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The Role of Early Initiation of Breastfeeding for Successful Exclusive Breastfeeding among Working Mothers in Indonesia

*Sri Sumarmi orcid  -  Faculty of Public Health, Universitas Airlangga, Indonesia
Agung Dwi Laksono orcid  -  National Research and Innovation Agency, Indonesia
Mohamad Samsudin  -  National Research and Innovation Agency, Indonesia
Hastin Dyah Kusumawardani  -  National Research and Innovation Agency, Indonesia
Nikmatur Rohmah  -  Faculty of Health Sciences, Universitas Muhammadiyah Jember, Indonesia
Ratih Wirapuspita Wisnuwardani  -  Faculty of Public Health, Universitas Mulawarman, Indonesia
Open Access Copyright (c) 2026 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: Working mothers are often considered at risk for suboptimal exclusive breastfeeding (EBF) due to employment-related constraints. Early initiation of breastfeeding (EIBF) is widely recognized as a critical first step in optimal infant feeding; however, its specific contribution to sustained EBF among working mothers remains insufficiently quantified nationally.

Purpose: This study examined the role of EIBF in achieving EBF among working mothers in Indonesia.

Methods: This secondary analysis used data from the 2022 Indonesian National Nutritional Status Survey, including 46,130 children aged 0–23 months born to working mothers. Exclusive breastfeeding was the outcome, with early initiation of breastfeeding as the main exposure. Seven covariates were examined: residence, maternal age, marital status, education, household wealth, antenatal care utilization, and child gender. Adjusted associations were estimated using binary logistic regression.

Results: The prevalence of EBF among working mothers was 40.4%, while 59.7% practiced EIBF. Working mothers who initiated breastfeeding within the first hour after birth were significantly more likely to achieve EBF than those who did not (AOR = 1.715; 95% CI = 1.706–1.724). All covariates were significantly associated with EBF.

Conclusion: EIBF emerged as the strongest determinant of EBF among working mothers in Indonesia, even after controlling for socioeconomic and health service factors. These findings provide robust national evidence supporting the integration of EIBF as a core strategy within maternal health services and workplace breastfeeding policies. However, maternal socioeconomic characteristics, health service utilization, and contextual factors also shape EBF practices, indicating the need for comprehensive, multilevel strategies.

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Keywords: Determinants; early initiation of breastfeeding; exclusive breastfeeding; Indonesia; working mothers

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