The Effect of Exclusive Breastfeeding in Grogol Petamburan Health

Center

Erlina Puspitaloka Mahadewi

, Ika Putri Yanuarti

, Ade Heryana

and Rokiah Kusumapradja

Public Health Faculty, Esa Unggul University

Departement of Hospital Administration, Esa Unggul University

Keywords: Influencing Factors, Exclusive ASI giving.

Abstract: The low rate of breastfeeding (ASI) giving is a threat to growing children. As we know, babies who are

not ASI giving for at least 6 months are more prone to nutritional deficiencies. Health Center in Grogol

Petamburan West Jakarta has data regarding mothers who provide exclusive breast (ASI) in 2015 reached

39%. The purpose of this study was to determine the factors that influence ASI giving in health centers in

the district of Grogol Petamburan, West Jakarta in 2016. The research method used in this study was a

descriptive analytic study with cross-section analysis. The results of the study are the relationship between

knowledge and exclusive ASI giving and there is support for family relationships with ASI giving. It is

concluded that there’s a significant relationship between knowledge and support of exclusive ASI giving

families and there is no relationship between age, occupation, place of delivery and exclusive ASI giving.

1 INTRODUCTION

The low supply of breastfeeding (ASI) is a threat to

a child's growth and development. As it is known

that babies who are not given breastfeeding at least

up to the age of 6 months are more prone to

experience nutritional deficiencies. Based on data

from Basic Health Research (Riskesdas) 2010, the

provision of Asi in Indonesia is still a concern.

Percentage of exclusively given breastfeeding babies

for up to 6 months is only 15.3%. The results of

2007 Indonesian Demographic and Health Survey

(IDHS) showed that exclusive ASI coverage of

infants from 0-6 months is 32% which later had a

meaningful increase to 42% in 2012.

DKI Jakarta area so far only reached 62.7%, the

target expected in the year 2013 is 75%. Therefore it

is necessary to make efforts to increase the coverage

of exclusive ASI giving and achieve predetermined

targets. For DKI Jakarta area, it is divided into 6

Regencies / Cities, namely Central Jakarta, North

Jakarta, West Jakarta, South Jakarta, East Jakarta

and ‘Pulau Seribu’. For West Jakarta, Exclusive ASI

coverage only reached 10.5% (City Regency Health

Profile in 2012).

The decrease of exclusive ASI giving can be

influenced by various factors; human behavior

factors from the level of health. The health of a

person or community is influenced by three factors:

predisposing factors that manifest in knowledge,

attitudes, beliefs, beliefs, values and so on.

Supporting factors manifested in the physical

environment, health facilities. The driving factor is

manifested in the attitudes and behavior of health

workers or other officers who are a reference group

of community behavior (Notoatmodjo, 2012).

Exclusive ASI giving can be influenced by many

factors, namely knowledge,maternal age, parity,

maternal education, mother's work, place of birth,

childbirth assistance, family support and support

from health workers. The coverage of ASI giving in

West Jakarta is still low at only 10.5%, so the

researcher is interested in researching at Grogol

Petamburan District Health Center, West Jakarta.

Coverage of exclusive ASI giving at Grogol

Petamburan District Health Center in West Jakarta

in 2015 only reached 39%. Based on these data, the

researcher wanted to find out the factors that

influence exclusive ASI giving in West Jakarta

Grogol Petamburan District Health Center in 2016.

2 LITERATURE REVIEW

The importance of Exclusive Breastfeeding:

Breastfeeding has many health benefits for both the

mother and infant. Breast milk contains all the

Puspitaloka Mahadewi, E., Putri Yanuarti, I., Heryana, A. and Kusumapradja, R.

The Effect of Exclusive Breastfeeding in Grogol Petamburan Health Center.

DOI: 10.5220/0009950026572662

In Proceedings of the 1st International Conference on Recent Innovations (ICRI 2018), pages 2657-2662

ISBN: 978-989-758-458-9

2657

nutrients an infant needs in the first six months of

life. Breastfeeding protects against diarrhoea and

common childhood illnesses such as pneumonia, and

may also have longer-term health benefits for the

mother and child, such as reducing the risk of

overweight and obesity in childhood and

adolescence.

Exclusive breastfeeding means that the infant

receives only breast milk. No other liquids or solids

are given – not even water – except oral rehydration

solution, or drops/syrups of vitamins, minerals or

medicines.

For infants to survive, grow and develop

properly, they require the right proportion of

nutrients. Breast milk is rich in nutrients and

antibodies and contains the right quantities of fat,

sugar, water and protein. These nutrients are major

pre-requisites to the health and survival of the baby.

When a child is exclusively breastfed, their immune

system is strengthened, enabling it to life-threatening

illnesses like pneumonia and diarrhoea amongst

other infections. Reports indicate that babies who

are not breastfed for the first six months of life are

15 times more likely to die from Pneumonia

compared to newborns that are breastfed exclusively

for six months after birth.

The World Health Organization estimates that

around 220,000 children could be saved every year

with exclusive breastfeeding. It recommends that

colostrum, the yellowish sticky breast milk that is

produced at the end of pregnancy as the ideal food

for newborns; to be given within the first hour of

birth, a process referred to as early initiation. Infants

breastfed within the first hour of birth are three times

more likely to survive than those who have their first

breast milk after a day. Exclusive breastfeeding

should be given from birth up to 6 months and

continued breastfeeding is recommended with

appropriate complementary food until the child

celebrates his/her second year birthday without

water, food or drink. The only exceptions are

rehydration salts and syrups that contain medicine.

3 RESEARCH METHODOLOGY

The Research location is in Grogol Petamburan

District Health Center, West Jakarta, on May to June

2016. This type of research is quantitative. This

research is a descriptive analytic study with Cross-

Sectional method. Where all variables consisting of

dependent variables and independent end variables

were measured at the same time as the study took

place.

The population in this study were all mothers

who had babies aged more than 0 months to 6

months (monitored babies) recorded at Grogol

Petamburan Subdistrict Health Center, West Jakarta

in 2016. The sampling method used was an

estimated proportion formula of Notoatmodjo (2012)

the researcher managed to obtain 185 samples.

Purposive sampling is based on a particular

consideration by inputting the health parameters of

the Health Center and those made by the researchers

themselves.

The source of research data was primary data

obtained by conducting interviews with

questionnaire tools. Secondary data were obtained

from data from Grogol Petamburan District Health

Center in the form of 2015 exclusive ASI giving

coverage data and the number of infants monitored.

Data analysis phase uses univariate and bivariate

analysis. The univariate analysis aims to see or get

an overview of the distribution of respondents and

to describe the dependent variable in this study. The

bivariate analysis aims to find out if there is a

significant relationship between two variables or

more sample groups. This bivariate research or

analysis uses the Quadratic Kai test (Chi-Square),

aims to determine the relationship between the

independent variable and the dependent variable.

4 RESULT AND DISCUSSION

4.1 Univariate Analysis

 Knowledge

Table 1: Frequency Distribution of Respondents Based on

Mother's Knowledge

Based on the table above, it is known that the

proportion of mother’s knowledge

at Grogol Petamburan Public Health Center, West

Jakarta in 2016, are mostly lacking; 98 respondents

(53%).

Variable Total

Frequency (n) %

Mother’s Knowledge

Lacking 98 53

Good 87 47

Total 185 100

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 Age

Table 2: Frequency Distribution of Respondents Based on

Mother’s Age

Variable

Total

Frequency %

Age

<20 years old an

>35 years old

69 37.3

20-35 years old 116 62.7

Total 185 100.0

Based on the table above, it can be seen that the

proportion of respondents’ age at Grogol

Petamburan Health Center, West Jakarta In 2016,

was mostly aged 20-35 years old; 116 respondents

(62.7%).

 Occupation

Table 3: Frequency Distribution of Respondents Based on

Mother’s Occupation

Based on the table above, it can be seen that the

proportion of respondents' work in Grogol

Petamburan Health Center, West Jakarta in 2016

mostly unemployed / not working; 112

respondents (60.5%)

 Place for Giving Birth

Table 4: Frequency Distribution of Respondents Based on

Place for Giving Birth

Variable

Total

Frequency (n) %

Place for Giving Birth

Health Facility 172 93

Non-Health Facility 13 7

Total 185 100

Based on the table above, it can be seen that the

respondents’ proportion of places for giving birth in

Grogol Petamburan Health Center, West Jakarta in

2016 was mostly health facilities; 172 respondents

(93%)

 Family Support

Table 5: Frequency Distribution of Respondents Based on

Family Support

Variable Total

Frequency(n) %

Family Support

Supportive 70 37.8

Not Supportive 115 62.2

Total 185 100.0

Based on the table above, it is known that the

proportion of the mother’s family support at Grogol

Petamburan Health Center, West Jakarta in 2016

were mostly not supportive 115 respondents

(62.2%).

 Exclusive Breastfeeding giving

Table 6: Frequency Distribution of Respondents Based on

Exclusive Breastfeeding

Variable Total

Frequency (n) %

Exclusive ASI giving

Giving exclusive

ASI giving

98 53

Not giving exclusive

ASI giving

87 47

Total 185 100

Based on the table above, it is known that the

proportion of exclusive breastfeeding at Grogol

Petamburan Health Center, West Jakarta in 2016

mostly didnot provide; 98 respondents (53%).

4.2 Bivariate Analysis

 The relationship between Knowledge and

Exclusive Breastfeeding

Table 7: The Relationship between Knowledge with

Exclusive Breastfeeding in Grogol Petamburan, West

Jakarta in 2016

Variabl

Category

Exclusive

Total

-value

Kno

wled

Lac

kin

74.5 25

25.5

100

0.000

Good

28. 62

71. 87

100

The highest proportion of respondents with poor

knowledge who does not give exclusive

breastfeeding were 73 people (74.5%), while from

respondents with good knowledge, the highest

Variable

Total

Frequency

(n)

Occu

ation

Working

39.5

ot Working

112

60.5

Total

185

100

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proportion in giving exclusive breastfeeding were 62

people (71.3%). Thus it can be concluded that there

is a significant relationship between knowledge and

exclusive breastfeeding.

 Relationship Between Age and Exclusive

Breastfeeding

Table 8: The relationship between Age and exclusive

breastfeeding at Grogol Petamburan Health Center, West

Jakarta in 2016

Variable

Category

Exclusive

No Yess

n % N % N %

Age

<20 and >35

years old

41 59.

28 40.

69 100 .175

20-35years 57 49. 59 50. 116 100

In this study, the age of respondents <20 and> 35

years have the highest proportion on not giving

Exclusive breastfeeding, which was 41 respondents

(59.4%) and the age category of 20-35 years have

the highest proportion of 59 respondents (50.9%)

who gives exclusive breastfeeding. It can be

concluded that there is no significant relationship

between age and exclusive breastfeeding.

 Relationship Between Works and Exclusive

Breastfeeding

Table 9: The relationship between work and exclusive

breastfeeding at Grogol Petamburan Health Center, West

Jakarta in 2016

Variable

Category

Exclusive Breastfeeding

Total

p-value

No Yes

N % N % N %

Occupati

Working 37 50.7 36 49.3 73 100

0.615

Working

61 54.5 51 45.5 112 100

The highest proportion of working respondents is

not giving exclusive breastfeeding as many as 37

people (50.7%), while the highest proportion of

unemployed respondents (IRT) are not providing

exclusive breastfeeding as many as 61 people

(54.5%). Thus it can be concluded that there is no

significant relationship between works with

exclusive breastfeeding.

 Relationship Between Place of Giving Birth

and Exclusive Breastfeeding

Table 10: The relationship between giving birth and

exclusive breastfeeding at Grogol Petamburan Health

Center, West Jakarta in 2016

Variable

Category

Exclusive Breastfeeding

Total

p-value

No Yes

N % N % N %

Place of

Giving

Birth

Non-

Health

Facility

8 61.5 5 38.5 13 100

0.521

Health

Facility

90 52.3 82 47.7 172 100

The proportion of respondents who uses non-health

facility as a place to give birth and not giving

exclusive breastfeeding were as many as 8 people

(61.5%), while from respondents who use health

facility as a place to give birth and giving exclusive

breastfeeding were as many as 90 people (52.3%).

Thus it can be concluded that there is no significant

relationship between place of giving birth and

exclusive breastfeeding.

 Relationship Between Family Support and

Exclusive Breastfeeding

Table 11: The relationship between family support and

exclusive breastfeeding at Grogol Petamburan Health

Center, West Jakarta in 2016

Variable

Category

Exclusive Breastfeeding

Total

p-value

No Yes

N % N % n %

Family

Support

Supportive

70 60.9 45 39.1 115 100

0.006

Supportive 28 40 42 60 70 100

The proportion of respondents with less family

support and not giving exclusive breastfeeding were

as many as 70 people (60.9%), while respondents

with good family support and give out exclusive

breastfeeding were as many as 42 people (60%).

Thus it can be concluded that there is a significant

relationship between family support and exclusive

breastfeeding.

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5 CONCLUSION

5.1 Overview of Exclusive Breastfeeding

Exclusive breastfeeding is giving out breastfeeding

without additional food at the age of 0-6 months.

Exclusive breastfeeding is that babies are only given

breastfeeding from birth without additional fluids

such as formula milk, oranges, honey, tea water,

water, and without solid foods such as bananas,

porridge, milk porridge, and steamed rice

(Maryunani, 2012, p.98). In this study, the results of

the univariate analysis showed that mothers who

carried out exclusive breastfeeding were mostly not

giving exclusive breastfeeding as many as 98

respondents (53%) and respondents who gave

exclusive breastfeeding were 87 respondents (47%).

5.2 Knowledge

Based on the results of the study, it was also

found that there’s a significant relationship between

knowledge factors with exclusive breastfeeding at

Grogol Petamburan Health Center, West Jakarta.

Knowledge is a domain that strongly shapes one's

actions (Overt Behavior) (Notoatmodjo, 2012).

5.3 Age

The result also found no significant relationship

between age factors with exclusive breastfeeding at

Grogol Petamburan Health Center, West Jakarta.

Age is the age of an individual starting from the time

of birth until now. Age <20 and> 35 years is a risky

age for childbirth which will affect exclusive

breastfeeding and can affect lactation ability. While

the age of 20-35 years is fertile or reproductive, so it

has good lactation to provide exclusive

breastfeeding (Utami, 2012).

5.4 Occupation

Based on the results of the study, it is also found that

there’s no significant relationship between

occupation and exclusive breastfeeding in Grogol

Petamburan Health Center, West Jakarta. The

increase in the female workforce can affect

exclusive breastfeeding in Indonesia, because it is

feared that female workers who have babies

experience difficulties in giving breast milk because

they do not get the opportunity and means to

breastfeed at work (Center for Data and Information

of the Ministry of Health, 2014).

5.5 Place for Giving Birth

Based on the results of the study it is also found that

there’s no significant relationship between the place

of for giving birth and exclusive breastfeeding at

Grogol Petamburan Health Center, West Jakarta. It

is very important for all health facilities to support

breastfeeding and commit to exclusive breastfeeding

because health facilities are institutions that are

trusted by the use of childbirth services (MOH,

2007).

5.6 Family Support

Based on the results of the study it is also found that

there’s a significant relationship between place for

giving birth and exclusive breastfeeding at Grogol

Petamburan Health Center, West Jakarta. Most

pregnant women and breastfeeding mothers who

have received counseling about breast milk do not

practice their knowledge because they are not the

maindecision-makers in the family to provide

exclusive breastfeeding (Utami, 2012).

In this study frequency of knowledge, age,

employment, place of birth, family support and

exclusive breastfeeding were tested. It is found that

there is a relationship between knowledge with

exclusive breastfeeding and there is a relationship

between family support and exclusive breastfeeding.

Forage, work and place of delivery, there were no

relationship with exclusive breastfeeding. From the

results of this study, following suggestions for the

future were concluded:

 The need to increase maternal knowledge

about breastfeeding until the baby is 6

months old, by expanding promotion and

education about exclusive breastfeeding, not

only to mothers but can be done for

husbands, parents, and in-laws.

 Establishment of breast milk Support Groups

as support for health workers to help promote

exclusive breastfeeding in the community.

 Health workers must provide education about

exclusive breastfeeding to pregnant women

so that they can carry out exclusive

breastfeeding.

 Ministry regulation policy on providing

breast milk space in each existing company

must be applied to each company so that

working mothers continue to provide

exclusive breastfeeding for their babies.

 Health workers must provide education so

that the community gives birth in health

facilities.

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