Family Support and Exclusive Breastfeeding: The Mediating Role of Breastfeeding Self-Efficacy

Penulis

  • Rochmawati Rochmawati Midwifery Professional Education Study Program, Faculty of Health and Pharmacy Sciences, Universitas Gunadarma, Depok, West Java, Indonesia
  • Qorry Wahyuni Septica Bachelor of Midwifery Study Program, STIKES Sukabumi, Sukabumi, West Java, Indonesia
  • Wina Chairunnisa Diploma III Midwifery Study Program, STIKES Sukabumi, Sukabumi, West Java, Indonesia

DOI:

https://doi.org/10.53770/amhj.v5i4.860

Kata Kunci:

Breastfeeding Self-Efficacy, Exclusive Breastfeeding, Family Support, Mediation, PLS-SEM

Abstrak

Family support is widely acknowledged as a key determinant of breastfeeding; however, the psychological mechanism linking it to exclusive breastfeeding remains inadequately examined in Indonesia, as no published study has formally tested breastfeeding self-efficacy as a mediator using path analysis frameworks. This study aimed to analyze the mediating role of breastfeeding self-efficacy in the relationship between family support and exclusive breastfeeding among postpartum mothers. A cross-sectional analytical study was conducted with 250 postpartum mothers in Tangerang City and Regency, recruited through purposive sampling across multiple healthcare settings. Data were collected using two validated instruments and analyzed via Partial Least Squares Structural Equation Modeling (PLS-SEM), with indirect effects examined through indirect effect analysis. Family support had no significant direct effect on exclusive breastfeeding (β = 0.097; p = 0.422), yet strongly predicted breastfeeding self-efficacy (β = 0.887; p < 0.001). Breastfeeding self-efficacy significantly predicted exclusive breastfeeding (β = 0.761; p < 0.001), and the indirect effect was confirmed (β = 0.675; p < 0.001), indicating full mediation. The model explained 45.1% of variance in exclusive breastfeeding and 78.6% in breastfeeding self-efficacy, though causal inference remains constrained by the cross-sectional design. These findings demonstrate that family support promotes exclusive breastfeeding only insofar as it simultaneously strengthens maternal psychological confidence. Exclusive breastfeeding promotion programs should integrate self-efficacy-building components as a core intervention element rather than targeting family support in isolation.

Referensi

Al-Thubaity, D. D., Alshahrani, M. A., Elgzar, W. T., & Ibrahim, H. A. (2023). Determinants of high breastfeeding self-efficacy among nursing mothers in Najran, Saudi Arabia. Nutrients, 15(8), 1919. https://doi.org/10.3390/nu15081919

Andini, F. R., Laohasiriwong, W., & Mahato, R. K. (2025). Exclusive breastfeeding and it’s determinants in Indonesia, 2022. International Journal of Public Health Asia Pacific, 4(9), 101-113. https://doi.org/10.62992/wy015m91

Brockway, M., Benzies, K., & Hayden, K. A. (2017). Interventions to Improve Breastfeeding Self-Efficacy and Resultant Breastfeeding Rates: A Systematic Review and Meta-Analysis. Journal of human lactation : official journal of International Lactation Consultant Association, 33(3), 486–499. https://doi.org/10.1177/0890334417707957

Chang, Y. S., Li, K. M. C., Li, K. Y. C., Beake, S., Lok, K. Y. W., & Bick, D. (2021). Relatively speaking? Partners' and family members’ views and experiences of supporting breastfeeding: a systematic review of qualitative evidence. Philosophical Transactions of the Royal Society B: Biological Sciences, 376(1827), 1-10. https://doi.org/10.1098/rstb.2020.0033

Christoffel, M. M., Gomes, A. L. M., Julio, C. L. A., Barros, J. F. D., Rodrigues, E. D. C., Góes, F. G. B., & Linares, A. M. (2021). Exclusive breastfeeding and professionals from the family health strategy. Revista brasileira de enfermagem, 75(3),1-8. https://doi.org/10.1590/0034-7167-2020-0545

Dennis, C. L. (2003). The breastfeeding self‐efficacy scale: Psychometric assessment of the short form. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 32(6), 734-744. https://doi.org/10.1177/0884217503258459

Ekayanthi, N. W. D., & Besral, B. (2024). Research Trends on Self-Efficacy in Breastfeeding Mothers During 2000-2023: A Bibliometric Analysis. Turkish archives of pediatrics, 59(5), 440–448. https://doi.org/10.5152/TurkArchPediatr.2024.24160

Fatmasari, B. D., Ernawati, E., & Wirastri, D. (2024). The Impact of Breastfeeding Technique Education on the Effectiveness of Postpartum Mothers in Breastfeeding at Montong Betok Health Center. Ahmar Metastasis Health Journal, 4(1), 54–58. https://doi.org/10.53770/amhj.v4i1.307

Gebrekidan, K., Hall, H., Plummer, V., & Fooladi, E. (2021). Exclusive breastfeeding continuation and associated factors among employed women in North Ethiopia: A cross-sectional study. PloS one, 16(7), 1-16. https://doi.org/10.1371/journal.pone.0252445

Ghozali, I., & Latan, H. (2014). Partial Least Squares Konsep, Metode dan Aplikasi Menggunakan Program WARPPLS 4.0. Semarang: Universitas Diponegoro.

Hair, J. F., Hult, G. T. M., Ringle, C., & Sarstedt, M. (2019). A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM). California: SAGE Publications.

Hossain, S., & Mihrshahi, S. (2022). Exclusive breastfeeding and childhood morbidity: A narrative review. International journal of environmental research and public health, 19(22), 14804. https://doi.org/10.3390/ijerph192214804

Hu, L., He, W., & Zhou, L. (2025). Association Between Family Support and Breastfeeding Self‐Efficacy in a Cross‐Sectional Study. Nursing Open, 12(4), e70210. https://doi.org/10.1002/nop2.70210

Isiguzo, C., Mendez, D. D., Demirci, J. R., Youk, A., Mendez, G., Davis, E. M., & Documet, P. (2023). Stress, social support, and racial differences: Dominant drivers of exclusive breastfeeding. Maternal & Child Nutrition, 19(2), e13459. https://doi.org/10.1111/mcn.13459

Kementerian Kesehatan Republik Indonesia. (2022). Survei Status Gizi Indonesia 2022. Jakarta: Kementerian Kesehatan Republik Indonesia.

Kinshella, M. L. W., Prasad, S., Hiwa, T., Vidler, M., Nyondo-Mipando, A. L., Dube, Q., ... & Kawaza, K. (2021). Barriers and facilitators for early and exclusive breastfeeding in health facilities in Sub-Saharan Africa: a systematic review. Global health research and policy, 6(1), 21. https://doi.org/10.1186/s41256-021-00206-2

Li, F., Huang, C., Lin, Q., Xi, Y., Xiang, C., Yong, C., & Deng, J. (2022). Maternal characteristics, intention, self-efficacy, perceived social support, and exclusive breastfeeding practice: Structural equation modeling approaches. Healthcare, 11(1), 87. https://doi.org/10.3390/healthcare11010087

Masang, N. (2023). Husband Support for Successful Breastfeeding of Exclusive Breast Milk in the Relationship. Midwifery Research Journal, 1(1), 17-23. Retrieved from https://jurnal.cakrabirawamedia.com/index.php/mrj/article/view/14

Meek, J. Y., & Noble, L. (2022). Policy Statement : Breastfeeding and the Use of Human Milk. 150(1), 1–15.

Nasir, M. (2024). The benefits of exclusive breastfeeding: a comprehensive literature review. J Liaquat Natl Hosp, 2, 81-88.

Nguyen, N. T., Prasopkittikun, T., Payakkaraung, S., & Vongsirimas, N. (2022). Factors predicting six-month exclusive breastfeeding among mothers in Ho Chi Minh City, Vietnam. Journal of Health Research, 36(2), 219-230. https://doi.org/10.1108/JHR-03-2020-0080

Nie, J., Ye, J., Wu, S., Wang, N., Li, Y., Liu, Y., ... & Shi, Y. (2023). Beyond mothers: the crucial role of family caregivers’ knowledge on exclusive breastfeeding in rural western China. International Breastfeeding Journal, 18(58), 1-10. https://doi.org/10.1186/s13006-023-00596-8

Nurokhmah, S., Rahmawaty, S., & Puspitasari, D. I. (2022). Determinants of Optimal Breastfeeding Practices in Indonesia: Findings From the 2017 Indonesia Demographic Health Survey. Journal of preventive medicine and public health, 55(2), 182–192. https://doi.org/10.3961/jpmph.21.448

Pakilaran, G., Rasni, H., Nur, K. R. M., & Wijaya, D. (2022). Family support on exclusive breastfeeding in babies aged 0-6 months in Indonesia: Literature Review. Nursing and Health Sciences Journal (NHSJ), 2(2), 104-107.

Sanchez, S. S., Rodr, I., Leon-larios, F., Andina-diaz, E., Perez-contreras, R., & Gonzalez-sanz, J. D. (2024). Influence of Perceived Maternal Self-Efficacy on Exclusive Breastfeeding Initiation and Consolidation : A Systematic Review. Healthcare, 12(23), 1–17. https://doi.org/10.3390/healthcare12232347

Sartika, R. A. D., Wirawan, F., Gunawan, W., Putri, P. N., & Shukri, N. H. M. (2024). Parental support and exclusive breastfeeding at 3 months in West Java, Indonesia: a mixed-methods approach. Clinical and experimental pediatrics, 67(7), 358–367. https://doi.org/10.3345/cep.2023.01375

Supriatin, S., Astriani, N. M. D. Y., Heri, M., & Sadli, M. (2024). Partner and Household Factors Associated with Breastfeeding Practice: A Systematic Review. Jurnal Info Kesehatan, 22(2), 429–440. https://doi.org/10.31965/infokes.Vol22.Iss2.1537

Thaithae, S., Yimyam, S., & Polprasarn, P. (2023). Prevalence and predictive factors for exclusive breastfeeding at six months among Thai adolescent mothers. Children, 10(4), 682. https://doi.org/10.3390/children10040682

Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J., ... & Rollins, N. C. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The lancet, 387(10017), 475-490. https://doi.org/10.1016/S0140-6736(15)01024-7

Zhou, S., Lu, J., Qin, A., Wang, Y., Gao, W., Li, H., & Rao, L. (2024). The role of paternal support in breastfeeding outcomes : a meta ‑ analytic review. International Breastfeeding Journal, 19(84), 1–15. https://doi.org/10.1186/s13006-024-00694-1

Diterbitkan

2026-03-31

Cara Mengutip

Rochmawati, R., Septica, Q. W., & Chairunnisa, W. (2026). Family Support and Exclusive Breastfeeding: The Mediating Role of Breastfeeding Self-Efficacy. Ahmar Metastasis Health Journal, 5(4), 352–365. https://doi.org/10.53770/amhj.v5i4.860