Breastfeeding and breastmilk substitute use and feeding motivations among mothers in Bandung City, Indonesia

Abstract: Suboptimal breastfeeding is common in Indonesia, with only half of infants 0–5 months of age exclusively breastfed and feeding of breastmilk substitutes (BMS) highly prevalent among infants and toddlers. Various factors influence these feeding practices, including social norms, limited health system support and BMS manufacturer marketing practices. This cross‐sectional survey aimed to identify the prevalence of breastfeeding and BMS feeding among children aged 0–35 months, explore socio‐demographic characteristics and motivating factors associated with these feeding behaviours and identify the prevalence of mothers' exposure to BMS promotions. Indonesian mothers of children <3 years of age (n = 595) were interviewed in Bandung City health facilities using structured questionnaires. Although all children were ever breastfed, half of children across all age groups received BMS in the previous day. Maternal employment outside the home and insufficient breastmilk production were associated with BMS use. The most important motivational factors for feeding BMS were perceived benefits for growth, intelligence and immunity. Despite Indonesian legislation restricting some BMS marketing, 93% of mothers reported observing a BMS promotion outside the health system, with television, social media and newspapers as the most common sources. Half of mothers (43%) reported observing a BMS promotion within the health system, and half (46%) reported receiving recommendations from health workers to use BMS. Such high prevalence of BMS marketing may be influencing caregivers' feeding choices; stronger national legislation and implementation of laws are needed to ensure mothers' ability to make feeding choices free from manufacturer influence

Community engagement in maternal and newborn health in eastern Indonesia

In Indonesia, high rates of maternal and child mortality can be attributed, in part at least, to a lack of access to medical facilities, especially in rural communities. In response, the Indonesian government developed a program to address the high rate of home births. A key element of the program involved drawing upon the contribution of community members to assist with facility-based births of pregnant women in their community. The success of the program was attributed to active participation from many groups, including community members, government officials and health-care workers who collaborated successfully to achieve a reduction in the maternal and infant mortality rates