FACTORS ASSOCIATED WITH EXCLUSIVE BREASTFEEDING IN INDONESIA: A QUALITATIVE STUDY AMONG WORKING MOTHERS

Authors

  • Ahmad Syafiq Centre for Nutrition and Health Studies, Faculty of Public Health Universitas Indonesia
  • Selma Avianty Centre for Nutrition and Health Studies, Faculty of Public Health Universitas Indonesia; Universitas Kusuma Husada, Surakarta, Central Java
  • Sandra Fikawati Centre for Nutrition and Health Studies, Faculty of Public Health Universitas Indonesia
  • Andrew Prasettya Japri Centre for Nutrition and Health Studies, Faculty of Public Health Universitas Indonesia; University of Melbourne, Victoria 3010, Australia
  • Seala Septiani Centre for Nutrition and Health Studies, Faculty of Public Health Universitas Indonesia; Nutrition Department, Yarsi Pratama University
  • Ray Wagiu Basrowi Indonesia Health Development Center, Jakarta, Indonesia; Department of Occupational Medicine, Faculty of Medicine, Universitas Indonesia

DOI:

https://doi.org/10.63953/jisn.v3i1.40

Keywords:

Exclusive breastfeeding, breast milk, working mother, Indonesia

Abstract

Exclusive breastfeeding (EBF) is a globally recommended practice, yet its proportion remains low in Indonesia, particularly among working mothers. Various factors, including workplace policies, socioeconomic status, and family support, influence EBF success. This study aims to explore the supporting and inhibiting factors of EBF among working mothers in urban and semi-urban areas in Indonesia. A qualitative study was conducted through in-depth interviews to 14 working mothers with children aged 6–24 months in Jakarta (urban) and Beji-Depok (semi-urban) between October 2016 and January 2017. Participants were selected using purposive and snowball sampling, considering variations in breastfeeding status, occupation, and dwelling location. Data were analyzed through thematic content analysis with expert triangulation. Key factors influencing EBF included postpartum health, maternity leave policies, socioeconomic conditions, family and external support, and access to EBF-related information. White-collar mothers faced workplace-related barriers but benefited from strong internal and external support. Blue-collar mothers, constrained by economic factors, showed higher EBF adherence due to lacked comprehensive EBF knowledge. Health worker
recommendations influenced breastfeeding decisions. Enhancing workplace support, strengthening family engagement, and improving targeted education for working mothers are crucial to increasing EBF adherence. Further research involving healthcare providers is recommended.

References

World Health Organization. The optimal duration of exclusive breastfeeding [Internet]. Geneva; 2001. Available from: https://iris.who.int/bitstream/handle/10665/67219/WHO_NHD_01.09.pdf?sequence=1

Erick M. Nutrition in pregnancy and lactation [Internet]. 13th ed. Mahan LK, Escott-Stump S, Raymond JL, editors. Missouri: Elsevier; 2012. Available from: https://www.researchgate.net/publication/284312442_Nutrition_in_pregnancy_and_lactation

WHO, UNICEF, USAID, UC Davis. Indicators for assessing infant and young child feeding practices [Internet]. 2008. Available from:

https://www.who.int/publications/i/item/9789240018389

UNICEF, WHO, UNESCO, UNFPA, UNDP, UNAIDS, et al. Facts for life [Internet]. 4th ed. UNICEF; 2010. Available from: https://resourcecentre.savethechildren.net/document/facts-life-fourth-edition

Syahri IM, Laksono AD, Fitria M, Rohmah N, Masruroh M, Ipa M. Exclusive breastfeeding among Indonesian working mothers: does early initiation of breastfeeding matter? BMC Public Health. 2024;24(1):1225. doi: 10.1186/s12889-024-18619-2.

Badan Pusat Statistik, BKKBN, Departemen Kesehatan. Survei Demografi dan Kesehatan Indonesia 2007 [Internet]. Jakarta; 2007. Available from:https://indonesiasehat1.wordpress.com/wp-content/uploads/2016/06/sdki2007.pdf

Badan Pusat Statistik. Tingkat Pengangguran Terbuka (TPT) dan Tingkat Partisipasi Angkatan Kerja (TPAK) Menurut Provinsi, 2015-2016 [Internet]. 2016. Available from:https://bekasikab.bps.go.id/id/statistics-table/1/MjQ4OCMx/tingkat-pengangguran-terbuka--tpt--dan-tingkat-partisipasi--angkatan-kerja--tpak--menurut-provinsi--2015-2016.html

Fikawati S, Syafiq A, Purbaningrum RP, Karima K. Energy consumption of lactating mothers: current situation and problems. Makara Journal of Health Research. 2014;18(2):2. doi: 10.7454/msk.v18i2.4068

Fikawati S, Syafiq A. Causes of success and failure of exclusive breastfeeding practices. Kesmas: Journal of National Public Health4 (3). 2009. doi: 10.21109/kesmas.v4i3.184.

Februhartanty J, Wibowo Y, Fahmida U, Roshita A. Profiles of eight working mothers who practiced exclusive breastfeeding in Depok, Indonesia. Breastfeeding medicine. 2012;7(1):54–9. doi: 10.1089/bfm.2011.0017.

Sulaiman Z, Liamputtong P, Amir LH. The enablers and barriers to continue breast milk feeding in women returning to work. J Adv Nurs. 2016;72(4):825–35. doi: 10.1111/jan.12884.

Ratnasari D, Paramashanti BA, Hadi H, Yugistyowati A, Astiti D, Nurhayati E. Family support and exclusive breastfeeding among Yogyakarta mothers in employment. Asia Pac J Clin Nutr. 2017;26:S31–5. doi: 10.6133/apjcn.062017.s8.

Johnston ML, Esposito N. Barriers and facilitators for breastfeeding among working women in the United States. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2007;36(1):9–20. doi: 10.1111/j.1552-6909.2006.00109.x

Stewart‐Knox B, Gardiner K, Wright M. What is the problem with breast‐feeding? A qualitative analysis of infant feeding perceptions. Journal of human nutrition and dietetics. 2003;16(4):265–73. doi: 10.1046/j.1365-277x.2003.00446.x.

Dictionary C. Cambridge advanced learner’s dictionary. 3rd ed. Cambridge: Cambridge University Press; 2008.

Stuebe A. The risks of not breastfeeding for mothers and infants. Rev Obstet Gynecol [Internet]. 2009;2(4):222; doi : 10.3909/riog0093]

Ong G, Yap M, Li FL, Choo TB. Impact of working status on breastfeeding in Singapore: evidence from the National Breastfeeding Survey 2001. The European Journal of Public Health. 2005;15(4):424–30. doi: 10.1093/eurpub/cki030.

Visness CM, Kennedy KI. Maternal employment and breast-feeding: findings from the 1988 National Maternal and Infant Health Survey. Am J Public Health. 1997;87(6):945– 50. doi: 10.2105/ajph.87.6.945.

Ryan AS, Zhou W, Arensberg MB. The effect of employment status on breastfeeding in the United States. Women’s Health Issues. 2006;16(5):243–51.

Darus F, Basrowi RW, Wasito E, Kartjito MS. Optimizing workplace support for breastfeeding in female worker; a narrative review. The Indonesian Journal of Community and Occupational Medicine. 2023;2(3):136–42. doi: 10.53773/ijcom.v2i3.75.136-42.

Biagioli F. Returning to work while breastfeeding. Am Fam Physician [Internet]. 2003 [cited 2025 Jun 14];68(11):2199–207. Available from: https://www.aafp.org/pubs/afp/issues/2003/1201/p2201.pdf

Lakati A, Binns C, Stevenson M. Breast-feeding and the working mother in Nairobi. Public Health Nutr. 2002;5(6):715–8. doi: 10.1079/PHN2002349.

Basrowi RW, Sulistomo AW, Adi NP, Widyahening IS, Vandenplas Y. Breastfeeding knowledge, attitude, and practice among white-collar and blue-collar workers in Indonesia. J Korean Med Sci. 2019;34(45):e284. doi: 10.3346/jkms.2019.34.e284.

Petry R. Breastfeeding and Socioeconomic Status an Analysis of Breastfeeding Rates among Low-SES Mothers. 2013.

Cardoso F, Wasito E, Sundjaya T, Basrowi RW, Yosia M. Implementation and preliminary assessment of workplace post-natal and breastfeeding support for working mothers. The Indonesian Journal of Community and Occupational Medicine. 2022;1(3):162–73. doi: 10.53773/ijcom.v1i3.40.162-73

Downloads

Published

2025-03-30

Issue

Vol. 3 No. 1 (2025): Journal of Indonesian Specialized Nutrition

Section

Articles

License

Copyright (c) 2025 admin jisn, Ahmad Syafiq, Selma Avianty, Sandra Fikawati, Andrew Prasettya Japri, Seala Septiani, Ray Wagiu Basrowi

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA) that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.

Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.

LICENSE TO PUBLISH

  • All material published by the Journal of Indonesian Specialized Nutrition is protected under International copyright and intellectual property laws. Journal of Indonesian Specialized Nutrition is licensed under a Creative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA) or an equivalent license as the optimal license for the publication, distribution, use, and reuse of scholarly works.
  • This license permits anyone to compose, repair, and make derivative creations even for commercial purposes, as long as appropriate credit and proper acknowledgment of the original publication from a journal are made to allow users to trace back to the original manuscript and author.
  • You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. If you remix, transform or build upon the material, you must distribute your contributions under the same license as the original.