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The Relationship between Place of Birth and Early Breastfeeding Initiation in Indonesia
Authors: Deni W. Kurniawan, Ilana R. A. Chertok, and Zelalem T. Haile
Source: Journal of Human Lactation, Published online; DOI: 10.1177/0890334420945299
Topic(s): Breastfeeding
Delivery care
Institutional births
Country: Asia
  Indonesia
Published: AUG 2020
Abstract: Background In many countries, hospital-based births are associated with the early initiation of breastfeeding, within the first hour postpartum, especially where the Baby Friendly Hospital Initiative guidelines have been adopted. While Indonesia has adopted the guidelines, there is a relatively low rate of early breastfeeding initiation in the country. Research Aim To determine the relationship between place of birth and early breastfeeding initiation in Indonesia. Method This study was a retrospective cross-sectional survey using national data from the 2017 Indonesia Demographic and Health Survey (N = 14,279). The association between place of birth and early breastfeeding initiation was examined using logistic regression models, adjusting for potential confounders. Results The overall prevalence of early breastfeeding initiation in Indonesia was 60.9% with a greater proportion of mothers giving birth in health facilities. In the multivariate model, there was a significant interaction between wealth index, insurance status, and place of birth on the timing of breastfeeding initiation. In the subgroup of mothers residing in middle wealth index households, women who gave birth in clinics and hospitals had lower odds of early breastfeeding initiation compared to those who gave birth at home (0.56; 0.34, 0.90; p = .018) and (0.58; 0.40, 0.85; p = .005), respectively. Conclusions Place of birth was significantly associated with early breastfeeding initiation. There is a need to consider health disparities and to strengthen the implementation of the WHO guidelines, Baby Friendly Hospital Initiative, and International Code of Marketing of Breastmilk Substitutes, to increase early breastfeeding initiation in Indonesia. Keywords breastfeeding, breastfeeding initiation, Baby-Friendly Hospital Initiative