Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 8, No. 6, 6535-6543 2024 Publisher: Learning Gate DOI: 10.55214/25768484.v8i6.3407 © 2024 by the authors; licensee Learning Gate © 2024 by the authors; licensee Learning Gate * Correspondence: ainalmardhiah@unimal.ac.id Influence of demographic factors and local wisdom on exclusive breastfeeding behavior Ainal Mardhiah1*, Decy Erni Nasution1, Rahmi Inayati1, Nurlaili1, Muhammad Daud2 1Department of Nursing, Faculty of Medicine, Universitas Malikussaleh, Lhokseumawe, Indonesia; ainalmardhiah@unimal.ac.id (A.M.) decyerni@unimal.ac.id (D.E.N.) rahmi.inayati@unimal.ac.id (R.I.) nurlaili@unimal.ac.id (N.). 2Department of Information Technology, Faculty of Engineering, Universitas Malikussaleh, Lhokseumawe, Indonesia; mdaud@unimal.ac.id (M.D.). Abstract: Exclusive breastfeeding from an early age is very important for a child's survival. The achievement of exclusive breastfeeding in Indonesia is still far from the target. There is a lot of research on the factors that influence exclusive breastfeeding, but there has been no research on the influence of local wisdom on exclusive breastfeeding especially in Pidie, Aceh, Indonesia. The aim of the research is to determine the influence of demographic factors and local wisdom on exclusive breastfeeding. Quantitative method with cross sectional study design was used in this research. The population was 3124 mothers’ breastfeeding babies aged 6 to 12 months in Pidie, Indonesia. Sample size was determined by Slovin formula with 95% convidence level so that the sample size to be 358 respondents. Data collection was done by distributing questionnaires or interviews. Univariate data analysis used to analyze all variables studied. Bivariate analysis used the chi square statistical test with SPSS 24. The research results show that 167 or 46.65% respondents provided exclusive breastfeeding. There is not influence of age, education, occupation, and food consumption on exclusive breastfeeding behavior. However, there is an influence of knowledge, dietary restrictions, postpartum care with local wisdom (such as sale and toet batee – refer to traditional treatment in Aceh) on exclusive breastfeeding. Health education is needed about the importance of exclusive breastfeeding and the effects of postpartum care with local wisdom on breast milk production. Keywords: Breastfeeding mothers, Demographic factors, Exclusive breastfeeding, Local wisdom, Postpartum care. 1. Introduction The World Health Organization (WHO) introduced exclusive breastfeeding for the first six months [1]. Increasing evidence shows that children who receive breast milk perform higher on intelligence tests. In addition, they have a lower chance of being obese or overweight, as well as their susceptibility to developing diabetes in the future [2]. Breast milk can prevent malocclusion or tooth decay [3]. Baby care cannot be separated from breastfeeding. Various international and national efforts have been made to provide exclusive breastfeeding, but the coverage rate for exclusive breastfeeding has not reached the target that has been set [4]. According to Basic Health Research data 52.5 percent - or only half of the 2.3 million babies aged less than six months who receive exclusive breastfeeding in Indonesia, or a decrease of 12 percent from the figure in 2019. Achievement of exclusive breastfeeding in Aceh, according to Ministry of Health data in 2019 it was recorded at 62.81 percent, increasing to 65.6 percent in 2020, and continuing to increase to 66.6 in 2021. Meanwhile the national average was recorded at 71.58 percent, below the target set set at 80 percent [5]. The achievement of exclusive breastfeeding in Pidie - Aceh, Indonesia in 2020 was recorded at 2390 babies or 67%; in 2021 the achievement will be 1593 or 57% of the number of babies of 2800; and in 2022 the number of achievements will be 1735 or 58% of 3044 people (Pidie Health Office, 2023). The failure rate for exclusive breastfeeding is still very high at both national and regional levels. Many 6536 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 8, No. 6: 6535-6543, 2024 DOI: 10.55214/25768484.v8i6.3407 © 2024 by the author; licensee Learning Gate studies have been conducted regarding the factors that influence exclusive breastfeeding, but there has been no research on the influence of local wisdom on exclusive breastfeeding in Pidie - Aceh, Indonesia. According to research [6] Maternal age and parity have an important influence on exclusive breastfeeding; the role of religion, occupation, family size, family type, maternal education, and marital status had a negligible influence on nursing mothers’ attitudes to breastfeeding. Based on research [4] there is a significant relationship between maternal knowledge about breastfeeding and exclusive breastfeeding. Research [7] the mother's level of knowledge and attitude regarding exclusive breastfeeding has a significant effect on exclusive breastfeeding. The people of Pidie - Aceh, Indonesia really maintain their culture from generation to generation, as well as caring for postpartum mothers so that it has become local wisdom. Researchers want to know breastfeeding mothers' understanding of local wisdom in providing exclusive breastfeeding in Pidie - Aceh, Indonesia. The panel research's problem formulation is a clear description of the characteristics and knowledge of mothers as well as local wisdom in providing exclusive breastfeeding in Pidie - Aceh, Indonesia. The aim of the research is to determine the characteristics of breastfeeding mothers in providing exclusive breastfeeding and to determine the influence of the characteristics of breastfeeding mothers and local wisdom on providing exclusive breastfeeding. Benefits of Research it is hoped that the results of this research can help breastfeeding mothers in providing exclusive breastfeeding. 2. Method This research is quantitative research with an analytical observational research design with a cross sectional study design. Data collection uses primary data in the form of a questionnaire. The population is mothers with babies aged 6 to 12 months who live in Pidie - Aceh, Indonesia, based on data from 3124 mothers who gave birth from October 2022 to March 2023. Pidie Regency consists of 23 sub-districts with 26 Community Health Centers. The number of samples was determined based on the Slovin formula with a Standard Deviation of 0.05 or a confidence level of 95%, resulting in a sample size of 358 people. The sampling method used quota sampling in 26 Community Health Centers in Pidie, that is, each community health center work area was given a sample quota based on its population proportionally. Bivariate analysis is a data analysis technique to test the influence of independent variables on the dependent variable. Bivariate analysis uses the chi square test. Data were coded and entered into SPSS Version 24 software, analyzed using the chi square test at p-value < 0.05 or at 95% confidence level. The observed or measured parameters were presented ini Table 1. This research also orserved two local wisdom treatment for mother’s postpartum care, namely sale and toet batee. Sale refers to traditional treatment using warm smoke and toet batee refers to traditional treatment using heated stones. The treatment of sale was illustrated in Figure 1 and the treatment of toet batee was illustrated in Figure 2. 6537 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 8, No. 6: 6535-6543, 2024 DOI: 10.55214/25768484.v8i6.3407 © 2024 by the author; licensee Learning Gate Table 1. Observed/Measured parameters. No. Variables Operational definition Parameters Scale 1 Exclusive breastfeeding Mother's way of giving breast milk to her baby in the first six months of life which includes aspects: breastfeeding, giving food other than breast milk, how to give breast milk and when to give breast milk. 1= Exclusive breastfeeding, if you get a score of 100% of all components assessed (score 3) 2= Not exclusive breastfeeding, if the mother gets a score < 3 Ordinal 2 Age The length of life according to the mother's confession was calculated from the time the mother was born until the time the research data was collected 1. 20-35 years (healthy reproductive age) 2. <20 or >35 years (unhealthy reproductive age) Ordinal 3 Level of education The last education completed by the mother according to the statement 1. Continue ≥ Senior Hight School 2. Basic < Senior Hight School Ordinal 4 Occupation The duties carried out by the mother in an agency, which has an interest in earning income 1. Work 2. Not Working Ordinal 5 Knowledge A mother's cognitive ability regarding exclusive breastfeeding is measured by the mother's ability to answer questions about exclusive breastfeeding based on aspects: understanding breast milk, giving food and/or drinks other than breast milk, the benefits of exclusive breastfeeding, and factors that need to be considered when giving breast milk 1. Good, if the mother gets a score ≥ 76% 2. Sufficient, if the mother gets a score of 56% - 74% 3. Less, if the mother gets a score ≤ 55% Ordinal 6 Food consumption behavior Foods consumed by breastfeeding mothers are believed by the local community to increase breast milk 1. Positive, if the value is ≥ 3 2. Negative, if the value is < 3 Ordinal 7 Food taboo behavior Foods that are believed to not be consumed by postpartum mothers 1. Abstinence, if the value is ≥ 3 2. Not abstaining, if the value is < 3 Ordinal 8 Postpartum care with sale Postpartum care carried out by the mother with sale 1. Yes, if the value is ≥ 1 2. No, if the value is < 1 Ordinal 9 Postpartum care with toet batee Postpartum care carried out by the mother with toet batee 1. Yes, if the value is ≥ 1 2. No, if the value is < 1 Ordinal 6538 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 8, No. 6: 6535-6543, 2024 DOI: 10.55214/25768484.v8i6.3407 © 2024 by the author; licensee Learning Gate Figure 1. The traditional treatment of sale. Figure 2. The traditional treatment of toet bate. 3. Results and Discussion The research results in the form bivariate analysis of maternal characteristics and knowledge and local wisdom regarding exclusive breastfeeding are presented in Table 2. 6539 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 8, No. 6: 6535-6543, 2024 DOI: 10.55214/25768484.v8i6.3407 © 2024 by the author; licensee Learning Gate Table 2. Bivariate analysis of maternal characteristics and knowledge and local wisdom regarding exclusive breastfeeding. Variables/Categories Breastfeeding P Value Exclusive Not exclusive Total n % n % N % Age Healthy reproductive age Unhealthy reproductive age 124 43 45.42 50.59 149 42 54.58 49.41 273 85 100 100 0.404 Level of education Continue Basic 142 25 46.41 48.08 164 27 53.59 51.92 306 52 100 100 0.823 Occupation Work Not working 20 147 38.46 48.04 32 159 61.54 51.96 52 306 100 100 0.201 Knowledge Good Sufficient Less 91 73 3 48.40 49.32 13.64 97 75 19 51.60 50.68 86.36 188 148 22 100 100 100 0.006 Food consumption behaviour Positive Negative 165 2 46.61 50.00 189 2 53.39 50.00 354 4 100 100 0.893 Food taboo behaviour Abstinence Not Abstaining 120 47 50.42 39.17 118 73 49.58 60.83 238 120 100 100 0.044 Postpartum care of sale Yes No 54 113 38.85 51.60 85 106 61.15 48.40 139 219 100 100 0.018 Postpartum care of toet batee Yes No 85 82 41.06 54.30 122 69 58.94 45.70 207 151 100 100 0.013 Total 167 191 358 100 3.1. Breastfeeding Mothers Age The research results showed that 167 respondents gave exclusive breastfeeding or 46.65% of the 358 respondents studied. The majority of mothers breastfeed their babies, but few provide exclusive breastfeeding [8]. Bivariate analysis of the age of breastfeeding mothers and exclusive breastfeeding using the Chi Square statistical test showed that there was no statistically significant effect, p- value=0.404. Previous research also obtained results that the age of breastfeeding mothers is not a factor related to the practice of exclusive breastfeeding [9], [10], however [11] in their research in Tanzania found the opposite result. Our research shows that exclusive breastfeeding by mothers at reproductively healthy age tends to be lower than at reproductively unhealthy age. This can happen because reproductive unhealthy age is only found at ages above 35 years and is not found at ages under 20 years. 3.2. Level of Education There is no significant influence between breastfeeding mother's education and exclusive breastfeeding based on the Chi Square statistical test p-value=0.823. Previous research with similar results includes [12]. Meanwhile, research with the opposite results includes [13] and [10]. The level of education does not influence the behavior of breastfeeding mothers in providing exclusive breastfeeding. This can be seen from the results of research where the ratio of exclusive breastfeeding by mothers with advanced education levels (46.41%) is almost the same as the basic education level (48.08%). This can happen because there are many factors that influence exclusive breastfeeding such as 6540 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 8, No. 6: 6535-6543, 2024 DOI: 10.55214/25768484.v8i6.3407 © 2024 by the author; licensee Learning Gate the mother's age, occupation, knowledge about exclusive breastfeeding, postpartum care and so on, so that the educational factor of breastfeeding mothers does not have a significant influence. 3.3. Occupation There is no significant influence between occupation and exclusive breastfeeding, p-value = 0.201 based on the Chi Square statistical test. The results of previous research with similar results, including [14] showed that the mother's employment factor was not important in providing exclusive breastfeeding. Meanwhile, research with the opposite results includes [15] [16]. Research [6] found that occupation had a negligible influence on nursing mothers’ attitudes to breastfeeding. The occupation of breastfeeding mothers, whether working or not working, does not show a significant relationship where the percentage of exclusive breastfeeding in both groups is equally low because there are many other factors that influence exclusive breastfeeding here, such as knowledge of breastfeeding mothers, local wisdom, namely food restrictions and also postpartum care. 3.4. Knowledge There is a significant influence on breastfeeding mothers' knowledge of exclusive breastfeeding, p- value = 0.006 based on the Chi Square test, where exclusive breastfeeding by mothers with good knowledge is 48.40%, mothers with sufficient knowledge is 49.32% while mothers with less knowledge is only 13.64%. Several previous studies with similar results include [17], [4], [18], [19], [20], [21] dan [22]. Meanwhile, previous research with the opposite results included [12]. The mother's level of knowledge about exclusive breastfeeding influences behavior in giving exclusive breast milk, where breastfeeding mothers who already understand the meaning, benefits and methods of giving exclusive breast milk will try to give it. 3.5. Food Consumption Behavior There is no significant effect on food consumption of breastfeeding mothers with exclusive breastfeeding based on the Chi Square test, with a value of p=0.893. This happened because the majority of respondents studied behaved positively or well in terms of consuming food which is believed to increase breast milk, namely 354 respondents, while there were only 4 respondents with negative behavior. However, previous research has obtained the opposite results, including [23] saying that there is an influence of postpartum food consumption on breast milk production, [24] finding that calorie supplementation has proven to be a significant factor in the success of reaching 6 months exclusive breastfeeding. Inadequate dietary intake during lactation may compromise the nutritional status of the mother, her recovery back to health, and her human milk production [25]. 3.6. Food Taboo Behavior There is a significant effect of breastfeeding mothers' dietary restrictions on exclusive breastfeeding based on the Chi Square statistical test with a value of p=0.044. Most breastfeeding mothers avoid certain types of food for no particular reason or because of vague concerns that the food could harm their baby [26]. For generations, the people of Aceh, especially Pidie - Aceh, Indonesia, believe that certain foods are dangerous if eaten by postpartum women, so this has become local wisdom. Several types of food generally contain high levels of protein which breastfeeding mothers need to increase the quality and quantity of breast milk. Foods that are often taboo for postpartum mothers include shrimp, chicken, duck eggs, milkfish, sticky rice, papaya, pineapple and limiting drinking. The result of abstaining from food in postpartum mothers is that mothers are unable to breastfeed their babies exclusively because of the limited food they can consume. 3.7. Postpartum Care with Sale There is a significant effect between postpartum care with sale and exclusive breastfeeding based on Chi Square analysis, p-value = 0.018. Postpartum care with sale is local wisdom in Aceh. Sale is the act of a mother after giving birth lying on a mat made of bamboo under which hot charcoal is placed. This tradition is believed to reduce body fat and make the body fitter [27]. Sale is the same in principle as a 6541 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 8, No. 6: 6535-6543, 2024 DOI: 10.55214/25768484.v8i6.3407 © 2024 by the author; licensee Learning Gate sauna, where the sauna process will cause the body to produce a lot of sweat which functions to provide a thorough cleansing effect on the skin and sweat glands [28]. Otherwise, research [29] [30] concluded that warm steam therapy has an effect on increasing breast milk production. Nursing mothers who carry out postpartum care cannot fulfill their baby's needs with breast milk, so they have to supplement it with other drinks such as formula milk. This can happen because postpartum care causes the body to sweat a lot so that the body experiences a lack of fluids if it is not balanced by drinking enough fluids. 3.8. Postpartum Care with Toet Batee There is a significant effect between postpartum care with toet batee and exclusive breastfeeding, where based on the Chi Square test, the p value = 0.013. Local wisdom is the tradition of burning stones (toet batee), namely hot stones wrapped in cloth or castor leaves placed on the stomach with the assumption that it can speed up the process of reducing the uterus and can expel dirty blood. This toet batee tradition is carried out for 44 days, starting on the second day after giving birth [27]. One study in Myanmar reported that after giving birth they underwent treatment with internal and external body warming [31]. Only 41.06% of breastfeeding mothers who had toet batee postpartum care provided exclusive breastfeeding compared to mothers who did not have toet batee postpartum care, up to 54.30% gave exclusive breast milk. This can happen because during the toet batee process, the postpartum mother's body experiences heating, especially in the stomach area, while the postpartum mother also limits her drinking water intake, which can cause breast milk production to decrease and she has to give drinks other than breast milk to meet the baby's needs breast milk. This can happen because during the toet batee process, the postpartum mother's body experiences heating, especially in the stomach area, while the postpartum mother also limits her drinking water intake, which can cause breast milk production to decrease and she has to give drinks other than breast milk to meet the baby's needs. 4. Conclusion Based on the research, the results obtained were 167 respondents who provided exclusive breastfeeding or 46.65% of the 358 respondents studied. The results of bivariate analysis with the Chi Square statistical test using SPSS 24 showed that there was no significant influence on the factors of age, education, employment, and food consumption of breastfeeding mothers with exclusive breastfeeding; There is a significant influence between knowledge, dietary restrictions for breastfeeding mothers, postpartum care, and postpartum toet batee care with exclusive breastfeeding. Health education is needed in order to increase the knowledge of breastfeeding mothers about the importance of exclusive breastfeeding and the effects caused by postpartum care and toet batee which are local wisdom in Aceh on the breast milk production of breastfeeding mothers in Pidie, Aceh, Indonesia. Acknowledgements: Authors thank to Universitas Malikussaleh which funded this research under organizing by Institution for Research and Community Service (LPPM). Copyright: © 2024 by the authors. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). References [1] J. Ahishakiye, L. Bouwman, I. D. Brouwer, L. Vaandrager, and M. Koelen, “Prenatal infant feeding intentions and actual feeding practices during the first six months postpartum in rural Rwanda: A qualitative, longitudinal cohort study,” Int. Breastfeed. J., vol. 15, no. 1, pp. 1–14, 2020, doi: 10.1186/s13006-020-00275-y. [2] Unicef, “Pekan Menyusui Sedunia: UNICEF dan WHO serukan dukungan yang lebih besar terhadap pemberian ASI di Indonesia seiring penurunan tingkat menyusui selama pandemi COVID-19 https://www.unicef.org/indonesia/id/siaran-pers,” 2022. [3] M. Carrillo-Díaz, A. R. Ortega-Martínez, A. Ruiz-Guillén, M. Romero-Maroto, and M. J. González-Olmo, “Impact of breastfeeding and cosleeping on early childhood caries: A cross-sectional study,” J. Clin. Med., vol. 10, no. 8, 2021, doi: https://creativecommons.org/licenses/by/4.0/ 6542 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 8, No. 6: 6535-6543, 2024 DOI: 10.55214/25768484.v8i6.3407 © 2024 by the author; licensee Learning Gate 10.3390/jcm10081561. [4] A. T. Tambunan, F. Tanggulungan, R. Poppy, F. Sinurat, L. Kartika, and S. Aiba, “Relationship between Mothers’ Knowledge and Exclusive Breastfeeding Behavior in One Private Hospital in West Indonesia,” Int. J. Nurs. Heal. Serv., vol. 4, no. 1, pp. 1–8, 2021. [5] Safrina, “Dyah: Pemberian ASI Eksklusif Bukan Tindakan Kuno,” 2022. [6] A. A. Ishola, K. A. Adekunle, and A. F. Temitope, “Social-Demographic Factors Influencing Exclusive Breastfeeding Atitude among Working Nursing Mothers in Urban Areas of Ibadan, Oyo State,” Psychol. Res. Urban Soc., vol. 2, no. 2, p. 76, 2019, doi: 10.7454/proust.v2i2.51. [7] B. Dadzie et al., “Investigating factors that influence the practice of exclusive breastfeeding among mothers in an urban general hospital in Ghana: a cross-sectional study,” BMC Womens. Health, vol. 23, no. 1, pp. 1–12, 2023, doi: 10.1186/s12905-023-02164-y. [8] K. Bala, B. S. Sahni, S. Bavoria, and A. Narangyal, “Knowledge, attitude, and breast-feeding practices of postnatal mothers in Jammu: A community hospital based cross sectional study,” J. Fam. Med. Prim. Care, vol. 9, no. 7, pp. 3433–3437, 2020, doi: 10.4103/jfmpc.jfmpc. [9] A. Jama et al., “Exclusive breastfeeding for the first six months of life and its associated factors among children age 6- 24 months in Burao district, Somaliland,” Int. Breastfeed. J., vol. 15, no. 1, pp. 1–8, 2020, doi: 10.1186/s13006-020- 0252-7. [10] K. Batubara and R. Pangaribuan, “Exclusive Breastfeeding Based On The Characteristics Of Breastfeeding Mothers In Kutelintang Village, Belangkejeren District, Gayo Lues Regency,” J. Kesehat. LLDikti Wil. 1, vol. 1, no. 1, pp. 9–14, 2021, doi: 10.54076/jukes.v1i1.28. [11] K. Samwel, Dede and H. Bras, “Exclusive breastfeeding patterns in Tanzania. Do individual, household, or community factors matter? Authors: Kwalu Samwel Dede 1 , Hilde Bras 2 1=”. [12] S. Wuryanti and H. Marsiati, “Relationship Between Maternal Education and Knowledge on Coverage of Exclusive Breastfeeding in Ten Stunting Locus Villages in Pandeglang District, Banten,” Indones. J. Med. Sci. Public Heal., vol. 2, no. 1, pp. 40–46, 2021, doi: 10.11594/ijmp.02.01.05. [13] A. D. Laksono, R. D. Wulandari, M. Ibad, and I. Kusrini, “The effects of mother’s education on achieving exclusive breastfeeding in Indonesia,” BMC Public Health, vol. 21, no. 1, pp. 1–6, 2021, doi: 10.1186/s12889-020-10018-7. [14] R. Wulandari, E. Martha, E. Guspaneza, and A. Cendanasari, “Exclusive Breastfeeding Among Working Mothers,” Int. Conf. Public Heal., pp. 183–195, 2019. [15] M. Mastan and E. L. Achadi, “Factors Determining Successful Exclusive Breastfeeding on Working Mothers in Indonesia: An Exploration by Using Positive Deviance Concept,” Indones. J. Public Heal. Nutr., vol. 2, no. 1, pp. 1–11, 2021, doi: 10.7454/ijphn.v2i1.5068. [16] A. L. Mazengia and H. Demissie, “Knowledge and Practice of Employed Mothers towards Exclusive Breastfeeding and Its Associated Factors in Mecha District, Northwest Ethiopia,” J. Nutr. Metab., vol. 2020, 2020, doi: 10.1155/2020/4820582. [17] A. J. et al Dukuzumuremyi J P C, Acheampong K, “Knowledge , attitude , and practice of exclusive breastfeeding among mothers in East Africa : a systematic review, https://doi.org/10.1186/s13006-020-00313-9,” Int. Breastfeed., vol. 9, no. 20, pp. 1–17, 2020. [18] E. D. Wanadi, S. Wahyuningsih, A. Widayati, and Sunanto, “The Relationship Between Mothers’ Knowledge Level about Exclusive Breastfeeding and Providing Exclusive Breastfeeding Behavior,” Heal. Technol. J., vol. 1, no. 4, pp. 414–419, 2023, doi: 10.53713/htechj.v1i4.72. [19] B. Johari, M. S. Nor Azwani, and N. azwani Mohd Shukri, “Exclusive Breastfeeding: Knowledge, Attitude, Practice, and Its Determinants Among Malay Mothers in Ampang, Selangor,” Int. J. Allied Heal. Sci., vol. 2, no. 1, pp. 117–128, 2018. [20] C. N. Ihudiebube-Splendor et al., “Exclusive Breastfeeding Knowledge, Intention to Practice and Predictors among Primiparous Women in Enugu South-East, Nigeria,” J. Pregnancy, vol. 2019, 2019, doi: 10.1155/2019/9832075. [21] D. Wahyuni, Rosdianah, and Asriani, “Relationship between Mother’s Knowledge of Breastfeeding and Exclusive Breastfeeding for Nursing Mothers in the Operational Area of the Sudiang Primary Health Center,” Green Med. J., vol. 3, no. 1, pp. 30–38, 2021, doi: 10.33096/gmj.v3i1.78. [22] L. J. Wicaksono, D. T. Anantyo, J. Dewantiningrum, and B. Hariyana, “the Effect of Breastfeeding Education Among Postpartum Mothers on Exclusive Breastfeeding Practice One Month After Delivery,” Diponegoro Med. J. (Jurnal Kedokt. Diponegoro), vol. 9, no. 3, pp. 263–268, 2020, doi: 10.14710/dmj.v9i3.27506. [23] D. Widiyanti and K. Heryati, “Effect on Food Consumption Postpartum Mother’s Breastfeeding in Clinical Pratice Midwife in Bengkulu City,” Int. J. Recent Sci. Res., vol. 9, no. 5, pp. 30693–30695, 2018, doi: 10.24327/IJRSR. [24] S. Fikawati, A. Syafiq, and Mardatillah, “Maternal calorie intake is a significant factor associated with 6 months of exclusive breastfeeding among lactating mothers in Depok City, Indonesia,” Malays. J. Nutr., vol. 23, no. 1, pp. 31–41, 2017. [25] S. M. Abdul Basir, R. Abdul Ghani, M. Bin Ibrahim, M. M. A. Khattak, M. N. Bin Omar, and N. A. Mohd Shukri, “Dietary Status of Exclusively Breastfeeding Mothers: the Influence of Traditional Postpartum Dietary Practices,” Int. J. Allied Heal. Sci., vol. 3, no. 2, pp. 634–642, 2019. [26] G. Jeong, S. W. Park, Y. K. Lee, S. Y. Ko, and S. M. Shin, “Maternal food restrictions during breastfeeding,” Korean J. Pediatr., vol. 60, no. 3, pp. 70–76, 2017, doi: 10.3345/kjp.2017.60.3.70. [27] L. Aprilia and N. R. I. Mukhlishah, “Artikel review: Perawatan tradisional Indonesia bagi ibu pada masa nifas,” Sasambo J. Pharm., vol. 4, no. 1, pp. 24–29, 2023, doi: 10.29303/sjp.v4i1.206. 6543 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 8, No. 6: 6535-6543, 2024 DOI: 10.55214/25768484.v8i6.3407 © 2024 by the author; licensee Learning Gate [28] T. M. Fuadi, “Pengobatan Tradisional Madeung Dan Sale pada Ibu Masa Nifas dalam Masyarakat Aceh,” Pros. Semin. Nas. Biot., vol. 5, no. 1, pp. 614–620, 2018. [29] Rosnani, Jawiyah, and D. Mediarti, “Warm Steam Therapy to Increase Breast Milk Production of Post-Partum Mothers,” in Proceedings of the 9th International Nursing Conference (INC 2018), 2018, pp. 373–378. doi: 10.5220/0008325503730378. [30] Shinta Wurdiana Rhomadona and Dianita Primihastuti, “The Effect of Herbal Steam Bath to Increasing Breast Milk Production in Postpartum Mothers,” Int. J. Adv. Heal. Sci. Technol., vol. 2, no. 6, pp. 420–425, 2022, doi: 10.35882/ijahst.v2i6.184. [31] A. N. Bazzano, J. A. Stolow, R. Duggal, R. A. Oberhelman, and C. Var, “Warming the postpartum body as a form of postnatal care: An ethnographic study of medical injections and traditional health practices in Cambodia,” PLoS One, vol. 15, no. 2, pp. 1–16, 2020, doi: 10.1371/journal.pone.0228529.