Despite the increasing rate of exclusive breastfeeding in Indonesia, there is still a need for supportive interventions. The breastfeeding self-efficacy of mothers is a key factor positively associated with optimum breastfeeding practices. Our analysis aims to assess the determinants of low breastfeeding self-efficacy amongst a sample of women with children aged under 6 months in Malang and Sidoarjo Districts, East Java, Indonesia. We used information from 1210 mothers of children aged < 6 months recruited in the BADUTA study conducted in 2015–2016 in Malang and Sidoarjo Districts. The outcome variable in this analysis was mothers’ self-efficacy for breastfeeding using the 14 statements in the Breastfeeding Self-Efficacy-Short Form. We evaluated 17 potential predictors of breastfeeding self-efficacy, organized into six sub-groups of variables: (1) context/demographic; (2) household factors; (3) maternal characteristics; (4) child characteristics; (5) breastfeeding practices; and (6) antenatal and delivery care. Logistic regression analyses were employed to examine factors associated with mothers’ self-efficacy with breastfeeding. More than half of the women in this study had a low level of self-efficacy. One of the factors associated with low breastfeeding self-efficacy found in this study was mothers’ problems related to breastfeeding. Mothers who had problems with breastfeeding not related to illness (adjusted odds ratio [aOR] 3.27; 95% CI 2.45, 4.36) or problems related to both illness and non-illness conditions (aOR 3.57; 95% CI 1.37, 9.33) had higher odds of low breastfeeding self-efficacy than those who did not have any problems. Compared to mothers who completed university education, there was a significantly higher odds of low breastfeeding self-efficacy in mothers who completed primary school or lower (aOR 1.88; 95% CI 1.16, 3.05); completed junior high school (aOR 2.27; 95% CI 1.42, 3.63); and completed senior high school (aOR 1.94; 95% CI 1.29, 2.91). Other significant predictors of low breastfeeding self-efficacy were mothers not exposed to any breastfeeding interventions (aOR 1.87; 95% CI 1.09, 3.22); working outside the house (aOR 1.69; 95% CI 1.23, 2.32); not obtaining any advice on breastfeeding (aOR 1.40; 95% CI 1.08, 1.82); with low knowledge of breastfeeding (aOR 1.38; 95% CI 1.03, 1.84); and delivered by Caesarean section (aOR 1.34; 95% CI 1.05, 1.70). Multipronged breastfeeding education programs and support are required to improve women’s self-efficacy with breastfeeding. Improved access to breastfeeding counselors, active support for mothers following cesarean delivery, and increased supporting facilities at workplaces are essential to improve self-efficacy with breastfeeding.

中文翻译：

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6 个月以下儿童母亲母乳喂养自我效能低的决定因素：印度尼西亚东爪哇 BADUTA 研究的结果

尽管印度尼西亚的纯母乳喂养率不断提高，但仍需要支持性干预措施。母亲的母乳喂养自我效能是与最佳母乳喂养实践正相关的关键因素。我们的分析旨在评估印度尼西亚东爪哇玛琅和 Sidoarjo 地区有 6 个月以下孩子的妇女样本中母乳喂养自我效能低的决定因素。我们使用了 2015-2016 年在玛琅和 Sidoarjo 区进行的 BADUTA 研究中招募的 1210 名 6 个月以下儿童母亲的信息。该分析中的结果变量是使用母乳喂养自我效能简表中的 14 项陈述的母亲母乳喂养自我效能感。我们评估了 17 个母乳喂养自我效能的潜在预测因素，分为六个子组变量：(1) 背景/人口统计；(2) 家庭因素；(3) 母性特征；(4) 儿童特征；(5) 母乳喂养做法；(6) 产前和分娩护理。使用逻辑回归分析来检查与母亲母乳喂养自我效能相关的因素。在这项研究中，超过一半的女性自我效能感较低。本研究中发现的与母乳喂养自我效能低相关的因素之一是母亲与母乳喂养相关的问题。有与疾病无关的母乳喂养问题（调整后的比值比 [aOR] 3.27；95% CI 2.45, 4.36）或与疾病和非疾病状况相关的问题（aOR 3.57；95% CI 1.37, 9.33）的母亲有更高的母乳喂养自我效能感比没有任何问题的人低的几率。与完成大学教育的母亲相比，完成小学或更低学历的母亲母乳喂养自我效能感低的几率明显更高（aOR 1.88；95% CI 1.16, 3.05）；完成初中（aOR 2.27；95% CI 1.42, 3.63）；并完成了高中（aOR 1.94；95% CI 1.29, 2.91）。母乳喂养自我效能低的其他重要预测因素是母亲未接受任何母乳喂养干预（aOR 1.87；95% CI 1.09, 3.22）；在屋外工作（aOR 1.69；95% CI 1.23, 2.32）；未获得任何有关母乳喂养的建议（aOR 1.40；95% CI 1.08, 1.82）；对母乳喂养知之甚少（aOR 1.38；95% CI 1.03, 1.84）；并通过剖腹产分娩（aOR 1.34；95% CI 1.05, 1.70）。需要多管齐下的母乳喂养教育计划和支持，以提高女性母乳喂养的自我效能。改善获得母乳喂养顾问的机会、对剖宫产后母亲的积极支持以及增加工作场所的支持设施对于提高母乳喂养的自我效能至关重要。