Breastfeeding Knowledge, Attitude, and Practice among White-Collar and Blue-Collar Workers in Indonesia.

BACKGROUND: Working status is identified as a major risk factor of poor breastfeeding practices among workers. This study aimed to evaluate the knowledge, attitude, and factors associated with breastfeeding practice among white-collar and blue-collar workers in Indonesia. METHODS: A cross-sectional study was performed in two factories and three government offices in Jakarta from December 2015 to February 2016. Subjects were woman workers whose children were age 6 to 24 months old and actively working in the factory and/or office. The factors studied were selected socio-demographic and occupational characteristics, score on knowledge and attitude, and breastfeeding practice during working hours. RESULTS: From a total of 192 subjects, 73% of white-collar workers had good knowledge on breastfeeding, in contrast with 55% of blue-collar workers who had not good breastfeeding knowledge (P < 0.001). Most of the subjects were conducting breast pumping during working hours, however 15% of white-collar workers and 17% of blue-collar workers never breastfeed nor breast pumped at work. Working status (P = 0.005) and knowledge (P = 0.002) were factors associated with breastfeeding practice among workers. CONCLUSION: White-collar workers have a better knowledge, attitude, and practice toward breastfeeding. Knowledge improvement related to breastfeeding benefits and supports to working mothers are a key priority, however advocacy to employers, managers, and supervisors in providing breastfeeding facilitation and program support were also critical to successful breastfeeding practice among workers.

Developing a workplace lactation promotion model in Indonesia using Delphi technique.

BACKGROUND: Working mothers have a higher risk to terminate breastfeeding earlier than stay-at-home mothers. Researchers reported that support from the workplace by creating lactation facilities and develop supportive programs are necessary to increase the success of exclusive breastfeeding. The aim was to achieve expert consensus on developing a workplace-based lactation promotion model. METHODS: A three-round online survey using Delphi approach was conducted to reach consensus on to the development of a lactation program at a workplace. RESULTS: Twenty-two experts from Indonesian health authority, community medicine, child health and obstetrics were invited to join the Delphi study; 15 (68.2%) enrolled in the first round. The response rate in the second and third round was 80.0% (12/15) and 86.7% (13/15), respectively. The first round categorized the workplace-based promotion model into seven dimensions, i.e. policy and regulation, facility, education material, target participants, promotion approach, human resources, and time. In the final round, "maternity leave of 3-6 months" (median (Q1;Q3):2 (1, 4)) and "employees have the right to breast-pumping every 3 hours" (median (Q1;Q3):3 (2, 4)) ranked as the two most important indicators regarding policy and regulation. A dedicated lactation room (median (Q1;Q3):1 (1)) is the highest ranked indicator regarding facility dimension. Regarding education materials, benefits of breast milk for babies ranked as the highest indicator while for the education and delivering methods dimensions, social media and interactive counseling were two highest ranked indicators. The top management in the company and lactation counselor are the two highest-ranked indicators in human resources dimension. CONCLUSION: In the view of experts, involvement of a dedicated policy maker in the company, a workplace-based lactation counselor, regular promotion with interactive education and dedicated facilities are necessary to develop an effective workplace-based lactation promotion model.

Challenges and Supports of Breastfeeding at Workplace in Indonesia.

Due to increased number of women workers in Indonesia in the last decade, numbers of women living as a worker and a housewife have increased. This also increases the potential risk of breastfeeding discontinuation. Three months of maternal leave policy and inadequate lactation promotion support in workplace have been identified as factors that hinder lactating practices. The World Health Organization recommendation of 6 months of exclusive breastfeeding and joined regulation of three Indonesia ministers (Ministry of Health, Ministry of Labour, and Ministry of Women Empower) have failed to improve the exclusive breastfeeding rate among female workers in Indonesia due to the lack of a standardized guideline on lactation promotion at workplace. In addition, very limited or no studies have been conducted to evaluate the impact of workplace-based lactation intervention programs on exclusive breastfeeding rate among female workers. This is because the relationship of lactation with working performance and productivity could not motivate employer to invest in workplace-based lactation promotion facility or program.