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Original Article

Parental support and exclusive breastfeeding at 3 months in West Java, Indonesia: a mixed-methods approach

Ratu Ayu Dewi Sartika¹  , Fadila Wirawan¹  , Wawan Gunawan¹  , Primasti Nuryandari Putri¹  , Nurul Husna Mohd Shukri² 

¹Department of Public Health Nutrition, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
²Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia

Correspondence Fadila Wirawan ,Email: fadila.wirawan@gmail.com

Received: October 4, 2023; Revised: April 23, 2024   Accepted: April 26, 2024.

Abstract

Background
The exclusive breastfeeding (EBF) rate in Indonesia is lower than expected. Among the key factors affecting breastfeeding practices, paternal support has been suggested.
Purpose
To explore the role of paternal support in EBF failure among 3-month-old infants.
Methods
This sequential mixed-methods study, part of an ongoing cohort study in West Java in early 2022, included 225 infants. The parents of 3-month-old infants were interviewed. Paternal support was assessed using a 15-point validated questionnaire for a total score of 15–60 points. Multivariate binary regression was used to determine adjusted odds ratios (aORs). The qualitative exploration was based on in-depth interviews (IDIs) and forum group discussions (FGDs) following the quantitative survey.
Results
Of the 225 infants, 52.2% were no longer EBF. High paternal support (greater than the mean score) of breastfeeding was determined in 52.9% of cases (mean± standard deviation, 38.7±6.7 for the overall population vs. 37.5±6.3 and 40.2±6.8 for infants who were and were not EBF at 3 months of age, respectively). Low paternal support was associated with an increased EBF failure rate (aOR, 2.84; 95% confidence interval [CI], 1.46–5.54). Other variables that remained as predictors in the final model were a low birth rate (aOR, 7.35; 95% CI, 1.73–31.20), negative maternal attitude (aOR, 3.31; 95% CI, 1.63–6.75), lower self-efficacy (aOR, 4.82; 95% CI, 2.43–9.57), and lower maternal education level (aOR, 2.87; 95% CI, 1.03– 8.03). The IDIs and FGD observed the importance of the father’s support of the mother and EBF. The qualitative exploration revealed a lack of knowledge about EBF as a parental support barrier.
Conclusion
Paternal support is important for EBF. Paternal involvement in EBF planning encouraged themother to continue. Plans that include fathers in breastfeeding education may help increase paternal support.

Keywords :Breast feeding, Fathers, Social support