Ramadhan Kadar, Adnani Qorinah Estiningtyas Sakilah, Khuzaiyah Siti, Aboagye Richard Gyan, Okyere Joshua, Ahinkorah Bright Opoku
Department of Midwifery, Poltekkes Kemenkes Palu, Palu, Indonesia.
Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia.
J Health Popul Nutr. 2025 Aug 20;44(1):298. doi: 10.1186/s41043-025-00988-y.
Timely initiation of breastfeeding is one of the core infant and young child feeding practices recommended for optimal nutrition, growth, and the overall health of neonates. Using nationally representative data, we examined the association between the type and place of birth on early initiation of breastfeeding (EIBF) segregated by place of residence in Indonesia.
Data for 12,144 mother-child pairs were extracted from the 2017 Indonesian Demographic and Health Survey. The proportion of EIBF was presented as a percentage. Multivariable logistic regression analysis was employed to examine the association between type and place of delivery on EIBF. The regression results were presented using adjusted odds ratios (AOR) with their respective 95% confidence intervals (CI).
The prevalence of EIBF in urban and rural areas was 56.87% and 56.16%, respectively. Women who gave birth in a general hospital or clinic in both urban (AOR = 0.66; 95% CI = 0.53, 0.83) and rural (AOR = 0.61; 95% CI = 0.49, 0.77) areas were less likely to practice EIBF relative to those who gave birth in a private facility. Also, women who gave birth at home had lower odds of EIBF in urban (AOR = 0.62; 95% CI = 0.45, 0.85) and rural (AOR = 0.74; 95% CI = 0.58, 0.94) areas compared to those who gave birth in a health center. In addition, the likelihood of practicing EIBF was lower among women who had a caesarean section in urban (AOR = 0.42;95% CI = 0.35, 0.50) and rural (AOR = 0.31; 95% CI = 0.24, 0.40) compared to those who had a vaginal birth in both areas.
Our study has shown that women's place and type of birth significantly predict EIBF in rural and urban areas. Women who gave birth in public facilities and homes and those who gave birth through caesarean section had lower likelihood of practicing EIBF. Targeted interventions should be developed to address specific barriers and challenges associated with birth and EIBF in rural and urban setting settings.
及时开始母乳喂养是为实现新生儿最佳营养、生长及整体健康而推荐的核心婴幼儿喂养方式之一。利用具有全国代表性的数据，我们在印度尼西亚按居住地区分，研究了出生类型和地点与早期开始母乳喂养（EIBF）之间的关联。
从2017年印度尼西亚人口与健康调查中提取了12144对母婴的数据。EIBF的比例以百分比形式呈现。采用多变量逻辑回归分析来研究分娩类型和地点与EIBF之间的关联。回归结果以调整后的优势比（AOR）及其各自的95%置信区间（CI）呈现。
城市和农村地区的EIBF患病率分别为56.87%和56.16%。在城市（AOR = 0.66；95% CI = 0.53，0.83）和农村（AOR = 0.61；95% CI = 0.49，0.77）地区，在综合医院或诊所分娩的女性相对于在私立机构分娩的女性，进行EIBF的可能性较小。此外，与在卫生中心分娩的女性相比，在城市（AOR = 0.62；95% CI = 0.45，0.85）和农村（AOR = 0.74；95% CI = 0.58，0.94）地区在家分娩的女性进行EIBF的几率较低。另外，与在两个地区顺产的女性相比，城市（AOR = 0.42；95% CI = 0.35，0.50）和农村（AOR = 0.31；95% CI = 0.24，0.40）地区剖宫产的女性进行EIBF的可能性较低。
我们的研究表明，女性的分娩地点和类型在农村和城市地区显著预测EIBF。在公共设施和家中分娩的女性以及剖宫产的女性进行EIBF的可能性较低。应制定有针对性的干预措施，以应对农村和城市环境中与分娩及EIBF相关的特定障碍和挑战。
