1Department of Pediatrics,University of California-San Francisco,3333 California Street,Box 0503,San Francisco,CA 94118,USA.
2School of Medicine,University of California-San Francisco,San Francisco,CA,USA.
Public Health Nutr. 2018 Oct;21(14):2689-2697. doi: 10.1017/S1368980018001453. Epub 2018 Jul 5.
Although initiating breast-feeding is common in Indonesia, rates of exclusive breast-feeding are low. Our objective was to identify early barriers to exclusive breast-feeding in Indonesian hospitals.
Qualitative. Semi-structured interviews were conducted in April-June 2015. The data were analysed using thematic analysis.
Indonesian provinces of Jakarta, Banten and West Java.
Fifty-four participants including public health officials, hospital administrators, health-care professionals and parents.
Five themes were identified as contributing to low rates of early exclusive breast-feeding in Indonesian hospitals: (i) quality and quantity of breast-feeding education; (ii) marketing and influence of infant formula manufacturers; (iii) hospital infrastructure; (iv) policy, legislation and protocols; and (v) perceived need for infant formula supplementation. Participants noted that providers and mothers receive inadequate or incorrect education regarding breast-feeding; manufacturers promote infant formula use both inside and outside hospitals; constraints in physical space and hospital design interfere with early breast-feeding; legislation and protocols designed to promote breast-feeding are inconsistently enforced and implemented; and providers and mothers often believe infant formula is necessary to promote infant health. All participants identified numerous barriers to early exclusive breast-feeding that related to more than one identified theme.
Our study identified important barriers to early exclusive breast-feeding in Indonesian hospitals, finding that participants consistently reported multifaceted barriers to early exclusive breast-feeding. Future research should examine whether system-level interventions such the Baby-Friendly Hospital Initiative might improve rates of exclusive breast-feeding by improving breast-feeding education, reducing manufacturer influence, modifying existing infrastructure and providing tools needed for protocols and counselling.
尽管在印度尼西亚，开始母乳喂养是很常见的，但纯母乳喂养的比例却很低。我们的目的是确定印度尼西亚医院中纯母乳喂养早期的障碍。
定性。2015 年 4 月至 6 月进行了半结构式访谈。使用主题分析对数据进行分析。
印度尼西亚雅加达、万丹和西爪哇省。
包括公共卫生官员、医院管理人员、卫生保健专业人员和家长在内的 54 名参与者。
确定了五个主题，这些主题导致印度尼西亚医院早期纯母乳喂养率低：（i）母乳喂养教育的质量和数量；（ii）婴儿配方奶粉制造商的营销和影响；（iii）医院基础设施；（iv）政策、法规和协议；以及（v）认为需要补充婴儿配方奶粉。参与者指出，提供者和母亲接受的关于母乳喂养的教育不足或不正确；制造商在医院内外宣传婴儿配方奶粉的使用；物理空间和医院设计的限制妨碍了早期母乳喂养；旨在促进母乳喂养的立法和协议执行和实施不一致；提供者和母亲通常认为婴儿配方奶粉对于促进婴儿健康是必要的。所有参与者都确定了许多早期纯母乳喂养的障碍，这些障碍与一个以上确定的主题有关。
我们的研究确定了印度尼西亚医院中早期纯母乳喂养的重要障碍，发现参与者一致报告了许多早期纯母乳喂养的多方面障碍。未来的研究应探讨系统层面的干预措施，如婴儿友好型医院倡议，是否可以通过改善母乳喂养教育、减少制造商的影响、修改现有基础设施以及提供协议和咨询所需的工具，来提高纯母乳喂养率。
