Nurokhmah Siti, Htet Min Kyaw, Ferguson Elaine, Dibley Michael J, Fahmida Umi
Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Department of Nutrition Science, Faculty of Health Science, Universitas Muhammadiyah Surakarta, Surakarta, Central Java, Indonesia.
Matern Child Nutr. 2025 Apr;21(2):e13790. doi: 10.1111/mcn.13790. Epub 2025 Jan 3.
Introducing commercial milk formula (CMF) as prelacteal feeds can disturb exclusive breastfeeding and shorten breastfeeding duration. However, the prelacteal feeding of CMF has been growing alongside its increasing sales in Indonesia. This study examined predictors of the CMF feeding in the Malang and Sidoarjo districts of Indonesia. This analysis used post-delivery data collected from 676 mothers in a cohort evaluation of a cluster randomised controlled trial (Baduta study). Multivariate random effects logistic models were employed to assess factors associated with the CMF feeding. A total of 467 (69.1%) respondents reported giving CMF to their infants during the first 3 days after delivery. Mothers with low breastfeeding self-efficacy (BFSE) were at a higher risk of providing CMF within 3 days of birth compared to those with medium or high BFSE (adjusted odds ratio (aOR) 8.12; 95% confidence interval (CI) (4.26-15.48). Receiving explanations to solve breastfeeding problems from health professionals (aOR: 1.87; 97% CI: 1.12-3.11) and primipara parity (aOR: 1.71; 95% CI: 1.12-3.04) were positively associated with the CMF feeding. Early initiation of breastfeeding (EIBF) was protective against CMF feeding (aOR: 0.40; 95% CI: 0.22-0.58). There was an interaction between EIBF and BFSE. EIBF was protective among mothers with high or medium BFSE, but had no effect among those with low BFSE. CMF feeding was prevalent in Indonesia. Future strategies should focus on improving health-staff capacity to strengthen BFSE during pregnancy and provide adequate counselling for mothers with breastfeeding problems.
引入商业配方奶作为初乳前喂养可能会干扰纯母乳喂养并缩短母乳喂养持续时间。然而，在印度尼西亚，随着商业配方奶销量的增加，初乳前喂养商业配方奶的情况也在增多。本研究调查了印度尼西亚玛琅和泗水河地区商业配方奶喂养的预测因素。该分析使用了在一项整群随机对照试验（巴杜塔研究）的队列评估中从676名母亲收集的产后数据。采用多变量随机效应逻辑模型来评估与商业配方奶喂养相关的因素。共有467名（69.1%）受访者报告在分娩后的头3天给婴儿喂了商业配方奶。与母乳喂养自我效能感（BFSE）中等或较高的母亲相比，母乳喂养自我效能感低的母亲在分娩后3天内提供商业配方奶的风险更高（调整后的优势比（aOR）为8.12；95%置信区间（CI）为（4.26 - 15.48））。从卫生专业人员那里获得解决母乳喂养问题的解释（aOR：1.87；97%CI：1.12 - 3.11）以及初产妇（aOR：1.71；95%CI：1.12 - 3.04）与商业配方奶喂养呈正相关。早期开始母乳喂养（EIBF）对商业配方奶喂养有预防作用（aOR：0.40；95%CI：0.22 - 0.58）。EIBF和BFSE之间存在相互作用。EIBF对BFSE高或中等的母亲有预防作用，但对BFSE低的母亲没有影响。在印度尼西亚，商业配方奶喂养很普遍。未来的策略应侧重于提高卫生人员的能力，以在孕期增强母乳喂养自我效能感，并为有母乳喂养问题的母亲提供充分的咨询。
