Pediatr Gastroenterol Hepatol Nutr.  2018 Oct;21(4):248-256. 10.5223/pghn.2018.21.4.248.

Challenges and Supports of Breastfeeding at Workplace in Indonesia

• Basrowi RW
• Sastroasmoro S
• Sulistomo
• Bardosono
• Hendarto A
• Soemarko D
• Sungkar A
• Khoe LC
• Vandenplas Y

• KMID: 2421986
• DOI: http://doi.org/10.5223/pghn.2018.21.4.248

Abstract

Due to increased number of women workers in Indonesia in the last decade, numbers of women living as a worker and a housewife have increased. This also increases the potential risk of breastfeeding discontinuation. Three months of maternal leave policy and inadequate lactation promotion support in workplace have been identified as factors that hinder lactating practices. The World Health Organization recommendation of 6 months of exclusive breastfeeding and joined regulation of three Indonesia ministers (Ministry of Health, Ministry of Labour, and Ministry of Women Empower) have failed to improve the exclusive breastfeeding rate among female workers in Indonesia due to the lack of a standardized guideline on lactation promotion at workplace. In addition, very limited or no studies have been conducted to evaluate the impact of workplace-based lactation intervention programs on exclusive breastfeeding rate among female workers. This is because the relationship of lactation with working performance and productivity could not motivate employer to invest in workplace-based lactation promotion facility or program.

Keyword

Breast feeding; Lactation; Workplace; Efficiency

MeSH Terms

Breast Feeding*
Clergy
Efficiency
Female
Humans
Indonesia*
Lactation
World Health Organization

Reference

1. Badan Pusat Statistik. Survei Demografi dan Kesehatan Indonesia 2012. Jakarta: Kementerian Kesehatan RI;2012.

2. Triaryati N. Pengaruh adaptasi kebijakan mengenai work family issue terhadap absen dan turnover. Jurnal Manajemen dan Kewirausahaan. 2003; 5:85–96.

3. Oktariyanti Fifi. Manajemen Konflik Pada Perempuan Dengan Peran Ganda (Studi Pada Ibu Bekerja di Kota Malang) [thesis]. Jakarta: Universitas Brawijaya;2012.

4. Basrowi RW, Sulistomo AB, Adi NP, Vandenplas Y. Benefits of a dedicated breastfeeding facility and support program for exclusive breastfeeding among workers in Indonesia. Pediatr Gastroenterol Hepatol Nutr. 2015; 18:94–99.

5. World Health Organization. Exclusive breastfeeding for optimal growth, development and health of infants [Internet]. Geneva: World Health Organization;cited 2016 Jan 9. Available from: http://www.who.int/elena/titles/exclusive_breastfeeding/en/.

6. Riordan J. Breastfeeding and human lactation. 3rd ed. Sudbury, MA: Jones & Bartlett Learning;2005.

7. United Nations. Improving child nutrition: The achievable imperative for global progress. New York: United Nations;2013.

8. World Health Organization. Global strategy for infant and young children feeding. Geneva: World Health Organization;2003.

9. Butte NF, Garza C, Lopez-Alarcon MG. Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life. Geneva: World Health Organization;2002.

10. Duffy LC, Faden H, Wasielewski R, Wolf J, Krystofik D. Exclusive breastfeeding protects against bacterial colonization and day care exposure to otitis media. Pediatrics. 1997; 100:E7.

11. Sassen ML, Brand R, Grote JJ. Breast-feeding and acute otitis media. Am J Otolaryngol. 1994; 15:351–357.

12. Morrow AL, Ruiz-Palacios GM, Jiang X, Newburg DS. Human-milk glycans that inhibit pathogen binding protect breast-feeding infants against infectious diarrhea. J Nutr. 2005; 135:1304–1307.

13. Feachem RG, Koblinsky MA. Interventions for the control of diarrhoeal diseases among young children: promotion of breast-feeding. Bull World Health Organ. 1984; 62:271–291.

14. Bachrach VR, Schwarz E, Bachrach LR. Breastfeeding and the risk of hospitalization for respiratory disease in infancy: a meta-analysis. Arch Pediatr Adolesc Med. 2003; 157:237–243.

15. Gdalevich M, Mimouni D, David M, Mimouni M. Breast-feeding and the onset of atopic dermatitis in childhood: a systematic review and meta-analysis of prospective studies. J Am Acad Dermatol. 2001; 45:520–527.

16. Gdalevich M, Mimouni D, Mimouni M. Breast-feeding and the risk of bronchial asthma in childhood: a systematic review with meta-analysis of prospective studies. J Pediatr. 2001; 139:261–266.

17. Arenz S, Rückerl R, Koletzko B, von Kries R. Breast-feeding and childhood obesity--a systematic review. Int J Obes Relat Metab Disord. 2004; 28:1247–1256.

18. Owen CG, Whincup PH, Odoki K, Gilg JA, Cook DG. Infant feeding and blood cholesterol: a study in adolescents and a systematic review. Pediatrics. 2002; 110:597–608.

19. ESPGHAN Committee on Nutrition. Agostoni C, Braegger C, Decsi T, Kolacek S, Koletzko B, et al. Breast-feeding: A commentary by the ESPGHAN committee on nutrition. J Pediatr Gastroenterol Nutr. 2009; 49:112–125.

20. Slusser W, Lange L. Breastfeeding programs and support systems in Los Angeles County: a needs assessment [Internet]. Los Angeles: UCLA Center for Healthier Children, Family and Communities;2013. cited 2016 Jan 9. Available from: http://publichealth.lacounty.gov/mch/reports/Prop10breastfeeding.pdf.

21. Kramer MS, Chalmers B, Hodnett ED, Sevkovskaya Z, Dzikovich I, Shapiro S, et al. Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. JAMA. 2001; 285:413–420.

22. Martin RM, Gunnell D, Smith GD. Breastfeeding in infancy and blood pressure in later life: systematic review and meta-analysis. Am J Epidemiol. 2005; 161:15–26.

23. Owen CG, Whincup PH, Gilg JA, Cook DG. Effect of breast feeding in infancy on blood pressure in later life: systematic review and meta-analysis. BMJ. 200; 327:1189–1195.

24. Norris JM, Scott FN. A meta-analysis of infant diet and insulin-dependent diabetes mellitus: do biases play a role? Epidemiology. 1996; 7:87–92.

25. Fraser AB, Grimes DA. Effect of lactation on maternal body weight: a systematic review. Obstet Gynecol Surv. 2003; 58:265–269.

26. López-Olmedo N, Hernández-Cordero S, Neufeld LM, García-Guerra A, Mejía-Rodríguez F, Méndez Gómez-Humarán I. The associations of maternal weight change with breastfeeding, diet and physical activity during the postpartum period. Matern Child Health J. 2016; 20:270–280.

27. Smith DE, Lewis CE, Caveny JL, Perkins LL, Burke GL, Bild DE. Longitudinal changes in adiposity associated with pregnancy. The CARDIA Study. Coronary Artery Risk Development in Young Adults Study. JAMA. 1994; 271:1747–1751.

28. Janney CA, Zhang D, Sowers M. Lactation and weight retention. Am J Clin Nutr. 1997; 66:1116–1124.

29. Kelly KM, Chopra I, Dolly B. Breastfeeding: an unknown factor to reduce heart disease risk among breastfeeding women. Breastfeed Med. 2015; 10:442–447.

30. Chojenta CL, Lucke JC, Forder PM, Loxton DJ. Maternal health factors as risks for postnatal depression: a prospective longitudinal study. PLoS One. 2016; 11:e0147246.

31. Cooper PJ, Murray L, Stein A. Psychosocial factors associated with the early termination of breast-feeding. J Psychosom Res. 1993; 37:171–176.

32. Henderson JJ, Evans SF, Straton JA, Priest SR, Hagan R. Impact of postnatal depression on breastfeeding duration. Birth. 2003; 30:175–180.

33. Ramos R, Kennedy KI, Visness CM. Effectiveness of lactational amenorrhoea in prevention of pregnancy in Manila, the Philippines: non-comparative prospective trail. BMJ. 1996; 313:909–912.

34. Bonia K, Twells L, Halfyard B, Ludlow V, Newhook LA, Murphy-Goodridge J. A qualitative study exploring factors associated with mothers' decisions to formula-feed their infants in Newfoundland and Labrador, Canada. BMC Public Health. 2013; 13:645.

35. Chen YC, Wu YC, Chie WC. Effects of work-related factors on the breastfeeding behavior of working mothers in a Taiwanese semiconductor manufacturer: a cross-sectional survey. BMC Public Health. 2006; 6:160.

36. Abdullah GI, Ayubi D. Determinan perilaku pemberian air susu eksklusif pada ibu pekerja. J Kesmas. 2013; 7:298–303.

37. Wulandari E. Pengaruh pendidikan laktasi di tempat kerja terhadap self efficacy pemberian ASI eksklusif pada pekerja wanita usia subur: Studi kasus di Chevron IndoAsia Business unit Jakarta tahun 2010 [thesis]. Depok: Universitas Indonesia;2010.

38. Rejeki S. Pengalaman menyusui ibu bekerja di daerah Kendal Jawa Tengah [thesis]. Depok: Universitas Indonesia;2004.

39. Panduan relaktasi. Asosiasi Ibu Menyusui Indonesia [Internet]. cited 2016 Apr 1. Available from: https://aimi-asi.org/layanan/lihat/panduan-relaktasi.

40. Tsai SY. Influence of partner support on an employed mother's intention to breastfeed after returning to work. Breastfeed Med. 2014; 9:222–230.

41. Susiloretni KA, Hadi H, Prabandari YS, Soenarto YS, Wilopo SA. What works to improve duration of exclusive breastfeeding: lessons from the exclusive breastfeeding promotion program in rural Indonesia. Matern Child Health J. 2015; 19:1515–1525.

42. Stewart-Glenn J. Knowledge, perceptions, and attitudes of managers, coworkers, and employed breastfeeding mothers. AAOHN J. 2008; 56:423–429.

43. Peraturan Bersama Peningkatan Pemberian Air Susu Ibu Di Tempat Kerja No. 48/MEN.PP/XII/2008, PER. 27/MEN/XII/2008 dan 1177/MENKES/PB/XII/2008. Available from: http://gizi.depkes.go.id/wp-content/uploads/2012/05/SKB-3-Menteri-tetanng-menyusuidi-wkatu-kerja.pdf.

44. Kementerian Kesehatan Republik Indonesia. Peraturan Pemerintah Republik Indonesia Nomor 33 Tahun 2012 tentang Pemberian Air Susu Ibu Eksklusif. Jakarta: Kementerian Kesehatan Republik Indonesia;2012. Available from: http://peraturan.go.id/pp/nomor-33-tahun-2012-11e44c4efb7dccb080e3313231383033.html.

45. Menteri Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Nomor 15 Tahun 2013 tentang Tata Cara Penyediaan Fasilitas Khusus Menyusui dan/atau Memerah Air Susu Ibu. Jakarta: Kementerian Kesehatan RI;2013. 01. Available from: http://peraturan.go.id/pp/nomor-15-tahun-2013-11e44c4ea367c9b0a058313231353336.html.

46. Undang-Undang Republik Indonesia Nomor 13 Tahun 2003 Tentang Ketenagakerjaan. Jakarta: Sekertaris Negara Republik Indonesia;2003. Available from: http://peraturan.go.id/inc/view/11e44c4e979b02208cc3313231353136.html.

47. Harianto R. Buku ajar kesehatan kerja. Jakarta: EGC;2012.

48. Kurniawidjaja LM. Teori dan aplikasi kesehatan kerja. Jakarta: UI Press;2010.

49. Abdulwadud OA, Snow ME. Interventions in the workplace to support breastfeeding for women in employment. Cochrane Database Syst Rev. 2012; 10:CD006177.

50. Galtry J. Lactation and the labor market: breastfeeding, labor market changes, and public policy in the United States. Health Care Women Int. 1997; 18:467–480.

51. Cohen R, Mrtek MB, Mrtek RG. Comparison of maternal absenteeism and infant illness rates among breast-feeding and formula-feeding women in two corporations. Am J Health Promot. 1995; 10:148–153.

52. Health Service Executive. Breastfeeding and work [Internet]. Ireland: Health Service Executive;2008. cited 2016 Jan 9. Available from: https://www.healthpromotion.ie/hp-files/docs/HPM00365.pdf.

53. Bar-Yam NB. Workplace lactation support, Part I: A return-to-work breastfeeding assessment tool. J Hum Lact. 1998; 14:249–254.

54. Johnson AM, Kirk R, Muzik M. Overcoming workplace barriers: A focus group study exploring African American mothers' needs for workplace breastfeeding support. J Hum Lact. 2015; 31:425–433.

55. Friedman MM, Savarsdottier EK, McCubbin M. Family stress and coping process: Family adaptation. In : Friedman MM, editor. Family nursing: research, theory, and practice. 4th ed. New York: Appleton & Lange;1998.

56. Heymann J, Raub A, Earle A. Breastfeeding policy: a globally comparative analysis. Bull World Health Organ. 2013; 91:398–406.

57. Tsai SY. Employee perception of breastfeeding-friendly support and benefits of breastfeeding as a predictor of intention to use breast-pumping breaks after returning to work among employed mothers. Breastfeed Med. 2014; 9:16–23.

58. Department of Health. Breastfeeding Policy of the Department of Health [Internet]. Hong Kong: Department of Health;2017. cited 2016 Jan 10. Available from: http://www.fhs.gov.hk/english/breastfeeding/files/bfpolicy.pdf.

59. Cattaneo A, Yngve A, Koletzko B, Guzman LR. Promotion of Breastfeeding in Europe project. Protection, promotion and support of breast-feeding in Europe: current situation. Public Health Nutr. 2005; 8:39–46.

60. Geneva Infant Feeding Association (IBFAN-GIFA). Report on the situation of infant and young child feeding in Sweden. Session 68. Geneva: The Committee on the Rights of the Child;2015.

61. Ræstad EW. Promotion, protection and support of breastfeeding in Norway [thesis]. Praha: Third Faculty of Medicine, Charles University;2009/2010.

62. Laanterä S, Pölkki T, Ekström A, Pietilä AM. Breastfeeding attitudes of Finnish parents during pregnancy. BMC Pregnancy Childbirth. 2010; 10:79.