL-July-29-2015.pdf
14. Rollins NC, Bhandari, N., Hajeebhoy, N., Horton, S., Lutter, C. K., Martines, J. C., & Victora, C. G. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387(10017): 491-504.
15. Jamali A, Ahmad F, S. Nikhil Gupta, Gupta N, Gupta S. breast feeding-a boon or bane for newborns. Indian Journal of Trauma and Emergency Pediatrics [Internet]. 2016 [cited 2016 Des 2];8(2):141-143. Available from: https://dx.doi.org/10.21088/ijtep.2348.9987.8216.17.
16. Danso J. Examining the practice of exclusive breastfeeding among professional working mothers in Kumasi metropolis of Ghana. International Journal of Nursing. 2014;1(1):11-24.
17. Lenggogeni P. Examining exclusive breastfeeding practice in Indonesia, and its association to maternal socio demographic determinants, to inform intervention efforts aimed at reducing infant mortality. [Master's thesis]. [Georgia]: Georgia State University; 2016:67p.
18. World Health Organization, UNICEF, IBFAN. Marketing of breast-milk substitutes: national implementation of the international code. WHO, 2016.
19. Leininger M. Culture care theory, research, and practice. Nursing Science Quarterly. 1996;9(2):71-8.
20. Jaafar SH, Ho JJ, Jahanfar S, Angolkar M. Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev. 2016 30(8):CD007202.
21. Alzaheb RA. Factors associated with the initiation of breastfeeding within the first 48 hours of life in Tabuk, Saudi Arabia. Int Breastfeed J. 2016 Jul 21:2838–45.
22. Berhanu M, Zemene W, Mekonnen M. Prevalence and associated factors of nonexclusive breastfeeding to infants within the first 6 months in Gondar Town, Northwest Ethiopia, 2014. Advances in Nursing [Internet]. 2015 [cited 2016 Jul 4];2015-7. Available from: https:// dx.doi.org/10.1155/2015/142319.
23. Mohamed S, Zaki NA-E, Thabe AM. Barriers of Initiation and exclusive breast feeding among infants. IOSR Journal of Nursing and Health Science. 2016;5(2):01-10.
24. Dun-Dery EJ, Laar AK. Exclusive breastfeeding among city-dwelling professional working mothers in Ghana. International Breastfeeding Journal. 2016;11(1):23.
25. Logan C, Zittel T, Striebel S, Reister F, Brenner H, Rothenbacher D, et al. Changing societal and lifestyle factors and breastfeeding patterns over time. Pediatrics. 2016;137(5):e20154473.
26. David Napier CA, Beverley B, Joseph C, Angel C, Helen C, François G, et al. Culture and health. Lancet. 2014; 384(9954):1607–39.
27. Rollins NC. Why invest, and what it will take to improve breastfeeding practices?. Lancet. 2016;387(10017): 491–504.
28. WHO. Global strategy for infant and young child feeding. Geneva: World Health Organization, 2003.
29. Kimani-Murage EW, Schofield L, Wekesah F, Mohamed S, Mberu B, Ettarh R, et al. Vulnerability to food insecurity in urban slums: experiences from Nairobi, Kenya. Journal of Urban Health : Bulletin of the New York Academy of Medicine. 2014;91(6):1098-113.
30. Beguy D, Ndugwa R, Kabiru CW. Entry into motherhood among adolescent girls in two informal settlements in Nairobi, Kenya. J Biosoc Sci. 2013;45(6):721–42.
31. Kenya National Bureau of Statistics, M.o.H., National AIDS Control Council, Kenya Medical Research Institute, National Council for Population and Development. Kenya Demographic and Health Survey: Key Indicators Report-2014. Nairobi, Kenya: Kenya National Bureau of Statistics, 2015.
32. Legesse M. Prelacteal feeding practices and associated factors among mothers of children aged less than 24 months in Raya Kobo district, North Eastern Ethiopia: a crosssectional study. Int Breastfeed J. 2014;9(1):1–8.
33. Kimani-Murage EW, Wekesah F, Wanjohi M, Kyobutungi C, Ezeh AC, Musoke RN, et al. Factors affecting actualisation of the WHO breastfeeding recommendations in urban poor settings in Kenya. Matern Child Nutr. 2015;11:314–32.
34. Rukmini, Fatmawati E, Trisnanto Y. Breastfeeding in the traditional frame on Dayak Ethnic Meratus and Banjar. Angkasawati TJ, editor. Yogyakarta: PT. Kanisius; 2016. (in Bahasa Indonesian)
35. Gardner H, Kent JC, Lai CT, Mitoulas LR, Cregan MD, Hartmann PE, et al. Milk ejection patterns: an intra- individual comparison of breastfeeding and pumping. BMC Pregnancy and Childbirth. 2015;15(1):156.
36. Dhippayom T, Kongkaew C, Chaiyakunapruk N, Dilokthornsakul P, Sruamsiri R, Saokaew S, et al. Clinical effects of thai herbal compress: A systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine [Internet]. 2015 [cited 2016 Des 15]. 2015:1-14. Available from: https://doi.org/10. 1155/2015/942378.
37. Paritakul P, Ruangrongmorakot K, Laosooksathit W, Suksamarnwong M, Puapornpong P. The effect of ginger on breast milk volume in the early postpartum period: A randomized, double-blind controlled trial. Breastfeed Med [internet]. 2016 [cited 2016 Des 15] ;11:361-65. Available from: https://doi.org/10.1089/bfm.2016.0073.