Breastfeeding practices and attitudes among women in West Sumatra, Indonesia

Background Significant variations in breastfeeding initiation and continuation exist in different global communities. Understanding women's attitude and experiences about breastfeeding within different communities is important to inform optimum infant feeding practices. Aim To explore breastfeeding practices and gain insights into women's practices, knowledge and beliefs concerning infant feeding in West Sumatra, Indonesia. Methods A mixed methods study was undertaken. Breastfeeding data were collected from mothers at birth, 6 weeks, 6 and 9 months of infant's age within a feasibility study of antenatal nutritional supplementation in West Sumatra (n = 158). Additionally, a convenience sample of mothers (n = 19) undertook qualitative semi-structured interviews. Interviews were analysed thematically. Results While only 84.2% of infants were exclusively breastfed within the 24 hours prior to hospital discharge, 93.7% of infants at 6 weeks and 64.7% at 6 months were exclusively breastfed. At 9 months 92.9% of infants continued to breastfeed. Qualitative interviews generated three overarching themes: (1) ‘Mothers’ attitude’. Women viewed breastfeeding as normal and natural and strongly valued the health benefits of exclusive breastfeeding. (2) ‘Cultural perspectives’ showed breastfeeding was the default choice within the women's communities. (3) ‘Family and social support’ found women received good family support and encouragement to breastfeed. Conclusion The exclusive breastfeeding rate of 64.7% and any breastfeeding rate of 96.0% at 6 months in West Sumatra is noteworthy. Cultural values, family and social support along with a positive attitude reinforced by information and knowledge regarding breastfeeding appeared to catalyse high rates of breastfeeding. Further international comparative studies to provide insights into the underpinning social and belief constructs that may contribute to these positive health behaviours (or lack of it in other communities) is worthy of further investigation.