Predictors of Exclusive Breast Milk Failure Before Six Months: A Study on Exclusive Breastfeeding in the City of Bogor, West Java, Indonesia

Wahyuni, Sri and Ni Gusti Made Ayu Agung Budi, Ni Gusti Made Ayu Agung Budi and Gurid, PEM and Sri Mulyati, Sri Mulyati and Fauzia, Fauzia (2022) Predictors of Exclusive Breast Milk Failure Before Six Months: A Study on Exclusive Breastfeeding in the City of Bogor, West Java, Indonesia. Journal of Medical Sciences, 10 (B). pp. 197-204. ISSN 1857-9655

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Abstract

Abstract BACKGROUND: Exclusive breastfeeding is the cornerstone of a child’s survival and health because it provides essential and irreplaceable nutrients for their growth and development. The coverage rate for exclusive breastfeeding for infants 0–6 months in West Java in 2017 was 55.4%, below the national figure of 61.33%. AIM: The purpose of this article is to identify the failure factors for exclusive breastfeeding. METHODS: The study began with a quasi-experimental period with a pre- and post-test group design approach through a health education process about exclusive breastfeeding in the third trimester of pregnancy, followed by a prospective study on breastfeeding practice in infants in the first 6 months of life. The analysis used was Chi-square analysis (χ2) and Paired t-test. Then, followed by a qualitative study to explore the supports and barriers to exclusive breastfeeding through in-depth interviews and carried out an analysis with modified Aronso’s qualitative analysis steps. The quantitative study sample is 50 people. The sample for the qualitative study was 15 people consisting of mothers with babies over 6-months-old, midwives, health staff. The study started from March 2017 to September 2018. RESULTS: The knowledge score of the intervention group increased significantly from 26.08 before the intervention to 31.78 after the intervention (p-value 0.000), with 3.52 more excellent than the control group. The attitude score of the intervention group rose significantly from 8.2 before the intervention to 13.16 after the intervention (p-value 0.000), with 3.12 more excellent than the control group. The intervention significantly affected exclusive breastfeeding behavior with a p-value of 0.047, but the behavior of exclusive breastfeeding was still 36%. The qualitative study findings contained support and obstacles in implementing exclusive breastfeeding in the city of Bogor. Supporting factors range from a support system in regional regulations and class programs for pregnant women to support for infrastructure. At the same time, obstacles include parenting patterns, individual factors, other internal and external influences. CONCLUSION: Health education can improve knowledge, attitudes and behavior of exclusive breastfeeding. There are still other predictors of the failure of exclusive breastfeeding before 6 months outside of health education.

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