Early Initiation of Breastfeeding and Exclusive Breastfeeding Practices Among Highly Educated Mothers in Indonesia: Evidence From the National Nutrition Status Survey 2022.

Abstract

Background: Despite increasing levels of women's education in Indonesia, exclusive breastfeeding (EBF) rates remain stagnant and lower than in neighboring Southeast Asian countries. Early initiation of breastfeeding (EIBF) plays a crucial role in determining EBF success, yet its impact among highly educated mothers-who face distinct sociodemographic challenges-has not been fully examined.

Research aim: This study aimed to analyze the association between EIBF and EBF practices among highly educated mothers in Indonesia, and to identify sociodemographic factors influencing breastfeeding outcomes.

Method: A cross-sectional analysis was conducted using data from the 2022 Indonesian Nutritional Status Survey, including 24,064 children aged 0-23 months. Binary logistic regression was used to assess the relationship between EIBF and EBF, controlling for place of residence, maternal age, marital status, employment, household wealth, antenatal care visits, birthplace, and the child's sex.

Results: Mothers who practiced EIBF had 1.577 times higher odds of achieving EBF (95% CI [1.566, 1.588]) than those who did not. Higher EBF rates were also observed among urban residents, younger and married mothers, unemployed women, those from wealthier households, mothers without antenatal care visits, non-institutional births, and mothers of female infants.

Conclusion: EIBF significantly increases the likelihood of EBF among highly educated mothers in Indonesia. Strengthening postpartum support, workplace policies, and partner involvement is crucial to transforming maternal knowledge into sustained breastfeeding practices and promoting equitable child nutrition nationwide.