Exclusive breastfeeding rate and factors associated with infant feeding practices in Indonesia

Main Article Content

Yovita Ananta
Ellen Gandaputra
Elina Waiman
I Gusti Ayu Nyoman Partiwi
Nanis Sacharina Marzuki
Elizabeth Yohmi
Eveline Panjaitan
Hanifah Oswari
Badriul Hegar


Background Breast milk is the ideal food for infants. According to the 2007 Indonesian National Household Health Survey, only 23% of mothers exclusively breastfeed for six months.

Objectives To determine the rate of exclusive breastfeeding in Indonesia, to evaluate factors associated with infant feeding practices, and to compare the nutritional and developmental status between exclusively-breastfed and formula-fed infants.

Methods A survey was conducted in hospitals located in 17 provinces in Indonesia. The rate of exclusive breastfeeding was calculated. Many variables were investigated as potential predictors for exclusive breastfeeding using a multivariable logistic regression analysis. Further analysis was performed to compare the nutritional and developmental status between exclusively breastfed and formula-fed infants at the time of survey.

Results From 1,804 infant subjects, the overall rate of exclusive breastfeeding was 46.3%, ranging from 10.5% in East Java to 66.9% in Jambi. Predominant breastfeeding, complementary feeding, and formula feeding rates were 14.3%, 8.6%, and 30.7%, respectively. Maternal unemployment was associated with a longer duration of breastfeeding (P=0.000). There were significantly more formula-fed infants who were undernourished compared to exclusively-breastfed infants (14% vs. 8%, P=0.001). There were also significantly more infants in the formula-fed group who had abnormal head circumference compared to those in the exclusively-breastfed group (9% vs. 6%, P=0.031). Child development, as assessed by the Pre-screening Developmental Questionnaire, was similar between the two groups (P=0.996).

Conclusion The overall rate of exclusive breastfeeding in Indonesia is 46.3%. Maternal unemployment is associated with longer duration of breastfeeding. Exclusive breastfed infants have significant better growth and head circumference compared to formula fed infants, while the development is similar between the two groups.

Article Details

How to Cite
Ananta Y, Gandaputra E, Waiman E, Partiwi IGA, Marzuki N, Yohmi E, Panjaitan E, Oswari H, Hegar B. Exclusive breastfeeding rate and factors associated with infant feeding practices in Indonesia. PI [Internet]. 12May2016 [cited 24Apr.2019];56(1):24-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/75
Author Biography

Yovita Ananta, Breastfeeding Task Force, Indonesian Pediatrics Society, Jakarta




1. Centers for Disease Control and Prevention (CDC). 2012 Breastfeeding Report Card, United States. [cited 15 July 2012]. Available from: http://www.cdc.gov/breastfeeding/pdf/2012BreastfeedingReportCard.pdf.
2. Statistics Indonesia (Badan Pusat Statistik—BPS) and Macro International. Indonesia Demographic and Health Survey 2007. Calverton : BPS and Macro International; 2008. Page 169-73.
3. Su LL, Chong YS, Chan YH, Chan YS, Fok D, Tun KT, et al. Antenatal education and postnatal support strategies for improving rates of exclusive breast feeding: randomised controlled trial. BMJ. 2007;335:596-602.
4. World Health Organization. The WHO Child Growth Standards. Geneva: world Health Organization (WHO). [cited 15 July 2012]. Available from: http://www.who.int/childgrowth/standards/en/.
5. Frakenburg WK, Fandal AW, Thornton SM. Revision of Denver Prescreening Developmental Questionnaire. J Pediatr. 1987; 110:653-7.
6. Kramer MS, Kakuma R. The optimal duration of exclusive breastfeeding: a systematic review. Adv Exp Med Biol. 2004;554:63-77.
7. Butte NF, Lopez-Alarcon MG, Cutberto G. Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life. Geneva: World Health Organization (WHO). 2002. [cited 15 July 2012]. Available from: http://whqlibdoc.who.int/publications/9241562110.pdf.
8. Fewtrell MS, Morgan JB, Duggan C, Gunnlaugsson G, Hibberd PL, Lucas A, et al. Optimal duration of exclusive breastfeeding: what is the evidence to support current recommendations? Am J Clin Nutr. 2007;85:635S-8S.
9. Al-Sahab B, Lanes A, Feldman M, Tamim H. Prevalence and predictors of 6-month exclusive breastfeeding among Canadian women: a national survey. BMC Pediatr. 2010;10:20.
10. Leung EY, Au KY, Cheng SS, Kok SY, Lui HK, Wong WC. Practice of breastfeeding and factors that affect breastfeeding in Hong Kong. Hong Kong Med J. 2006;12:432-6.
11. Brekke HK, Ludvigsson JF, van Odijk J, Ludvigsson J. Breastfeeding and introduction of solid foods in Swedish infants: the All babies in Southeast Sweden study. Br J Nutr. 2005;94:377-82.
12. Lande B, Andersen LF, Baerug A, Trygg KU, Lund-Larsen K, Veierod MB, et al. Infant feeding practices and associated factors in the first six months of life: the Norwegian infant nutrition survey. Acta Paediatr. 2003;92:152-61.
13. Alemayehu T, Haidar J, Habte D. Determinants of exclusive breastfeeding practices in Ethiopia. Ethiop J Health Dev. 2009;23:12-8.
14. Patel A, Badhoniya N, Khadse S, Senarath U, Agho KE, Dibley MJ, et al. Infant and young child feeding indicators and determinants of poor feeding practices in India: secondary data analysis of National Family Health Survey 2005-06. Food Nutr Bull. 2010;31:314-33.
15. Olang B, Farivar K, Heidarzadeh A, Strandvik B, Yngve A. Breastfeeding in Iran: prevalence, duration and current recommendations. Int Breastfeed J. 2009;4:8.
16. Tan KL. Factors associated with exclusive breastfeeding among infants under six months of age in peninsular Malaysia. Int Breastfeed J. 2011;6:2.
17. Forster DA, McLachlan HL, Lumley J. Factors associated with breastfeeding at six months postpartum in a group of Australian women. Int Breastfeed J. 2006;1:18.
18. Blyth RJ, Creedy DK, Dennis CL, Moyle W, Pratt J, De Vries SM, et al. Breastfeeding duration in an Australian population: the influence of modifiable antenatal factors. J Hum Lact. 2004;20:30-8.
19. Grossman LK, Fitzsimmons SM, Larsen-Alexander JB, Sachs L, Harter C. The infant feeding decision in low and upper income women. Clin Pediatr (Phila). 1990;29:30-7.
20. Avery M, Duckett L, Dodgson J, Savik K, Henly SJ. Factors associated with very early weaning among primiparas intending to breastfeed. Matern Child Health J. 1998;2:167-79.
21. Scott JA, Landers MC, Hughes RM, Binns CW. Factors associated with breasfeeding at discharge and duration of breastfeeding. J Paediatr Child Health. 2001;37:254-61.
22. Li L, Li S, Ali M, Ushijima H. Feeding practice of infants and their correlates in urban areas of Beijing, China. Pediatr Int. 2003;45:400-6.
23. Mandal B, Roe BE, Fein SB. The differential effects of full-time and part-time work status on breastfeeding. Health Policy. 2010;97:79-86.
24. Ogbuanu C, Glover S, Probst J, Liu J, Hussey J. The effect of maternity leave length and time of return to work on breastfeeding. Pediatrics. 2011;127:e1414-27.
25. Agostoni C, Grandi F, Gianni ML, Silano M, Torcoletti M, Giovannini M, et al. Growth patterns of breast fed and formula fed infants in the first 12 months of life: an Italian study. Arch Dis Child. 1999;81:395-9.
26. Zadik Z, Borondukov E, Zung A, Reifen R. Adult height and weight of breast-fed and bottle-fed Israeli infants. J Pediatr Gastroenterol Nutr. 2003;37:462-7.
27. Mandic Z, Piricki AP, Kenjeric D, Hanicar B, Tanasic I. Breast vs. bottle: differences in the growth of Croatian infants. Matern Child Nutr. 2011;7:389-96.
28. Gale C, Logan KM, Santhakumaran S, Parkinson JR, Hyde MJ, Modi N. Effect of breastfeeding compared with formula feeding on infant body composition: a systematic review and meta-analysis. Am J Clin Nutr. 2012;95:656-69.
29. Donma MM, Donma O. The influence of feeding patterns on head circumference among Turkish infants during the first 6 months of life. Brain Dev. 1997;19:393-7.
30. Dewey KG. Growth characteristics of breast-fed compared to formula-fed infants. Biol Neonate. 1998;74:94-105.
31. Anderson JW, Johnstone BM, Remley DT. Breastfeeding and cognitive development: a meta-analysis. Am J Clin Nutr. 1999;70:525-35.
32. Kramer MS, Aboud F, Mironova E, Vanilovicb I, Platt RW, Matush L, et al. Breastfeeding and child cognitive development: new evidence from a large randomized trial. Arch Gen Psychiatry. 2008;65:578-84.