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Exclusive breastfeeding (EBF) is critical during the early stages of life. Babies require only breast milk from birth until 6 months of age. This study analyzed the correct target for increasing EBF in Indonesia.
Methods
This cross-sectional study included 12,534 infants and examined EBF practices as outcome variables. Seven maternal characteristics were included as exposure variables (residence, age, marital status, education, employment, prenatal class, and wealth) and four infant characteristics as control variables (age, sex, birth weight, and early initiation of breastfeeding). Finally, binary logistic regression analysis was performed.
Results
Result showed that the proportion of EBF in Indonesia is 52.90% (95% confidence interval [CI], 52.37%–53.43%). Mothers in rural areas were 1.134 times more likely to perform EBF than were those in urban areas (95% CI, 1.126–1.141). All maternal age groups were more likely to achieve EBF than the youngest group (<20 years), except for those aged >44 years, for which there was no significant difference compared with those aged <20 years. Married mothers were 1.361 times more likely to achieve EBF than were divorced/widowed mothers (95% CI, 1.311–1.412). Maternal education and employment were associated with EBF achievement. There was no significant relationship between the prenatal class and EBF performance in Indonesia. Furthermore, results indicate that all wealth statuses are less likely to achieve EBF than the poorest in Indonesia.
Conclusion
Six maternal characteristics were specifically targeted to increase EBF in Indonesia: living in urban areas, being young, having a divorced/widowed status, having poor education, being employed, and being wealthy.
Breastfeeding is one of the most effective ways to ensure children’s health and survival [1]. Optimal breastfeeding is essential for the health and development of infants. Adequate nutrition during infancy and early childhood ensures maximum growth and development of infants and children [2]. Babies must be exclusively breastfed; babies only receive breast milk for the first 6 months of life [1]. Breast milk is the only food and drink babies receive. Exclusive breastfeeding (EBF) involves feeding the infants exclusively with breast milk, no formula or water, with the exception of medicines, vitamins, and mineral supplements. Good maternal knowledge and positive attitudes are essential for practicing EBF [3].
EBF helps children develop healthier eating habits, less extended hospital stays, better weight gain, normal body mass index, lower adiposity, lower total cholesterol, cognitive development, better behavior, and metabolic rate stability in children with metabolic disorders [4]. EBF is the cheapest strategy to prevent childhood obesity, hypertension, gastroenteritis, and death [5]. A Spanish study found that increasing EBF could save the National Health System considerably [6]. Other chronic diseases caused by breastfeeding include diabetes (types 1 and 2), obesity, hypertension, cardiovascular diseases, hyperlipidemia, and some types of cancer [5].
According to the Malawi Demographic and Health Survey, EBF decreased from 70.2% (2014) to 61% (2016) [7]. The prevalence of EBF in Ghana is 50%, with a higher prevalence in rural areas (54%) than in urban areas (44%) [8]. China comprises approximately 30% [9]. Various factors, including the baby, mother, and the environment, can influence EBF in infants.
EBF in Indonesia increased from 66.1% to 69.7% of the 45% national target between 2020 and 2021. This targeted increase must be maintained to improve newborn health in Indonesia. Three provinces, Papua (11.9%), West Papua (21.4%), and West Sulawesi (27.8%), fell below the objective, whereas West Nusa Tenggara achieved the best result (86.7%) [10].
Infant factors that influence EBF include a history of premature birth and hospitalization in the neonatal intensive care unit, which are associated with non-EBF [9]. Skin-to-skin care of babies immediately after birth, early initiation of breastfeeding (EIBF), hospitalization, and single births are associated with EBF [9]—the baby’s gender and number of siblings. Mothers of baby girls and mothers with three to four children are more likely to be involved in EBF [7]. Low birth weight (LBW) infants are less likely to be exclusively breastfed than typical and high-birth-weight newborns. Regular newborns are more likely to be nursed. Results showed that birth weight and size affected mothers’ EBF decisions [11].
Factors that affect EBF include no education or primary education, not inspecting children after birth, giving birth outside of health facilities, and being associated with non-EBF mothers [12]. In a previous study, informal workers and mothers with six or more children were more likely to breastfeed. Factors contributing to successful breastfeeding include higher education, paid maternity leave, support from family and friends, and improved knowledge and experience of breastfeeding [9]. Information about breastfeeding during antenatal care, follow-up postnatal care, and the initiation of breastfeeding within one hour after birth are factors that significantly influence EBF. EBF facilitators also included mother’s age, self-employment status, employment status, hospital birth, cesarean delivery, receipt of adequate antenatal care, counseling, participation in support groups, knowledge of EBF, a positive attitude, and higher education. Average birth weight helps with EBF [10]. Factors that limit EBF include maternity leave for 3 months, mothers with HIV, partner abuse, lack of information, poor milk production, family support, and partners who want more children [7,8]. Identifying the factors that influence EBF can inform policymakers and program implementers about the implementation of appropriate interventions to optimize infant growth and development and reduce infant mortality and morbidity. Thus, this study identified the most suitable audience for increasing EBF in Indonesia.
Methods
Study design and data source
This study analyzed secondary data from the 2021 Indonesian National Nutritional Status Survey. A nationwide cross-sectional survey was conducted by the Indonesian Ministry of Health. As the survey owner, the Indonesian Ministry of Health has implemented complex survey weights, strata, and primary sampling unit clustering, which are incorporated in the dataset provided to the authors.
The study population consisted of all Indonesian infants under 6 months old (1–5 months). Infants served as the unit of analysis, and their mothers served as the respondents. This study employed a multistage cluster random sampling procedure to generate a weighted sample of 12,534 infants.
Setting
This study was conducted at the national level.
Outcome variable
This study examined the EBF practices of mothers of infants under 6 months. We dichotomized the EBF into 0 (no) and 1 (yes). “No” (0) was assigned to mothers who stated that they had given their children any food other than breast milk; “yes” (1) was set to those who indicated that they had not given their children any food other than breast milk [13].
Exposure variables
Six maternal characteristics were used as exposure variables: type of residence, maternal age group, maternal marital status, educational level, employment status, prenatal class, and wealth status. Types of residence included urban and rural areas. Maternal age was categorized into <20, 20–24, 25–29, 30–34, 35–39, 40–44, and >44 years. Additionally, maternal education was categorized into four levels: no formal education, primary, secondary, and higher education. Maternal marital status consisted of being married or living with a partner and being divorced or widowed. Maternal employment status included employed and unemployed individuals.
Expectant parents can learn about pregnancy, labor, and the early stages of parenthood in prenatal classes. These programs provide information and support to help parents prepare for the physical, emotional, and psychological changes associated with having a child. Although the subject matter of prenatal classes varies, they often address pain management, delivery alternatives and techniques, breastfeeding, infant care, and postpartum rehabilitation. Prenatal classes were primarily taught by medical experts (obstetricians, midwives, nurses, or certified childbirth instructors) [14]. The classes generally focused on maternal and fetal health, pregnancy complications, labor preparation, and postpartum care, with breastfeeding education often included as a supplementary topic rather than a central component. Sessions are typically held once or twice during pregnancy, which limits opportunities for reinforcement and practice. In this study, participation was measured dichotomously (attended vs. not attended) without capturing variations in frequency, quality, or breastfeeding-specific content. Prenatal classes comprised no and yes responses.
This study uses the wealth quintile of a household’s possessions to estimate its wealth level. When assigning grades, the survey considered the quantity and variety of items in a family home. The poll also considered the home’s qualities and numerous possessions such as bicycles, cars, and televisions to establish wealth. The survey considered the principal floor construction materials, drinking water sources, and restroom amenities. Principal component analysis was used to calculate the scores. The pool uses household scores to determine the national wealth quintiles, which are divided into the same five groups and represent 20% of the population. The survey divided wealth status into five categories: poorest, poor, middle, more prosperous, and most affluent [15].
Control variables
Control variables were determined based on previous studies and data provided in the 2021 Indonesian National Nutritional Status Survey [2,7,16]. Four infant characteristics were used as control variables: age, birth weight, sex, and EIBF. Infant age is a critical factor because the likelihood of maintaining EBF typically declines as children grow older. The infants were boys and girls, and their ages were categorized as 0–1, 2–3, and 4–5 months.
Birth weight is strongly associated with infant feeding practices, as LBW infants may require alternative feeding support. Previous studies have shown that infant sex influences feeding patterns, and cultural preferences sometimes shape breastfeeding behavior. This study classified birth weight into three types: LBW (<2,500 g), regular (2,500–4,000 g), and macrosomia (>4,000 g) [17]. This study also defined EIBF as the beginning of the mothers’ nursing of newborns within the first hour of birth, ensuring that the newborn receives colostrum [18]. EIBF is widely recognized as a determinant of sustained EBF because timely initiation fosters maternal confidence and successful lactation. The EIBF comprised no and yes responses.
Data analysis
The available dataset contained relatively few missing data (<100 cases). This study used regression imputation to predict the missing values based on other variables. Chi-square test was used in the initial analysis. A collinearity test was then conducted to confirm that there was no significant correlation between the independent variables. The final phase involves a binary logistic regression test (entry method). This study used a 95% confidence interval (CI) and P-value of 0.05 to determine statistical significance. IBM SPSS Statistics ver. 26.0 (IBM Corp.) was used to perform all statistical analyses.
Additionally, ArcGIS ver. 10.3 (ESRI Inc.) was employed to create a distribution map of EBF prevalence in Indonesia. Indonesian Statistics provided a shapefile with administrative border polygons for this study.
Ethical approval and consent to participate
The National Ethics Commission granted the Indonesian National Nutritional Status Survey 2021 an ethical license (LB.02.01/2/KE.248/2021). The survey required written informed consent, and respondents or their guardians provided written informed consent to account for the voluntary and confidential nature of the data collection.
Results
The findings showed that the proportion of EBF in Indonesia was 52.90% (95% CI, 52.37%–53.43%). Figure 1 shows a map of the prevalence of EBF according to Indonesian province. The map shows substantial regional variation, with provinces in eastern Indonesia generally exhibiting a higher prevalence of EBF, whereas several provinces in western Indonesia records lower proportions. This pattern highlights geographic disparities in breastfeeding practices, which may reflect differences in socioeconomic conditions, cultural norms, and access to healthcare services.
Table 1 shows that EBF in Indonesia varies significantly according to maternal and household characteristics. EBF was more common among mothers living in rural areas, aged 25 to 34 years, who were married, had higher education, were unemployed, and came from poor households. By contrast, younger mothers (<20 years), divorced or widowed mothers, and those in the wealthiest group had a significantly lower prevalence of EBF. These patterns highlight sociodemographic disparities that may influence breastfeeding practices and indicate specific groups that require greater programmatic attention.
Table 2 shows significant differences in EBF across infant characteristics. EBF was most common among infants aged 0 to 1 month but declined as infants grew older. Girls, infants with normal birth weight, and those who experienced EIBF had higher prevalence of EBF. By contrast, boys, LBW infants, and those without EIBF were less likely to be exclusively breastfed. These results point to critical infant-related factors that influence breastfeeding practices.
The following analyses used collinearity tests: Results showed that the tolerance values for all variables were, on average, more significant than 0.10; the variance inflation factor values for all variables were simultaneously more significant than 10.00. Collinearity tests revealed no collinearity between the independent variables. Thus, the study found no strong relationship between two or more independent variables in the regression model.
Table 3 shows the results of the binary logistic regression. Regarding the type of residence, mothers in rural areas were 1.134 times more likely to perform EBF than those in urban areas (adjusted odds ratio [AOR], 1.134; 95% CI, 1.126–1.141). In terms of maternal age, all groups were more likely to initiate EBF than the youngest group (<20 years old) in Indonesia, except for those aged 44 years and above, for which there was no significant difference compared with those aged <20 years.
Based on maternal marital status, Table 3 shows that married mothers are 1.361 times more likely to achieve EBF than divorced/widowed mothers (AOR, 1.361; 95% CI, 1.311–1.412). The study also found that maternal education was associated with achievement of EBF. Moreover, in terms of maternal employment status, unemployed mothers were 1.126 times more likely to perform EBF than employed mothers (AOR, 1.126; 95% CI, 1.118–1.135).
Table 3 shows that there was no significant association between prenatal class and EBF performance in Indonesia. Furthermore, results suggest that people of all wealth statuses in Indonesia are less likely to achieve EBF than those in the poorest category.
Moreover, the study found that all the control variables were associated with EBF performance in Indonesia. Infants in all age groups were more likely to achieve EBF than those aged 4 to 5 months. Girls were 1.113 times more likely to achieve EBF than boys (AOR, 1.113; 95% CI, 1.106–1.120). In addition, all birth weights were more likely to receive EBF in Indonesia than were LBWs. Furthermore, infants with EIBF were 1.856 times more likely to have EBF than those without EBF (AOR, 1.856; 95% CI, 1.844–1.868).
Discussion
EBF is an effective strategy for addressing nutritional and health needs, particularly in infants under 6 months. A previous study showed that exclusively breastfed newborns were more resilient to disease than partially nursed newborns. Breast milk contains various natural immune biomarkers that help prevent illness. Breast milk also meets the nutritional needs of infants by providing macro- and micronutrients. Nutrition protects children from morbidity and infant mortality. Breast milk provides the bacteria and nutrients essential for newborn development [19].
The EBF policy in Indonesia is governed by Government Regulation No. 33 of 2012. Under this policy, the government actively promotes EBF. EBF is supported by allowing mothers to practice it while working. The government also builds EBF facilities in public and office areas and offers education and training to increase community awareness and coverage [20].
Results illustrate the spatial distribution of EBF prevalence across Indonesian provinces in 2021, which is categorized into five quantiles. Provinces with the highest prevalence of EBF, depicted in dark blue, were primarily located in the eastern region, including East Nusa Tenggara, West Nusa Tenggara, and parts of Maluku and Sulawesi. These regions may benefit from stronger cultural norms surrounding breastfeeding, limited access to formula, and robust community-based health support. By contrast, the provinces with the lowest EBF rates, shown in light blue, included Jakarta, Bangka Belitung, and parts of Papua and North Maluku, which could reflect urban lifestyle barriers, insufficient workplace support, or weaker implementation of EBF promotion policies. For instance, despite its advanced healthcare infrastructure, Jakarta may struggle with a low EBF because of maternal employment pressures and aggressive formula marketing. The difference between urban and rural provinces underscores the need for context-specific interventions in which policy support, such as workplace lactation rooms, flexible maternity leave, and community outreach, must be tailored to the local socioeconomic and cultural environment [21,22].
The Indonesian maternal attributes of EBF success included domicile, mother’s age, marital status, education, occupation, and wealth. Rural Indonesian women practiced EBF more often than their urban counterparts. Other data suggest that rural women practice EBF more commonly than urban women [23]. Rural parents may work in an informal economy or rear their children for 6 months. This study indicated that rural and urban mothers had greater prevalence of EBF. Other studies suggest that the mother’s education, expertise, and employment status also influence this. Even mothers living in urban environments, as highly aware female workers, have practiced EBF well [21].
These findings imply that breastfeeding promotion efforts in Indonesia should particularly target adolescent mothers who remain the most vulnerable group for not practicing EBF. Young women are less likely to practice EBF. However, mothers aged >44 years showed a decreased rate in EBF. Breastmilk production and sociocultural variables may have contributed to this decline. Previous studies have shown that young mothers have more trouble practicing EBF than those aged 20 to 35 years [12].
This study suggests that EBF interventions should provide additional support for divorced and widowed mothers who may face greater social and economic barriers. Spouses, particularly those with secondary education or higher, may be more aware of the benefits of timed complementary feeding. The early detection of the effects of non-EBF enables them to counter outside intervention after several months, contrary to conventional wisdom and incorrect assumptions. Moreover, mothers require assistance from pregnancy to birth. In the first 1,000 days of pregnancy and EBF, husband’s support is crucial when resources are limited to maternal nutrition and extra feeding. Most studies have examined mother-specific EBF-supportive therapy [24]. Single or divorced mothers typically do not have access to these resources.
These findings underscore the importance of policies that integrate breastfeeding support into educational initiatives and workplace settings to ensure that maternal education and employment do not hinder EBF practices. Maternal and child health considerations favor EBF as women’s education increases. Higher education increases women’s awareness of the benefits of EBF and their willingness to apply it. These results aligned with those of a study in Noakhali, Bangladesh, which showed that higher maternal education was associated with increased prevalence of EBF. EBF is easy for women who understand that breastmilk is the best. Furthermore, health awareness and behavior improve with education [25].
Results indicate that workplace- and community-based interventions are crucial for supporting employed mothers in maintaining EBF practices. New mothers have more time to care for their children when unemployed. However, working mothers may struggle to breastfeed exclusively because of fatigue and time constraints. Other causes include working mothers not having enough time to nurse their children during work hours, having a short time to bond with their newborns because of short maternity leave, or the lack of a proper place to breastfeed at work such as lactation room [19,26].
The relationship between participation in prenatal classes and EBF practices in Indonesia is not statistically significant. Therefore, the government must promote EBF through effective prenatal classes. Practical prenatal classes have considerable potential to increase EBF success. However, the limited support and coordination among stakeholders can hinder optimal outcomes. Currently, many prenatal class programs face challenges, particularly in terms of inflexible schedules and suboptimal implementation. Therefore, improving health facilities and infrastructure, community outreach, and comprehensive program monitoring and evaluation are crucial to strengthen their impact [27]. Because prenatal classes depend on government support, government policies must support and promote EBF. This policy must improve the local implementation of prenatal courses [28].
In Indonesia, the wealth class is less likely to receive EBF. This finding validates that of previous studies on socioeconomic disparities in EBF practices in low- and middle-income countries, including Peru, Kenya, and Ethiopia. Affluent mothers had lower prevalence of EBF. EBF is more challenging for mothers with higher income, particularly working mothers. The most common challenges include concerns regarding insufficient breastmilk, limited time for EBF, and difficulties associated with breastfeeding while working. Additionally, many working mothers reported receiving minimal support from their employers to continue breastfeeding [29]. The government should prioritize policies that protect against breastfeeding in the workplace and strengthen approaches to minimize formula advertising, particularly among wealthy women.
This study found that all the control variables (infant age, sex, birth weight, and EIBF) were associated with Indonesian EBF performance. This finding supports a multi-country study that found that EBF diminishes with baby age [7]. Younger babies have better EBF success rates because they require breast milk for sustenance and immunity. EBF support services should help mothers with older babies to stay committed.
A previous study has associated newborn sex with EBF rates. In Malawi, female newborns are more likely to be exclusively breastfed than male infants, supporting the results of this study [7]. By contrast, a finding was reported that male infants were more likely to be introduced to complementary foods earlier than female infants [16]. Social and cultural backgrounds have undoubtedly affected these results. Thus, sex preferences should be considered, and all infants should be provided with equal EBF support and opportunities.
The World Health Organization recommends that LBW infants be exclusively breastfed for 6 months [30]. Based on poor evidence, a meta-analysis suggested that non-exclusively breastfed LBW children under 6 months might grow differently from exclusively breastfed neonates. Medical issues, difficulties in sucking, and formula pressure can prevent LBW neonates from gaining EBF. Advocates must exclusively help LBW infants breastfeed. EBF improves with EIBF. Solo colostrum feeding predicts EBF. An early start boosts milk production and fosters a strong bond between the mother and child. EIBF requires support from fathers and mothers-in-law [13]. Thus, breastfeeding support programs must educate health workers and communities on EIBF.
Targeting mothers who are classified as rich and employed requires a cautious approach, as this group may face systemic barriers, such as time constraints, work pressure, or lack of support at work, rather than simply a lack of motivation to breastfeed exclusively. The government must adopt this specific audience to accelerate the increase in the proportion of EBF in Indonesia [19].
Applying behavior change theory, such as the social ecological model, can be a relevant approach to enrich the interpretation of the findings. This model emphasizes that individual behavior, including EBF practices, is influenced by multiple factors: individual (knowledge, attitudes, age, and education), interpersonal (support from partners and family), institutional (workplace and health facility policies), community (social norms and access to information), and public policy (government regulations and support) [22]. The findings of this study indicate that EBF success depends not only on maternal characteristics but also on broader environmental support. Therefore, interventions to increase EBF coverage must be designed at multiple levels, considering interrelated systemic and social factors [22].
Strength and limitations
This study requires extensive data analysis to achieve national outcomes. This study used the 2021 Indonesian National Nutrition Status Survey as secondary data to exclusively examine the variables. The study did not address other EBF-related elements from previous research, including birth order, total number of children born, children’s worth, fever, diarrhea, and health beliefs [13].
Conclusions
This study demonstrates that sociodemographic disparities, particularly among urban, young, divorced or widowed, less educated, employed, and wealthier mothers, significantly shape the likelihood of not practicing EBF in Indonesia. These findings highlight the need for targeted policies and programs that prioritize vulnerable groups to improve the national EBF rates.
Article Information
Conflict of interest
No potential conflict of interest relevant to this article was reported.
Acknowledgments
The author would like to thank the Ministry of Health of the Republic of Indonesia for processing the 2021 Indonesian National Nutrition Status Survey data.
Funding
None.
Data availability
The author cannot freely distribute the data because a third party, the Indonesian Ministry of Health, owns the data and does not have permission to share it. However, the survey data set can be accessed via http://www.layanandata.kemkes.go.id/ for researchers who meet the conditions for access to confidential data.
Author contribution
Conceptualization: ADL, RDW. Data curation: ADL. Formal analysis: ADL, RDW. Investigation: NR, MM, HDK, MS, IK. Methodology: ADL, RDW. Project administration: RDW. Software: NR, MM. Validation: RDW. Visualization: ADL. Writing–original draft: NR, MM, HDK, MS, IK. Writing–review & editing: ADL, RDW. Final approval of the manuscript: all authors.
Figure 1
Exclusive breastfeeding distribution map according to province in Indonesia in 2021. Visualization by the author based on the 2021 Indonesian National Nutritional Status Survey data.
Table 1
Descriptive statistics of maternal characteristics and exclusive breastfeeding in Indonesia in 2021 (n=12,534)
Mothers’ characteristic
Exclusive breastfeeding (%)
P-value
No (n=5,904)
Yes (n=6,630)
Residence type
<0.001
Urban
48.7
51.3
Rural
45.2
54.8
Maternal age (y)
<0.001
<20
59.1
40.9
20–24
50.1
49.9
25–29
44.1
55.9
30–34
43.6
56.4
35–39
48.9
51.1
40–44
51.7
48.3
>44
58.2
41.8
Maternal marital status
<0.001
Married/living with partner
47.0
53.0
Divorced/widowed
57.0
43.0
Maternal education
<0.001
No formal education
45.1
54.9
Primary
47.0
53.0
Secondary
48.5
51.5
Higher
43.8
56.2
Maternal employment status
<0.001
Unemployed
46.7
53.3
Employed
48.1
51.9
Prenatal class
<0.001
No
47.3
52.7
Yes
46.3
53.7
Wealth status
<0.001
Poorest
43.1
56.9
Poorer
47.5
52.5
Middle
50.4
49.6
Richer
45.3
54.7
Richest
48.8
51.2
The table was analyzed using weighting.
Table 2
Descriptive statistics of infant characteristics and exclusive breastfeeding in Indonesia in 2021 (n=12,534)
Infants’ characteristics
Exclusive breastfeeding (%)
P-value
No (n=5,904)
Yes (n=6,630)
Age of infant (mo)
<0.001
0–1
37.8
62.2
2–3
43.0
57.0
4–5
56.2
43.8
Sex of infant
<0.001
Boy
48.3
51.7
Girl
45.9
54.1
Birth weight
<0.001
Low birth weight (<2,500 g)
58.8
41.2
Normal (2,500–4,000 g)
45.9
54.1
Macrosomia (>4,000 g)
51.4
48.6
Early initiation of breastfeeding
<0.001
No
54.2
45.8
Yes
39.0
61.0
The table was analyzed using weighting.
Table 3
Binary logistic regression of exclusive breastfeeding in Indonesia in 2021 (n=12,534)
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Policy to increase exclusive breastfeeding in Indonesia: a secondary analysis to identify priority promotion groups
Figure 1
Exclusive breastfeeding distribution map according to province in Indonesia in 2021. Visualization by the author based on the 2021 Indonesian National Nutritional Status Survey data.
Graphical abstract
Figure 1
Graphical abstract
Policy to increase exclusive breastfeeding in Indonesia: a secondary analysis to identify priority promotion groups
Descriptive statistics of maternal characteristics and exclusive breastfeeding in Indonesia in 2021 (n=12,534)
Mothers’ characteristic
Exclusive breastfeeding (%)
P-value
No (n=5,904)
Yes (n=6,630)
Residence type
<0.001
Urban
48.7
51.3
Rural
45.2
54.8
Maternal age (y)
<0.001
<20
59.1
40.9
20–24
50.1
49.9
25–29
44.1
55.9
30–34
43.6
56.4
35–39
48.9
51.1
40–44
51.7
48.3
>44
58.2
41.8
Maternal marital status
<0.001
Married/living with partner
47.0
53.0
Divorced/widowed
57.0
43.0
Maternal education
<0.001
No formal education
45.1
54.9
Primary
47.0
53.0
Secondary
48.5
51.5
Higher
43.8
56.2
Maternal employment status
<0.001
Unemployed
46.7
53.3
Employed
48.1
51.9
Prenatal class
<0.001
No
47.3
52.7
Yes
46.3
53.7
Wealth status
<0.001
Poorest
43.1
56.9
Poorer
47.5
52.5
Middle
50.4
49.6
Richer
45.3
54.7
Richest
48.8
51.2
The table was analyzed using weighting.
Descriptive statistics of infant characteristics and exclusive breastfeeding in Indonesia in 2021 (n=12,534)
Infants’ characteristics
Exclusive breastfeeding (%)
P-value
No (n=5,904)
Yes (n=6,630)
Age of infant (mo)
<0.001
0–1
37.8
62.2
2–3
43.0
57.0
4–5
56.2
43.8
Sex of infant
<0.001
Boy
48.3
51.7
Girl
45.9
54.1
Birth weight
<0.001
Low birth weight (<2,500 g)
58.8
41.2
Normal (2,500–4,000 g)
45.9
54.1
Macrosomia (>4,000 g)
51.4
48.6
Early initiation of breastfeeding
<0.001
No
54.2
45.8
Yes
39.0
61.0
The table was analyzed using weighting.
Binary logistic regression of exclusive breastfeeding in Indonesia in 2021 (n=12,534)
Predictor
Exclusive breastfeeding
P-value
AOR (95% CI)
Residence
Urban (ref)
-
-
Rural
<0.001***
1.134 (1.126–1.141)
Maternal age (y)
<20 (ref)
-
-
20–24
<0.001***
1.502 (1.477–1.527)
25–29
<0.001***
1.937 (1.906–1.969)
30–34
<0.001***
1.960 (1.928–1.992)
35–39
<0.001***
1.633 (1.605–1.661)
40–44
<0.001***
1.517 (1.487–1.548)
>44
0.264
1.019 (0.986–1.054)
Maternal marital
Married
<0.001***
1.361 (1.311–1.412)
Divorced/widowed (ref)
-
-
Maternal education
No formal education (ref)
-
-
Primary
0.214
1.018 (0.990–1.046)
Secondary
0.002**
0.958 (0.931–0.985)
Higher
<0.001***
1.187 (1.153–1.222)
Maternal employment
Unemployed
<0.001***
1.126 (1.118–1.135)
Employed (ref)
-
-
Prenatal class
No (ref)
-
-
Yes
0.956
1.000 (0.992–1.008)
Wealth
Poorest (ref)
-
-
Poorer
<0.001***
0.818 (0.809–0.826)
Middle
<0.001***
0.698 (0.690–0.705)
Richer
<0.001***
0.870 (0.861–0.879)
Richest
<0.001***
0.723 (0.715–0.732)
Age of infant (mo)
0–1
<0.001***
2.133 (2.116–2.151)
2–3
<0.001***
1.731 (1.719–1.743)
4–5 (ref)
-
-
Sex of infant
Boy (ref)
-
-
Girl
<0.001***
1.113 (1.106–1.120)
Birth weight
Low birth weight (<2,500 g) (ref)
-
-
Normal (2,500–4,000 g)
<0.001***
1.535 (1.516–1.554)
Macrosomia (>4,000 g)
<0.001***
1.205 (1.184–1.226)
Early initiation of breastfeeding
No (ref)
-
-
Yes
<0.001***
1.856 (1.844–1.868)
The table was analyzed using weighting.
AOR, adjusted odds ratio; CI, confidence interval; ref, reference.
**P<0.01 and
***P<0.001 (Statistically significant).
Table 1
Descriptive statistics of maternal characteristics and exclusive breastfeeding in Indonesia in 2021 (n=12,534)
The table was analyzed using weighting.
Table 2
Descriptive statistics of infant characteristics and exclusive breastfeeding in Indonesia in 2021 (n=12,534)
The table was analyzed using weighting.
Table 3
Binary logistic regression of exclusive breastfeeding in Indonesia in 2021 (n=12,534)
The table was analyzed using weighting.
AOR, adjusted odds ratio; CI, confidence interval; ref, reference.
, Ratna Dwi Wulandari3
