Journal of Preventive Medicine and Public Health

Original Articles

Determinants of Optimal Breastfeeding Practices in Indonesia: Findings From the 2017 Indonesia Demographic Health Survey: Siti Nurokhmah, Setyaningrum Rahmawaty, Dyah Intan Puspitasari; J Prev Med Public Health. 2022;55(2):182-192. Published online February 23, 2022; DOI: https://doi.org/10.3961/jpmph.21.448

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Objectives
Understanding the factors influencing mothers’ decision to breastfeed their infants is essential to formulate effective breastfeeding interventions. This study explored the determinants of optimal breastfeeding indicators in Indonesia.
Methods
We used the 2017 Indonesia Demographic and Health Survey to analyze factors associated with early initiation of breastfeeding, exclusive breastfeeding (EBF), and continued breastfeeding at 1 year (CBF-1) and 2 years (CBF-2). Multivariate logistic regression models were used to examine bio-demographic, socio-cultural, and behavioral characteristics associated with breastfeeding after considering the survey design effect.
Results
The risk of delayed breastfeeding initiation was higher among infants who were born smaller, first-born children, were delivered via cesarean delivery, and did not have immediate skin-to-skin contact (p<0.01). Infant’s age, birth pattern, household wealth index, and the mother’s occupation and smoking status were predictors of EBF (p<0.05). CBF-1 was less common among first-time mothers and those working in the non-agricultural sector, mothers from wealthier families, and mothers who had cesarean deliveries (p<0.01). Infant’s age was negatively associated with CBF-2 (adjusted odds ratio [aOR], 0.85; 95% confidence interval [CI], 0.74 to 0.99). Mothers attending college were less likely to practice CBF-2 than those with no education or primary education (aOR, 0.45; 95% CI, 0.26 to 0.77). The absence of postnatal visits was a risk factor for CBF-1 and CBF-2 (p<0.05).
Conclusions
Breastfeeding interventions in Indonesia should pay particular attention to at-risk groups such as women from wealthier families, working outside the agricultural sector, and with a higher education level. Nutrition-sensitive programs (e.g., postnatal care and smoking cessation) should also be encouraged.

Summary

Citations

Citations to this article as recorded by

Concomitant Factors Influencing Breastfeeding Practices in India: Evidence from Demographic and Health Survey 2019–21
Charu Tayal, Rajesh Sharma, Kusum Lata
Global Social Welfare.2025;[Epub] CrossRef
Correlations between family characteristics and childcare in optimizing the growth of children under six years
Laili Rahayuwati, Desy Indra Yani, Sri Hendrawati, Arlette Suzy Setiawan, Damar Irza, Sherllina Rizqi Fauziah
BMC Public Health.2025;[Epub] CrossRef
Duration and Sociodemographic Factors Associated with Exclusive Breastfeeding Among Mothers in Urban and Semi-Rural Areas of Libreville and Lambaréné in Gabon
Steeve Minto'o, Fifi Claire Loembe, Midili Thècle Larissa, Mireille Mensan Pemba, Koumba Maniaga Raïssa, Mylène Mimbila-Mayi, Yolande Nzame, Essomo Murielle, Eliane Kuissi-Kamgaing, Jean Koko, Simon Ategbo
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition.2024; 3(1): 1. CrossRef
Exclusive breastfeeding among Indonesian working mothers: does early initiation of breastfeeding matter?
Isyatun Mardhiyah Syahri, Agung Dwi Laksono, Maya Fitria, Nikmatur Rohmah, Masruroh Masruroh, Mara Ipa
BMC Public Health.2024;[Epub] CrossRef
Partner and Household Factors Associated with Breastfeeding Practice: A Systematic Review
Supriatin Supriatin, Ni Made Dwi Yunica Astriani, Mochamad Heri, Mohamad Sadli
JURNAL INFO KESEHATAN.2024; 22(2): 429. CrossRef
Trends and determinants of early initiation of breastfeeding in Indonesia: A multivariate decomposition analysis
Siti Nurokhmah, Lucinda Middleton, Judhiastuty Februhartanty, Aryono Hendarto, Veincent Christian Pepito
PLOS ONE.2023; 18(11): e0294900. CrossRef
Association between Skin-to-Skin Contact Duration after Caesarean Section and Breastfeeding Outcomes
Juan Juan, Xiaosong Zhang, Xueyin Wang, Jun Liu, Yinli Cao, Ling Tan, Yan Gao, Yinping Qiu, Huixia Yang
Children.2022; 9(11): 1742. CrossRef

Birth Patterns and Delayed Breastfeeding Initiation in Indonesia: Tika Dwi Tama, Erni Astutik, Septa Katmawanti, Jauhari Oka Reuwpassa; J Prev Med Public Health. 2020;53(6):465-475. Published online October 26, 2020; DOI: https://doi.org/10.3961/jpmph.20.212

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Abstract PDF

Objectives
This study was conducted to examine the association between birth patterns (defined in terms of birth order and interval) with delayed breastfeeding initiation in Indonesia. Methods: A cross-sectional study was carried out using data from the Indonesian Demographic and Health Survey 2017. The weighted number of respondents was 5693 women aged 15-49 years whose youngest living child was less than 2 years old. Multivariable logistic regression was conducted to evaluate associations between birth patterns and delayed breastfeeding initiation after adjusting for other covariates. Results: This study found that 40.2% of newborns in Indonesia did not receive timely breastfeeding initiation. Birth patterns were significantly associated with delayed breastfeeding initiation. Firstborn children had 77% higher odds of experiencing delayed breastfeeding initiation (adjusted odds ratio, 1.77; 95% confidence interval, 1.02 to 3.04; p<0.05) than children with a birth order of 4 or higher and a birth interval ≤ 2 years after adjusting for other variables. Conclusions: Firstborn children had higher odds of experiencing delayed breastfeeding initiation. Steps to provide a robust support system for mothers, especially first-time mothers, such as sufficient access to breastfeeding information, support from family and healthcare providers, and national policy enforcement, will be effective strategies to ensure better practices regarding breastfeeding initiation.

Summary

Citations

Citations to this article as recorded by

Development of the "Mother Give Me Exclusive Breastfeeding" e-booklet based on Android as a nutrition educational media
Septa Katmawanti, Farah Paramita, Agung Kurniawan, Siti Khuzaimah A. Sharoni, Rosuzeita Fauzi, Dea Aflah Samah, Yassinda Thasia Audina, Muhammad Irfan Syahputra, Reza Pahlevi, Intan Gumilang Pratiwi
Healthcare in Low-resource Settings.2024;[Epub] CrossRef
Associated Factors of Early Breastfeeding Initiation and Exclusive Breastfeeding in South Africa: Evidence From the South African Demographic and Health Survey
Azeez Adeboye
Epidemiology and Health System Journal.2024; 11(1): 13. CrossRef
Modeling spatial determinants of initiation of breastfeeding in Ethiopia: A geographically weighted regression analysis
Samuel Hailegebreal, Yosef Haile, Binyam Tariku Seboka, Ermias Bekele Enyew, Tamiru Shibiru, Zeleke Abebaw Mekonnen, Shegaw Anagaw Mengiste, James Mockridge
PLOS ONE.2022; 17(9): e0273793. CrossRef
Correlation between Use of the Contraception and Exclusive Breastfeeding in Indonesia in 2017 (2017 Indonesian Demographic and Health Survey analysis data)
Febrianti Prasmono Putri, Septa Katmawanti, Erianto Fanani
Matrix Science Medica.2022; 6(4): 106. CrossRef
The Intervention of Maternal Nutrition Literacy Has the Potential to Prevent Childhood Stunting: Randomized Control Trials
Sirajuddin, Saifuddin Sirajuddin, Amran Razak, Ansariadi, Ridwan M Thaha, Toto Sudargo
Journal of Public Health Research.2021;[Epub] CrossRef

Risk Reduction of Breast Cancer by Childbirth, Breastfeeding, and Their Interaction in Korean Women: Heterogeneous Effects Across Menopausal Status, Hormone Receptor Status, and Pathological Subtypes: Seok Hun Jeong, Yoon Suk An, Ji-Yeob Choi, Boyoung Park, Daehee Kang, Min Hyuk Lee, Wonshik Han, Dong Young Noh, Keun-Young Yoo, Sue K. Park; J Prev Med Public Health. 2017;50(6):401-410. Published online November 10, 2017; DOI: https://doi.org/10.3961/jpmph.17.152

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Abstract PDF Supplementary Material

Objectives
The purpose of this study was to examine the associations of childbirth, breastfeeding, and their interaction with breast cancer (BC) risk reduction, and to evaluate the heterogeneity in the BC risk reduction effects of these factors by menopause, hormone receptor (HR) status, and pathological subtype.
Methods
BC patients aged 40+ from the Korean Breast Cancer Registry in 2004-2012 and controls from the Health Examinee cohort participants were included in this study after 1:1 matching (12 889 pairs) by age and enrollment year. BC risk according to childbirth, breast-feeding, and their interaction was calculated in logistic regression models using odds ratios (ORs) and 95% confidence intervals (CIs).
Results
BC risk decreased with childbirth (3+ childbirths relative to 1 childbirth: OR, 0.66; 95% CI, 0.56 to 0.78 and OR, 0.80; 95% CI, 0.68 to 0.95 in postmenopausal and premenopausal women, respectively); and the degree of risk reduction by the number of children was heterogeneous according to menopausal status (p-heterogeneity=0.04), HR status (p-heterogeneity<0.001), and pathological subtype (p-heterogeneity<0.001); whereas breastfeeding for 1-12 months showed a heterogeneous association with BC risk according to menopausal status, with risk reduction only in premenopausal women (p-heterogeneity<0.05). The combination of 2 more childbirths and breastfeeding for ≥13 months had a much stronger BC risk reduction of 49% (OR, 0.51; 95% CI, 0.45 to 0.58).
Conclusions
This study suggests that the combination of longer breastfeeding and more childbirths reduces BC risk more strongly, and that women who experience both 2 or more childbirths and breastfeed for ≥13 months can reduce their BC risk by about 50%.

Summary

Citations

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Exploring novel protein-based biomarkers for advancing breast cancer diagnosis: A review
Christina Jane Vellan, Tania Islam, Sumadee De Silva, Nur Aishah Mohd Taib, Galhena Prasanna, Jaime Jacqueline Jayapalan
Clinical Biochemistry.2024; 129: 110776. CrossRef
Reproductive characteristics, menopausal status, race and ethnicity, and risk of breast cancer subtypes defined by ER, PR and HER2 status: the Breast Cancer Etiology in Minorities study
Esther M. John, Jocelyn Koo, Amanda I. Phipps, Teri A. Longacre, Allison W. Kurian, Sue A. Ingles, Anna H. Wu, Lisa M. Hines
Breast Cancer Research.2024;[Epub] CrossRef
Association of reproductive risk factors and breast cancer molecular subtypes: a systematic review and meta-analysis
Xihua Mao, Chioma Omeogu, Shama Karanth, Ashwini Joshi, Clare Meernik, Lauren Wilson, Amy Clark, April Deveaux, Chunyan He, Tisha Johnson, Karen Barton, Samantha Kaplan, Tomi Akinyemiju
BMC Cancer.2023;[Epub] CrossRef
Perikonzeptionelle Beratung bei Risikokonstellationen
Christian Gnoth, Mareen ten Busch, Nadine Sutter, Peter Mallmann
Journal für Gynäkologische Endokrinologie/Schweiz.2022; 25(4): 176. CrossRef
Isoflavone intake on the risk of overall breast cancer and molecular subtypes in women at high risk for hereditary breast cancer
Eun Ji Sim, Kwang-Pil Ko, Choonghyun Ahn, Sang Min Park, Young-Joon Surh, Seokyung An, Sung-Won Kim, Min-Hyuk Lee, Jong Won Lee, Jeong Eon Lee, Ku Sang Kim, Cha Kyong Yom, Hyun-Ah Kim, Sue K. Park
Breast Cancer Research and Treatment.2020; 184(2): 615. CrossRef
Combination of circulating miR-145-5p/miR-191-5p as biomarker for breast cancer detection
Yeldar Ashirbekov, Arman Abaildayev, Nazgul Omarbayeva, Dauren Botbayev, Ayaz Belkozhayev, Anel Askandirova, Alena Neupokoyeva, Gulzhakhan Utegenova, Kamalidin Sharipov, Nagima Aitkhozhina
PeerJ.2020; 8: e10494. CrossRef
PI3K/AKT/mTOR Signaling Pathway in Breast Cancer: From Molecular Landscape to Clinical Aspects
Daniela Miricescu, Alexandra Totan, Iulia-Ioana Stanescu-Spinu, Silviu Constantin Badoiu, Constantin Stefani, Maria Greabu
International Journal of Molecular Sciences.2020; 22(1): 173. CrossRef
Perikonzeptionelle Beratung bei Risikokonstellationen
Christian Gnoth, Mareen ten Busch, Nadine Sutter, Peter Mallmann
Der Gynäkologe.2019; 52(10): 779. CrossRef
Epidemiological characteristics of breast cancer in Koreans
Sue K. Park
Journal of the Korean Medical Association.2019; 62(8): 424. CrossRef
The contribution of breastfeeding to the prevention of breast cancer
ASIMENIA MAMAKOU
European Journal of Midwifery.2019;[Epub] CrossRef
Maternal Personality and Psychosocial Variables Associated with Initiation Compared to Maintenance of Breastfeeding: A Study in Low Obstetric Risk Women
Patricia Catala, Cecilia Peñacoba, Javier Carmona, Dolores Marin
Breastfeeding Medicine.2018; 13(10): 680. CrossRef

Senior Medical Students' Attitudes toward and Knowledge about Breastfeeding.: Mi Young Lee, Mi Jung Kang, Choong Won Lee, Kyu Bok Jin, Eun Jung Suh, Jae Suk Ahn, Suk Kwon Suh; Korean J Prev Med. 1999;32(1):95-100.

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Abstract PDF: OBJECTIVES
This study surveyed medical students attending clerkship to assess their attitude toward and knowledge about breastfeeding, and self-confidence to manage common breast-feeding problems. METHODS: A self-report questionnaire was administered to the 323 medical students at four medical colleges in Taegu in May 1997. The response rate was 92.9%, but the respondents used in the final data analysis were 245 (75.8%) due to missing variables. RESULTS: Overall, respondents showed equivocal attitudes toward breastfeeding (mean score 2.9 on a 6-point scale). Knowledge about breastfeeding was substantially low with the median % correct 39.2%. Of nine knowledge areas, weak areas were especially "contraindications and barriers to breastfeeding", "use of breastfeeding aids", "expression and storage of breast milk". Those reported to be confident to manage common breastfeeding problems were only 25.7%. Correlations between knowledge and self-confidence were not statistically significant except in college A (r=0.35, p<0.05). Correlations between knowledge and attitude were not significant. CONCLUSIONS: These results suggest that medical students attending clerkship in Taegu show equivocal attitudes toward breastfeeding, low self-confidence to manage common breastfeeding problems and have substantially limited level of knowledge. There should be more concerted efforts to improve this situation on the part of those involved in breastfeeding education.; Summary

English Abstract

Factors Affecting Breastfeeding Rate and Duration.: Won Ju Hwang, Woo Jin Chung, Dae Ryong Kang, Moon Hee Suh; J Prev Med Public Health. 2006;39(1):74-80.

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Abstract PDF: OBJECTIVES
The purpose of this study is to examine the factors affecting the rate and duration of breastfeeding. METHODS: We analyzed the data from the year 2000 Korea National Fertility Survey that was collected through direct interviews. In particular, the mothers who delivered their last child and the child was under 1 year of age from January 1998 to June 2000 (N=1,066) were analyzed via a logistic model to assess the factors affecting the breastfeeding rate. Among the study subjects, those who had initiated breastfeeding (N=740) were analyzed through Cox's proportional hazard model to evaluate the factors affecting the duration of breastfeeding. RESULTS: The multivariate logistic model showed that the delivery type and the baby's birth-weight have a statistically significant influence on the breastfeeding rate. Women who delivered their babies through Cesarean section were less likely than others to breastfeed. In contrast, the women whose babies weighed 2.5Kg or more were more likely than others to breastfeed. The results obtained from the survival analysis are as follows: the higher the mother's education level, the shorter is the breastfeeding duration. The mother's work status played a significant role in the early termination of breastfeeding. Women aged 35 or older showed a longer breastfeeding duration than the younger age groups, whereas the maternal age was not a significant factor in affecting whether or not a mother would breastfeed. CONCLUSIONS: Reducing the cases of operative delivery (Cesarean section) and low weight births, enlightening young and highly educated women on breastfeeding and improving the environment for breastfeeding on the job are important strategies to encourage women to breastfeed.; Summary

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