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Epidemiology and Society Health Review| ESHR 
 

Vol 2, No2 (2020) 
 

53 

Research Article  
 
Correlations between mother’s knowledge level of 
exclusive breastfeeding and the pattern in the 6-month 
child in Posyandu of Jatimulyo Village, Petanahan Sub-
District, Kebumen Regency, Central Java, Indonesia 
 
Hastin Ika Indriyastuti 1*, Wuri Utami2, Juad Juad2 

 
1 Midwifery Program, Sekolah Tinggi Ilmu Kesehatan Muhammadiyah, Gombong, Central 

Java, Indonesia 
2 Nursing Program, Sekolah Tinggi Ilmu Kesehatan Muhammadiyah, Gombong, Central 

Java, Indonesia 
 
*Correspondence: hastin.myu@gmail.com. Telp: +6285292234445 
 Received 05 May, 2020; Accepted 25 June, 2020; Published 26 June, 2020 

ABSTRACT  

Background: Globally, the infant mortality rate (IMR) is still extremely high. One of the 
efforts to improve children's health is exclusive breastfeeding for six months. Exclusive 
breastfeeding can reduce infant mortality rate caused by various infectious diseases. Thus, 
the community, especially mothers need to have proper knowledge about exclusive 
breastfeeding, and then they are expected to practice it. This study aims to determine the 
relationship between mothers’ knowledge of exclusive breastfeeding and the breastfeeding 
patterns of 6-month children in Jatimulyo Village, Petanahan Sub-district, Kab, Indonesia. 
Kebumen Regency, Central Java Province, Indonesia. 
Methods: The study was conducted in Jatimulyo Village using quantitative methods and 
correlation design with a cross-sectional approach. This study sample consisted of 56 
mothers who had children aged 6-24 months selected based on the total sampling approach. 
Data were analyzed using univariate analysis and bivariate analysis using chi-square 
statistical tests. 
Results: This study found that most of the respondents are 26-30 years old and have a high 
school education level with multigravida parity and have a moderate level of knowledge. The 
study showed a relationship between the level of exclusive breastfeeding knowledge and 
breastfeeding patterns with a p-value of 0.002 (<0.05) and a correlation value of 0.499. 
Conclusions: Therefore, it can be concluded that there is a relationship between the level of 
knowledge about exclusive breastfeeding and breastfeeding patterns with a p-value of 0.002 
(<0.05) and a correlation value of 0.499. 

Keywords: Mothers’ knowledge, breastfeeding pattern, baby nutrition, exclusive 
breastfeeding 

 

INTRODUCTION 

One of the efforts to improve children's health is by providing exclusive breastfeeding for six 
months of inborn babies. Exclusive breastfeeding can reduce infant mortality rate caused by 
common infectious diseases in children such as diarrhea and pneumonia. Moreover, 



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exclusive breastfeeding can accelerate the recovery from an illness (1). Without exclusive 
breastfeeding, children will quickly get diarrhea 30 times higher than those receiving 
exclusive breastfeeding, even though they have higher risks of death due to malnutrition (2). 
Breast milk is beneficial for infant to support their lives, such as immunological, 
psychological, intelligence, and neurological, while for mothers, it can be a method for 
controlling pregnancy (3).  

Indonesia’s national health survey (Susenas) data show that one in two infants aged 0-5 
months receives exclusively breastfeeding (4). The percentage of infants receiving exclusive 
breastfeeding in rural areas is higher than in urban areas, namely 57.22%, compared to 
54.77 % (4). The achievement of exclusive breastfeeding in Kebumen District is 66.95% (5). 
It has not met the government's target yet, as stated in the Decision of the Ministry of Health 
Number 450/Menkes/SK/IV/2004 concerning the exclusive breastfeeding target in Indonesia, 
80%. Thus, it can be said that exclusive breastfeeding has not yet reached the goal (3).  

Many factors affect the success of exclusive breastfeeding. A study revealed that mothers 
whose husbands support exclusive breastfeeding would succeed in practicing it twice as 
much as those without husbands’ support (6). In other studies, education, knowledge, and 
experience of the mother become a predisposing factor affecting exclusive breastfeeding, 
and the support of health workers becomes a motivating factor for exclusive breastfeeding 
(7). World Health Organization (WHO) divides breastfeeding patterns into three: sole, 
predominant, and partial breastfeeding. Exclusive breastfeeding is providing breast milk from 
birth until six months without any supplementary food except vitamins and both oral and 
injection medicine. The predominant pattern of breastfeeding is to give water or others 
before the milk comes out. In contrast, the partial pattern provides complementary foods 
such as formula milk, water, porridge, or other foods before the baby is six months old, either 
continuously or pre-reactively (8). 

Based on previous research shows there was a relationship between exclusive 
breastfeeding knowledge and provision of complementary foods (MPASI) for infants aged 
6─12 months in the coverage areas of Puskemas Samigaluh II. Most mothers who provide 
MPASI have a secondary education level and are aged 20-40 years with multigravida and do 
not work or housewives. Mothers with a moderate knowledge level of exclusive 
breastfeeding do not provide MPASI (9). 

Based on the preliminary study conducted in April 2019 in Petanahan Sub-district, Jatimulyo 
village has the lowest exclusive breastfeeding level in 2018, with only 30%. Jatimulyo village 
has 4 RWs (a unit area under village) with seven integrated health services post (Posyandu) 
and 56 mothers with children aged 6-24 months. A total of 3 out of 8 interviewed mothers 
practice exclusive breastfeeding, and 5 out of 8 interviewed mothers used a partial pattern in 
breastfeeding. The reasons for using partial patterns include feeling tired to get up in the 
middle of the night to breastfeed, low breast milk production, and working.   

Based on the mentioned background, we formulated a research question "is there a 
relationship between the mother's level of knowledge about the exclusive breastfeeding 
pattern in a 6-month-old child in Posyandu of Jatimulyo village". Given the importance of 
exclusive breast milk, authors want to know if the knowledge is the underlying of exclusive 
breastfeeding. 

METHODS 

This quantitative research used a correlation research design with a cross-sectional 
approach. It aims to link a variable with another. The researchers only observed and 
measured variables at one particular time. The measurement was not limited to one time 



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simultaneously, but each subject was only subjected to one measurement without any 
repetition (6). Subjects were measured for their knowledge of exclusive breastfeeding and 
associated with the breastfeeding patterns. We used a knowledge questionnaire adopted 
from the Tri Hartatik study that had been tested for validity (10). 

The study applied a total sampling technique with 56 respondents with children aged 6-24 
months in 7 integrated health services post in Jatimulya Village, Petanahan Sub-district. 
Data were analyzed using univariate and bivariate analysis. 

RESULTS 

Respondents Characteristic 
Thirty-nine of respondents (69.7%) are 26-30 years old. A total of 30 respondents (53.6%) 
have senior high education levels. Most of them (35 respondents or 62.5%) parity status is 
multigravida (Table 1) 

Table 1. Demographic characteristic of respondents 

 

 

 

 

 

 

 

 

Table 2 shows that 40 respondents (71.4%) have a moderate level of exclusive 
breastfeeding knowledge.  

Table 2. Distribution frequency of respondents based on knowledge of 
exclusive breastfeeding in Jatimulyo Village, June 2020 

Knowledge of exclusive 
breastfeeding 

N = 56 Percent (%) 

High 
Moderate 

Low 

12 
40 
4 

21.4 
71.4 
7.2 

Total 56 100 
 

 

 

 

Variable Characteristics N = 56 Percent (%) 
Age (year) 17-25  

26-35 
36-45 

12 
39 
5 

21.4 
69.7 
8.9 

 Total 56 100 
Education  PS 

JHS 
SHS 
University 

5 
17 
30 
4 

8.9 
30.4 
53.6 
7.1 

 Total 56 100 
Parity Primigravida 

Multigravida 
21 
35 

37.5 
62.5 

 Total 56 100 



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Table 3 shows that a total of 24 respondents (42.9%) practice predominant breastfeeding 
patter. 

Table 3. The frequency distribution of respondents based on breastfeeding 
patterns in Jatimulyo Village, Petanahan Sub-district, June 2020 

Breastfeeding patterns N = 56 Percent (%) 
Exclusive  
Predominant 
Partial 

21 
24 
11 

37.5 
42.9 
19.6 

Total 56 100 
 

Table 4 shows that most respondents have a moderate level of knowledge of exclusive 
breastfeeding with the breastfeeding pattern varied from exclusive (12 respondents or 
21.4%), predominant (20 respondents or 35.7%), and partial (8 respondents or 14.3%). 

Table 4. The relationship between the level of knowledge about exclusive 
breastfeeding and breastfeeding patterns in Jatimulyo Village, Petanahan Sub-

district, June 2020 

 Breastfeeding pattern   
Knowledge of exclusive 
breastfeeding 

Exclusive  Predominant  Partial  r p 

 N (%) N (%) N (%)   
High 
 
Moderate  
 
Low 

9 (16) 
 
12 (21.4) 
 
0 (0) 
 

3 (35.4) 
 
20 (35.7) 
 
1 (1.8) 

0 (0) 
 
8 (14.3) 
 
3 (5.4) 

0.499 0,002 
 

Total 21 24 11   

      r = coefficient correlation; p = p-value 

The Chi-square test result shows the correlation coefficient value of 0.499 with a p-value of 
0.002 (<0. 05). Therefore, it can be concluded that there is a significant relationship between 
mothers' exclusive breastfeeding and breastfeeding patterns in 6-month-old children at 
Jatimulyo Village, Petanahan Sub-district. 

DISCUSSIONS 

This research found that mothers aged 26-30 years are not fully aware of the importance of 
exclusive breastfeeding. Individuals in this age group are mature enough and able to 
manage family and children (11). According to previous research shows the relationship 
between the age of mothers and the giving of exclusive breast milk with the value P = 0,026 
(< 0.05) (12). The study in Jatimulyo village obtained that the respondents with sufficient 
knowledge in early adulthood due to lack of breast milk experience and were also influenced 
by cultural cultures still detrimental.   

Based on the research result, a person's education level will affect the level of knowledge. 
The higher education, the higher awareness of the importance of exclusive breastfeeding 
and vice versa (11). The result of the study in Jatimulyo Village revealed that most of the 
respondents have a high school education level. Still, most of them do not have sufficient 



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knowledge about exclusive breastfeeding because of another factor, namely, parent's 
culture in breastfeeding.  

A total of 35 respondents (62.5%) in Jatimulyo Village have multigravida, and 27 (48.3%) 
had a moderate level of exclusive breastfeeding knowledge. The result of research in 
Jatimulyo Village shows that most respondents with primigravida have a moderate level of 
knowledge due to lack of experience. Previous research shows that 18 mothers (54.54%) 
with multigravida have a level of knowledge and awareness, and 13 mothers (48.18%) do 
not have the awareness to practice exclusive breastfeeding with a value of 0.043 <0.05. It 
means that there is a relationship between parity and the level of awareness in 
breastfeeding (13). Based on data on breastfeeding patterns in Jatimulyo Village, 24 
respondents (42.9%) have a predominant pattern; 21 respondents (37.5%) have exclusive 
breastfeeding patterns, and 11 respondents (19.6%) have a partial pattern in breastfeeding. 
It indicates that the mother's exclusive breastfeeding awareness is low and has not met the 
government targets.  

Based on the collected data from Jatimulyo Village, respondents of productive age do not 
always apply exclusive breastfeeding patterns. They also apply predominant patterns due to 
lack of motivation from health workers and families, and the place of delivery. Typically, 
respondents who give birth at the primary health center will be motivated to practice early 
initiation breastfeeding and to complete the exclusive breastfeeding. 

Adequate education is the basis for developing insight of people as well as produces 
motivation on practicing knowledge to attitude and practice. Mother with low education 
causes they slow in adopting new knowledge, including about breastfeeding (14). Most 
respondents or a total of 30 respondents (53.6%) in Jatimulyo Village have a high school 
education level, and 14 (25%) of them have predominant breastfeeding patterns. Although 
their education is quite high, some of them lack experience in breastfeeding, lack of 
motivation from health workers and families, and cultural influences. However, only 14 (25%) 
respondents with high school education practice the exclusive breastfeeding pattern 
because they have the motivation and ability to absorb the information provided by health 
workers. 

Meanwhile, 4 (7.1%) out of 5 (8.9%) respondents with low education level or primary school 
level have partial patterns due to lack of exclusive breastfeeding knowledge. Then, four 
respondents (7.1%) with university education level have the exclusive breastfeeding pattern.  
Many highly educated mothers manage to give exclusive breastfeeding and open and 
absorb information easily. Accordingly, they know more about the importance of exclusive 
breastfeeding. This is in line with Mardeyanti's research in Yogyakarta that found a link 
between nursing mothers' education and exclusive breastfeeding. It was concluded that low 
maternal education level increases the risk of mothers not giving exclusive breast milk to 
their babies (15). 

Our result shows that respondents most widely apply the exclusive pattern with primigravida 
because they have broader information and knowledge about exclusive breastfeeding, 
health workers, and family support. It is in line with Mabud's research, which showed a 
relationship between parity and the breastfeeding p-value of 0.04 <0.05 (16). 

Based on the result of research in Jatimulyo Village, Petanahan Sub-district, the data 
obtained from the chi-square test shows a p-value of <0.002 (<0.05). The standard for 
accepting the hypothesis is if the p-value is <0.05, then Ha is accepted. It indicates the 
relationship between exclusive breastfeeding and breastfeeding patterns with a correlation 
value of 0.499. The current study shows a relationship between exclusive breastfeeding 
knowledge and breastfeeding patterns in Jatimulyo Village. The result of research in 



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Posyandu in Jatimulyo Village shows that 12 (21.4%) respondents with a moderate level of 
knowledge have exclusive breastfeeding patterns; 20 respondents (35.7%) have a 
predominant pattern, and eight respondents (14.3%) apply partial breastfeeding pattern. 
Therefore, the higher level of exclusive breastfeeding knowledge, the higher motivation to 
practice exclusive breastfeeding. This finding is in line with Mabud's research, which shows 
the relationship between knowledge and exclusive breastfeeding (16). However, the success 
of exclusive breastfeeding is also affected by several factors such as mother's attitude, 
family support, information from health workers, and culture. 

CONCLUSIONS 

Most of the respondents in Posyandu of Jatimulyo Village are 26─30 years old with a high 
school education level and in the second parity. The knowledge of respondents in Posyandu 
of Jatimulyo Village, Petanahan Sub-district about exclusive breastfeeding, is moderate. This 
can be one of the factors in the failure of exclusive breastfeeding. Most of the respondents in 
Posyandu, Jatimulyo Village, Petanahan Sub-district, have predominant breastfeeding 
patterns. It indicates that the failure of exclusive breastfeeding is still high. There is a 
relationship between the level of mothers’ knowledge about exclusive breastfeeding and 
breastfeeding patterns in 6-month-old children in integrated health services post of Jatimulyo 
Village, Petanahan Sub-district. 

Authors’ contribution 

HS, WR, & JD; Study Design. HS & JD; Data collection. HS, WR, JD&SG; Data analysis and 
revisions for important intellectual content. HS; Manuscript writing. All authors read and 
approved the final manuscript. 

Funding 

This research was financially supported by Sekolah Tinggi Ilmu Kesehatan Muhammadiyah 
Gombong, Central Java, Indonesia 

Acknowledgments 

We acknowledge the supported Research Department of Sekolah Tinggi Ilmu Kesehatan 
Muhammadiyah Gombong made this research done well. 
 

Conflict of interest 

There is no conflict of interest in this research.  

 

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