EFFECT OF A BREASTFEEDING SUPPORT PACKAGE ON BREASTFEEDING SELF-EFFICACY AMONG POSTPARTUM MOTHERS IN PRIMARY HEALTHCARE: A QUASI-EXPERIMENTAL STUDY
Abstract
Background: Exclusive breastfeeding remains a major public health challenge despite its well-documented benefits for infant growth, development, and disease prevention. Low breastfeeding self-efficacy is recognized as one of the key determinants contributing to unsuccessful exclusive breastfeeding, highlighting the need for comprehensive breastfeeding support interventions. Purpose: This study aimed to examine the effect of a comprehensive breastfeeding support package on breastfeeding self-efficacy among postpartum mothers at Boyolali I Community Health Center, Central Java, Indonesia. Methods: A quasi-experimental study with a non-equivalent pretest–posttest control group design was conducted among 34 postpartum mothers, who were allocated into intervention (n = 17) and control (n = 17) groups using consecutive sampling. The intervention group received a comprehensive breastfeeding support package consisting of breastfeeding education, practical breastfeeding assistance, emotional support, and motivational reinforcement, whereas the control group received routine postpartum care. Breastfeeding self-efficacy was assessed using the Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF), while breastfeeding effectiveness was evaluated using the LATCH Assessment Tool. Data were analyzed using paired t-tests, independent t-tests, and Spearman's rank correlation with a significance level of p < 0.05. Results: Baseline characteristics were comparable between groups (p > 0.05). Following the intervention, the breastfeeding self-efficacy score increased significantly in the intervention group from 43.71 ± 6.15 to 60.24 ± 4.82 (p < 0.001), whereas the control group showed no significant improvement (44.18 ± 5.92 vs. 47.53 ± 5.41; p = 0.084). The mean improvement in breastfeeding self-efficacy was significantly greater in the intervention group than in the control group (16.53 ± 5.12 vs. 3.35 ± 4.26; p < 0.001). Furthermore, breastfeeding self-efficacy was positively correlated with breastfeeding effectiveness (r = 0.612, p < 0.001). Conclusion: A comprehensive breastfeeding support package effectively improved breastfeeding self-efficacy among postpartum mothers and was associated with better breastfeeding effectiveness. Integrating structured breastfeeding support into routine postpartum care may enhance maternal confidence and contribute to improving exclusive breastfeeding outcomes in primary healthcare settings.References
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Yang, X., et al. (2021). Predictors of breastfeeding self-efficacy during the COVID-19 pandemic. Midwifery, 102, 103090.
Yuliani, D. R., Aini, F. N., Winarso, S. P., & Amalia, R. (2023). The Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF) Versi Indonesia: Studi Pendahuluan Uji Validitas dan Reliabilitas pada Ibu Hamil. Journal of Midwifery Science: Basic and Applied Research, 5(2). https://doi.org/10.31983/jomisbar.v5i2.1042
U.S. Preventive Services Task Force. (2025). Interventions to support breastfeeding: US Preventive Services Task Force recommendation statement. JAMA.
Asih, Y., & Nurlaila. (2022). Breastfeeding Self-Efficacy pada Ibu Hamil Trimester III Hingga Menyusui. Jurnal Kesehatan, 13(3). https://doi.org/10.26630/jk.v13i3.3543
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215.
Blixt, I., Johansson, M., Hildingsson, I., Papoutsi, Z., & Rubertsson, C. (2022). Breastfeeding support interventions and maternal breastfeeding outcomes: A systematic review. International Breastfeeding Journal, 17(1).
Chipojola, R., Chiu, H. Y., Huda, M. H., Lin, Y. M., & Kuo, S. Y. (2020). Effectiveness of theory-based educational interventions on breastfeeding self-efficacy and exclusive breastfeeding: A systematic review and meta-analysis. International Journal of Nursing Studies, 109, 103675.
Dennis, C. L. (2021). Theoretical underpinnings of breastfeeding confidence: A self-efficacy framework. Journal of Human Lactation, 15(3), 195–201.
Dennis, C. L. (2003). The Breastfeeding Self-Efficacy Scale: Psychometric assessment of the short form. Journal of Obstetric, Gynecologic & Neonatal Nursing, 32(6), 734–744. https://doi.org/10.1177/0884217503258459
Dennis, C. L., & Faux, S. (1999). Development and psychometric testing of the Breastfeeding Self-Efficacy Scale. Research in Nursing & Health, 22(5), 399–409. https://doi.org/10.1002/(SICI)1098-240X(199910)22:5<399::AID-NUR6>3.0.CO;2-4
Dennis, C. L., McQueen, K., Dol, J., Brown, H., Beck, C., & Shorey, S. (2024). Psychometrics of the Breastfeeding Self-Efficacy Scale and short form: A systematic review. BMC Public Health, 24.
Diah Listiyaningsih, M., Putri, R. A., & Ismiryan, F. V. (2022). Hubungan Usia dan Paritas dengan Breastfeeding Self Efficacy pada Ibu Post Partum. Indonesian Journal of Midwifery, 5(1), 84–89. https://doi.org/10.35473/ijm.v5i1.1543
Economou, M., Kolokotroni, O., Paphiti-Demetriou, I., et al. (2021). The association of breastfeeding self-efficacy with breastfeeding duration and exclusivity: Longitudinal assessment of the predictive validity of the Greek version of the BSES-SF tool. BMC Pregnancy and Childbirth, 21, 421.
Hu, X., et al. (2025). Association between family support and breastfeeding self-efficacy in a cross-sectional study. Nursing Open.
Jang, G. J., Kim, S. H., & Jeong, K. S. (2021). Effectiveness of breastfeeding education and support interventions on breastfeeding self-efficacy: A systematic review. Women and Birth.
Jiang, Q., et al. (2022). Postnatal mental health, breastfeeding beliefs, and breastfeeding practices in rural China. International Breastfeeding Journal, 17.
Lin, Y. M., Chiu, H. Y., Huda, M. H., Chipojola, R., & Kuo, S. Y. (2021). Theory-based breastfeeding interventions for improving maternal breastfeeding self-efficacy: A systematic review. International Journal of Nursing Studies.
McFadden, A., Gavine, A., Renfrew, M. J., et al. (2017). Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews, 2, CD001141.
Meedya, S., Fernandez, R., & Fahy, K. (2020). Effect of educational and support interventions on breastfeeding outcomes: A systematic review and meta-analysis. Women and Birth, 33(5).
Nugraheni, S. A., et al. (2025). Determinants of breastfeeding self-efficacy among postpartum mothers in Indonesia. Nurse and Health: Jurnal Keperawatan.
Nurmiaty, Arsin, A. A., Syafar, M., Aswita, Dolofu, M., Batjo, S. H., & Aji, R. (2024). The Effect of Lactation Education on Self-Efficacy of Breastfeeding Mothers. Poltekita: Jurnal Ilmu Kesehatan, 17(1). https://doi.org/10.33860/jik.v17i1.2136
Özöztürk, N., et al. (2025). Breastfeeding self-efficacy among first-time mothers: A mixed-methods study comparing spontaneous and assisted conceptions in Turkey. International Journal of Nursing Practice.
Pezley, L., et al. (2022). Behavioral interventions to improve breastfeeding outcomes: An updated review. International Breastfeeding Journal.
Putri, R. A., Listiyaningsih, M. D., & Ismiryan, F. V. (2022). Pekerjaan dan Dukungan Sosial terhadap Breastfeeding Self Efficacy Ibu Post Partum. Indonesian Journal of Midwifery, 5(2), 161–166. https://doi.org/10.35473/ijm.v5i2.1934
Suartiningsih, S. A. K., Astiti, N. K. E., Ningtyas, L. A. W., Sriasih, N. G. K., & Wirata, I. N. (2022). The Relationship Between Breastfeeding Contact and Breastfeeding Self-Efficacy in Wangaya Hospital, Denpasar City. Jurnal Ners dan Kebidanan Indonesia, 10(4), 285–291. https://doi.org/10.21927/jnki.2022.10(4).285-291
United Nations Children's Fund. (2023). Breastfeeding: A mother's gift, for every child. New York, NY: UNICEF.
Widayanti, A., & Mawardika, T. (2023). Pengaruh Pendidikan Kesehatan ASI Eksklusif terhadap Breastfeeding Self-Efficacy pada Ibu Menyusui. Jurnal Ilmiah Ners Indonesia, 4(2), 177–188. https://doi.org/10.22437/jini.v4i2.27673
World Health Organization. (2023). Breastfeeding. Geneva, Switzerland: World Health Organization.
World Health Organization. (2023). WHO recommendations on maternal and newborn care for a positive postnatal experience. Geneva, Switzerland: World Health Organization.
World Health Organization & United Nations Children's Fund. (2023). Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services. Geneva, Switzerland.
Yang, X., et al. (2021). Predictors of breastfeeding self-efficacy during the COVID-19 pandemic. Midwifery, 102, 103090.
Yuliani, D. R., Aini, F. N., Winarso, S. P., & Amalia, R. (2023). The Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF) Versi Indonesia: Studi Pendahuluan Uji Validitas dan Reliabilitas pada Ibu Hamil. Journal of Midwifery Science: Basic and Applied Research, 5(2). https://doi.org/10.31983/jomisbar.v5i2.1042
U.S. Preventive Services Task Force. (2025). Interventions to support breastfeeding: US Preventive Services Task Force recommendation statement. JAMA.
Published
2026-08-29
How to Cite
Dewi, R. K., Nardina, E. A., & Wahyuningsih, W. (2026). EFFECT OF A BREASTFEEDING SUPPORT PACKAGE ON BREASTFEEDING SELF-EFFICACY AMONG POSTPARTUM MOTHERS IN PRIMARY HEALTHCARE: A QUASI-EXPERIMENTAL STUDY. Jurnal Cakrawala Keperawatan, 3(02), 87-98. https://doi.org/10.35872/jck.v3i02.1043
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