Association of Family Support and Breastfeeding Self Efficacy with Exclusive Breastfeeding Practice Among Lactating Mothers in The Working Area of Gunung Tinggi Health Center

Authors

  • Edy Marjuang Purba Nutrition Study Program, Universitas Negeri Medan
  • Yatty Destani Sandy Nutrition Study Program, Universitas Negeri Medan
  • Kanaya Yori Damanik Nutrition Study Program, Universitas Negeri Medan
  • Fitni Hidayati Nutrition Study Program, Universitas Negeri Medan
  • Saut Purba Educational Administration Study Program, Universitas Negeri Medan
  • Anna Waris Nainggolan Midwifery Study Program, STIKes Mitra Husada Medan

DOI:

https://doi.org/10.51556/ejpazih.v14i2.506

Keywords:

exclusive breastfeeding, breastfeeding self-efficacy, family support, Gunung Tinggi Health Center

Abstract

Background: Exclusive breastfeeding during the first six months of life is one of the most effective public health interventions to reduce infant mortality. However, its coverage in the working area of Gunung Tinggi Health Center remains below the national target(80%), as many mothers face barriers such as limited family support and low self-efficacy in breastfeeding. Objectives:  This study aimed to examine the association between family support and breastfeeding self-efficacy (BSE) with exclusive breastfeeding practices among lactating mothers. Methods: An analytical observational study with a cross-sectional design was conducted from June to August 2025 involving 78 mothers with infants aged 6–11 months, selected using multistage sampling. Family support was assessed using a 20-item questionnaire covering informational, emotional, instrumental, and appraisal aspects, while BSE was measured using the Breastfeeding Self-Efficacy Scale–Short Form. Data were analyzed using univariate and bivariate analyses, and associations were tested with the Chi-square test. Results: About 67.9% of mothers received good family support, and 51.3% had low BSE levels. The proportion of exclusive breastfeeding was 62.8%. Significant associations were found between family support and BSE (p=0.023;PR=1.735, 95%CI: 1.160-2.594), family support and exclusive breastfeeding (p=0.009; PR=2.271, 95%CI: 1.308-3.944), and BSE and exclusive breastfeeding (p=0.002; PR=2.986, 95%CI: 1.445-6.167). Conclusions: The findings highlight that family support plays a crucial role in enhancing maternal BSE, which in turn contributes to the success of exclusive breastfeeding. Health centers are encouraged to implement family-based education programs involving husbands and parents to strengthen maternal confidence and improve exclusive breastfeeding coverage.

References

WHO. Protecting, supporting and promoting breastfeeding. Geneva: World Health Organization; 2023. Available from: www.who.int/westernpacific/activities/protecting-supporting-and-promoting-breastfeeding.

WHO/UNICEF. Global Breastfeeding Scorecard 2021: Only 44% of infants under six months of age are exclusively breastfed. Geneva: World Health Organization; 2021. Available from: https://iris.who.int/bitstream/handle/10665/348546/WHO-HEP-NFS-21.45-eng.pdf

WHO. Breastfeeding: Exclusive breastfeeding under 6 months (%) / Infant and young child feeding fact sheet. Geneva: World Health Organization; 2023. Available from: www.who.int/data/gho/indicator-metadata-registry/imr-details/130

Uddin MF, Jabeen I, Islam MA, Rahman M, Chisti MJ, Ahmed T, Sarma H. Barriers to breastfeeding are shaped by sociocultural context: an exploratory qualitative study in Bangladesh. J Health Popul Nutr. 2022;41(1):34. https://doi.org/10.1186/s41043-022-00312-y

Pérez-Escamilla R, Tomori C, Hernández-Cordero S, Baker P, Barros AJD, Bégin F, et al. Breastfeeding: crucially important, but increasingly challenged in a market-driven world. Lancet. 2023;401(10375):472–85. https://doi.org/10.1016/S0140-6736(23)00410-5

Kebede SD, Forster EM, Agmas K, Aytenew TM, Creedy DK. Prevalence and contributing factors of early initiation of breastfeeding (EIBF) in Ethiopia: a systematic review and meta-analysis. BMC Public Health. 2025;25(1):1377. https://doi.org/10.1186/s12889-025-22568-9

Meng F, Uniacke-Lowe T, Lanfranchi E, Meehan G, O'Shea CA, Dennehy T, et al. A longitudinal study of fatty acid profiles, macronutrient levels, and plasmin activity in human milk. Front Nutr. 2023;10:1172613. https://doi.org/10.3389/fnut.2023.1172613

Yi DY, Kim SY. Human breast milk composition and function in human health: from nutritional components to microbiome and microRNAs. Nutrients. 2021;13(9):3094. https://doi.org/10.3390/nu13093094

Nuzzi G, Trambusti I, Di Cicco ME, Peroni DG. Breast milk: more than just nutrition! Minerva Pediatr (Torino). 2021;73(2):111–4. https://doi.org/10.23736/S2724-5276.21.06223-

Marliana S, Sholihah M, Sa’adah DA. Hubungan pemberian ASI eksklusif terhadap perkembangan kognitif anak usia 18–24 bulan di Posyandu Bougenvile Desa Ngandong Kecamatan Grabangan Kabupaten Tuban. Alzam J Islamic Early Childhood Educ. 2023;3(1):23–31. https://doi.org/10.51675/alzam.v3i1.523

Gialeli G, Panagopoulou O, Liosis G, Siahanidou T. Potential epigenetic effects of human milk on infants' neurodevelopment. Nutrients. 2023;15(16):3614. https://doi.org/10.3390/nu15163614

Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 15 Tahun 2013 tentang Tata Cara Penyediaan Fasilitas Khusus Menyusui dan/atau Memerah Air Susu Ibu. Jakarta: Kementerian Kesehatan RI; 2013. Available from: https://peraturan.bpk.go.id/Details/165952/permenkes-no-15-tahun-2013

Kementerian Kesehatan Republik Indonesia. 1000 HPK Kunci Cegah Stunting. Jakarta: Kementerian Kesehatan RI; 2023. Available from: https://ayosehat.kemkes.go.id/1000-hpk-kunci-cegah-stunting

A’ini S, Nst SWR, Lubis AS, Fakhreni F, Harahap RA. Edukasi program Gerakan 1000 Hari Pertama Kehidupan (HPK) dalam pencegahan stunting dengan media promosi. J Ilm Univ Batanghari Jambi. 2023;23(2):2091–7. https://doi.org/10.33087/jiubj.v23i2.3317

Hadihardjono DN, Green M, Stormer A, Agustino, Izwardy D, Champeny M. Promotions of breastmilk substitutes, commercial complementary foods and commercial snack products commonly fed to young children are frequently found in points-of-sale in Bandung City, Indonesia. Matern Child Nutr. 2019;15(Suppl 4):e12808. https://doi.org/10.1111/mcn.12808

Paramashanti BA, Dibley MJ, Huda TM, Prabandari YS, Alam NA. Factors influencing breastfeeding continuation and formula feeding beyond six months in rural and urban households in Indonesia: a qualitative investigation. Int Breastfeed J. 2023;18(1):48. https://doi.org/10.1186/s13006-023-00586-w

Utami RB, Susilowati VDAT. Dukungan keluarga dengan pemberian ASI eksklusif pada bayi usia 0–6 bulan di Posyandu Desa Blimbing Kecamatan Dolopo Kabupaten Madiun. Judika (Jurnal Nusantara Medika). 2025;9(1):108–14. https://doi.org/10.29407/judika.v9i1.25916

Budiati T, Adjie S, Gunawijaya J, Setyowati S. Fathers' role in sustainability of exclusive breastfeeding practice in post-cesarean-section mothers. J Public Health Res. 2021;11(2):2744. https://doi.org/10.4081/jphr.2021.2744

Jiang L, Nianogo RA, Prelip M, Wang MC. The role of breastfeeding support in racial/ethnic disparities in breastfeeding practices. Prev Med. 2024;179:107857. https://doi.org/10.1016/j.ypmed.2024.107857

Islam MJ, Broidy L, Baird K, Rahman M, Zobair KM. Early exclusive breastfeeding cessation and postpartum depression: assessing the mediating and moderating role of maternal stress and social support. PLoS One. 2021;16(5):e0251419. https://doi.org/10.1371/journal.pone.0251419

Fan HSL, Fong DYT, Lok KYW, Tarrant M. The association between breastfeeding self-efficacy and mode of infant feeding. Breastfeed Med. 2022;17(8):687–97. https://doi.org/10.1089/bfm.2022.0059

Kehinde J, O'Donnell C, Grealish A. The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: a systematic review. Midwifery. 2023;118:103579

Li F, Huang C, Lin Q, Xi Y, Xiang C, Yong C, et al. Maternal characteristics, intention, self-efficacy, perceived social support, and exclusive breastfeeding practice: structural equation modeling approaches. Healthcare (Basel). 2022;11(1):87. https://doi.org/10.3390/healthcare11010087

Krikitrat P, Park CG, McCreary LL, Koenig MD, Abboud S, Sansiriphun N, Patil CL. Relationships between Thai fathers' self-efficacy to support breastfeeding and exclusive breastfeeding duration. Midwifery. 2022;106:103261. https://doi.org/10.1016/j.midw.2022.103261

Mercan Y, Tari Selcuk K. Association between postpartum depression level, social support level and breastfeeding attitude and breastfeeding self-efficacy in early postpartum women. PLoS One. 2021;16(4):e0249538. https://doi.org/10.1371/journal.pone.0249538

Dessì A, Pianese G, Mureddu P, Fanos V, Bosco A. From breastfeeding to support in mothers' feeding choices: a key role in the prevention of postpartum depression? Nutrients. 2024;16(14):2285. https://doi.org/10.3390/nu16142285

Puskesmas Gunung Tinggi. Profil Puskesmas Gunung Tinggi Tahun 2024. Kecamatan Pancur Batu

Purba EM, Nainggolan AW, Purba S. Factors related to postpartum mothers’ knowledge of exclusive breastfeeding in the Tuntungan Health Center Work Area, Pancur Batu Subdistrict. Quantum Wellness J Ilmu Kesehatan. 2025;2(2):341–51. https://doi.org/10.62383/quwell.v2i2.2058

Ibrahim F, Rahayu B. Analisis faktor yang berhubungan dengan pemberian ASI eksklusif. J Ilm Kesehat Sandi Husada. 2021;10(1):18–24. https://doi.org/10.35816/jiskh.v10i1.497

Pratiwi EH, Yuliana W, Hikmawati N. Hubungan tingkat pendidikan ibu dengan pemberian ASI eksklusif pada bayi usia 7–12 bulan di Desa Cepoko Puskesmas Sumber Kabupaten Probolinggo. ASSYIFA J Ilmu Kesehatan. 2024;2(1):146–58. https://doi.org/10.62085/ajk.v2i1.43

Nainggolan AW, Siregar EP, Rezeki S, Simanjorang NA, Tarigan I, Muliana R. The effectiveness of using a wearable breast pump to increase breast milk production and breastfeeding comfort among working mothers at Rosalina Munthe Primary Clinic, Kwala Bekala, Medan Johor District, North Sumatra Province in 2025. Mitra Husada Health Int Conf (MIHHICo). 2025;5(1):15–21.

Maulidiyah LM, Asthiningsih NWW. Hubungan paritas ibu dan promosi susu formula dengan pemberian ASI eksklusif pada bayi usia 6–12 bulan di Posyandu Harapan Baru Samarinda. Borneo Stud Res. 2021;2(3):1576–83

James L, Sweet L, Donnellan-Fernandez R. Self-efficacy, support and sustainability – a qualitative study of the experience of establishing breastfeeding for first-time Australian mothers following early discharge. Int Breastfeed J. 2020;15(1):98. https://doi.org/10.1186/s13006-020-00337-

Dennis CL. Theoretical underpinnings of breastfeeding confidence: a self-efficacy framework. J Hum Lact. 1999;15(3):195–201. https://doi.org/10.1177/089033449901500303

Susanti IY, Hety DS. Dukungan keluarga dengan pemberian ASI eksklusif di Puskesmas Mojosari Kabupaten Mojokerto. Hosp Majapahit J Ilm Kesehatan Poltekkes Mojokerto. 2021;13(2):116–28. https://doi.org/10.55316/hm.v13i2.735

Tseng JF, Chen SR, Au HK, Chipojola R, Lee GT, Lee PH, et al. Effectiveness of an integrated breastfeeding education program to improve self-efficacy and exclusive breastfeeding rate: a single-blind, randomised controlled study. Int J Nurs Stud. 2020;111:103770. https://doi.org/10.1016/j.ijnurstu.2020.103770

Moraes GGW, Christoffel MM, Toso BRGO, Viera CS. Association between duration of exclusive breastfeeding and nursing mothers' self-efficacy for breastfeeding. Rev Esc Enferm USP. 2021;55:e03702. https://doi.org/10.1590/S1980-220X2019038303702

Suja MDD, Roslina R, Sudarmi S, Sulistianingrum L. Breastfeeding self-efficacy and exclusive breastfeeding success in Bandar Lampung City. Preventif J Kesehatan Masyarakat. 2023;14(3):473–82. https://doi.org/10.22487/preventif.v14i3.955

Da Silva MV, Machado RZ, Bittencourt VFZ, Bittencourt MF, Willig DQ, Iser BPM. Breastfeeding self-efficacy in postpartum women. Healthcare (Basel). 2025;13(14):1690. https://doi.org/10.3390/healthcare13141690

Published

2025-11-18

How to Cite

Purba, E. M., Sandy, Y. D., Damanik, K. Y., Hidayati, F., Purba, S., & Nainggolan, A. W. (2025). Association of Family Support and Breastfeeding Self Efficacy with Exclusive Breastfeeding Practice Among Lactating Mothers in The Working Area of Gunung Tinggi Health Center. Jurnal Pangan Gizi Dan Kesehatan, 14(2), 109-119. https://doi.org/10.51556/ejpazih.v14i2.506