Early Initiation of Breastfeeding Related to Exclusive Breastfeeding and Breastfeeding Duration in Rural and Urban Areas in Subang, West Java, Indonesia

Background: Reports suggest that early initiation of breastfeeding can reduce infant mortality rates by around 22%.  Infants who are given early initiation of breastfeeding will obtain colostrum that contains immunoglobul in to improve infants’ immunity. Early initiation of breastfeeding within twenty four hours of birth can determine exclusive breastfeeding (EBF) and breastfeeding duration. However, in Indonesia, the rate of breastfeeding initiation was only 34.5%, and exclusive breastfeeding was about 54.3% in 2014.  West Java is one of the provinces with the lowest exclusive breastfeeding rate, as low as 35%.  The objective of this study was to analyze the relationship between early initiation of breastfeeding with exclusive breastfeeding and with breastfeeding duration in rural and urban areas in Subang, West Java-Indonesia. Methods: A cross-sectional study was conducted from January to June2013 to analyze the relationship between early initiation of breastfeeding with EBF and breastfeeding duration. A total of 243 mothers who had babies aged between 12-24 months were interviewed using the questionnaire.  The inclusion criteria are mothers  aged ≤40 years who have spontaneous birth, singleton birth, baby’s birth weight ≥2500 grams, not disabled, and been willing to participate in this study. 107 mothers who live in Pagaden sub-district (a rural area), and 136 mothers in Subang sub-district (an urban area) have completed the social and demographic data questionnaire. The participants were recruited using cluster random sampling technique. Results: The overall early initiation of breastfeeding was seen in 33.7% of mothers (from the total of 243 mothers), and the rate of exclusive breastfeeding was about 38.6%.  A total of 42.0% of the babies have beenbreastfed for more than 12 months. The mothers in the urban area are more likely to initiate early breastfeeding (about 39.7% in ≥1-2 hours and 52.9% <1 hour) and perform exclusive breastfeeeding (45.6%) than mothers in the rural area. The multiple logistic regression analysis showed that early initiation of breastfeeding has statictically significant positive relationship with exclusive breastfeeding and breastfeeding duration. The most significant relationship is on exclusive breastfeeding (OR: 2.14,95% CI1.19 to 4.18) Conclusions: Early initiation of breastfeeding is related to exclusive breastfeeding and breastfeeding duration, with the most significant relationship on exclusive breastfeeding. Educational strategies need to improveand to increase the knowledge of breastfeeding mothers who livein urban and rural areas, which in turn can gradually increase the rate of  early initiation of breastfeeding and exclusive breastfeeding in Subang District, West Java-Indonesia.