THE RELATIONSHIP BETWEEN BEHAVIOUR OF MOTHERS WHO

HAVE CHILDREN AGED 2-5 YEARS ON EXCLUSIVE BREASTFEEDING

AND THE PREVALENCE OF STUNTING IN DESA MEKARBAKTI,
SUMEDANG, WEST JAVA IN 2019
Vidi Posdo Simarmata, Adilla R, Clara Meidina D, Otniel Kalalinggi D, Nadya Regina P, Lisa Novita P.
Faculty of Medicine, Christian University of Indonesia, Jakarta, Indonesia
Department of Public Health, Christian University of Indonesia, Jakarta, Indonesia

Abstract

Breast milk is considered the best food for babies that contains white blood cells,
proteins and immune substances that are suitable for babies. According to the World
Health Organization, exclusive breastfeeding is the maternal activity to provide
breast milk as the single food source for babies until they reach 6 months of age, and
the mothers are recommended not to provide other sources of food and drink except
drugs and vitamins to the babies. However, when the infants reach six months of age,
in addition to the provision other sources of healthy foods, the mothers should
breastfeed their children until up to the age of 2 years. Stunting is a condition in
which the length or height of infants is less than the length or the height of normal
infants in their age, and currently, Indonesia has this serious problems. Result of
Basic Health Research of 2013 (Riskedas/ Riset Kesehatan Dasar 2013) shows that
the prevalence of stunting in Indonesia reached 37.2%. The mean prevalence of
stunting among infants in Indonesia in 2005-2017 was 36.4%. In connection with
this description, the researchers are interested to conduct a research on the
relationship between the behavior of mothers who have children aged 2-5 years on
exclusive breastfeeding and the prevalence of stunting in Desa Mekarbakti,
Sumedang Regency, West Java. Data obtained using questionnaires distributed to
mothers who have children aged 2 - 5 years in Mekarbakti Village, Sumedang, West
Java. The results of this study were that most respondents had poor knowledge about
exclusive breastfeeding (85.7%), good practices / practices in exclusive breastfeeding
(74.0%), negative attitudes in exclusive breastfeeding of 50 people (64, 9%), and did
not experience stunting (88.3%).
Introduction

Breast milk is considered the breastfeeding is recommended in the

best food for babies that contains first few months of life because breast
white blood cells, proteins and milk is considered uncontaminated
immune substances that are suitable and contains a lot of nutrients needed
for babies. Breast milk helps the by children of that age.2
optimal growth and development of Stunting is a condition in
children as well as protecting the which the length or height of infants is
children from disease (Profil less than the length or the height of
Kesehatan RI, 2013)1. According to normal infants in their age, and
the World Health Organization, currently, Indonesia has this serious
exclusive breastfeeding is the maternal problems. Result of Basic Health
activity to provide breast milk as the Research of 2013 (Riskedas/ Riset
single food source for babies until they Kesehatan Dasar 2013) shows that the
reach 6 months of age, and the prevalence of stunting in Indonesia
mothers are recommended not to reached 37.2%.3 In 2017, around 150.8
provide other sources of food and million children (22.2%) in the world
drink except drugs and vitamins to the suffered from stunting and more than
babies. However, when the infants half of the infants with stunting are
reach six months of age, in addition to from Asia ( 55%) while more than one
the provision other sources of healthy third of infants with stunting (39%)
foods, the mothers should breastfeed live in Africa. According to the data
their children until up to the age of 2 on the prevalence of stunting among
years (WHO, 2017).2 infants collected by the World Health
In order to reduce pediatric Organization (WHO), Indonesia is one
morbidity and mortality, the United of the third world countries with the
Nations Children Fund (UNICEF) and highest prevalence of stunting in the
the World Health Organization Southeast Asia/ South-East Asia
(WHO) recommend that infants Regional (SEAR). The mean
should be exclusively breastfed for at prevalence of stunting among infants
least six months. Exclusive in Indonesia in 2005-2017 was
36.4%.4 Stunting is a condition that availability of costs to access the
can be prevented, and exclusive services of immunization, and
breastfeeding as well as strengthening factors include the
complementary feeding are among the family support.
best ways to prevent the stunting.5 In connection with this
In the developing countries, description, the researchers are
individual behavior is the most interested to conduct a research on the
influential factor that contributes to the relationship between the behavior of
health problems. Maternal behavior is mothers who have children aged 2-5
highly important because the use of years on exclusive breastfeeding and
health facilities by the children is the prevalence of stunting in Desa
closely related to the maternal Mekarbakti, Sumedang Regency, West
behavior on health and immunization. Java. This research is aimed to
In this particular case, the role of determine the Table 4.1 above shows
parents, especially mothers is very that among 77 respondents, the
important because mother is the majority of them (66 respondents/
closest the person to the children. 85.7%) did not have good and
According to Green and adequate knowledge about exclusive
Kreuter, health-related human breastfeeding, and only 11 of 77
behavior is driven by three factors. respondents (14.3%) were considered
These factors are: predisposing having good and adequate knowledge
factors, enabling factors, and about exclusive breastfeeding.level of
reinforcing factors. Each factor has a knowledge among women about
different influence on behavior. exclusive breastfeeding, and this
Predisposing factors include research can be a source of
knowledge, attitudes and demographic information for infant-rearing women
variables (age, education level, about the importance of breastfeeding
occupation, family income level). as one of stunting prevention
Enabling factors are manifested in the strategies.
Methods
This study is correlational
analytic survey type of research with
cross-sectional study design, and this
research is aimed to determine the
relationship between the knowledge of
mothers who have children aged 2-5
years on exclusive breastfeeding and
the incidence of stunting in Desa
Mekarbakti in 2019. The research was
Results
This research was conducted in
Desa Mekarbakti, Kecamatan
Pamulihan, Sumedang, West Java in
April 2019, and the researchers
involved mothers or infant-rearing
conducted from April 4th, 2019 until
April 8th, 2019 in Desa Mekarbakti,
Sumedang, West Java. The population
or research are all rearing-women who
have children aged 2 - 5 years in Desa
Mekarbakti, Sumedang, West Java.
The researchers involved 77 infant-
rearing women that meet the sampling
criteria as the sample of this research.
women who had children aged 2 - 5
years.
Based on the research that has
been conducted, the researchers gave
questionnaires to 77 respondents who
met the inclusion criteria and agreed to
participate in the study.

Univariate Analysis

Stunting

Cumulative
Frequency Percent Valid Percent Percent

Valid Experienced stunted growth 9 11.7 11.7 11.7

Did not experience stunted

68 88.3 88.3 100.0
growth

Total 77 100.0 100.0

Table 1. Frequency distribution of respondents based on the incidence

Tof stunting

able 1 above shows that 68 of 77

infants of respondents (88.3%) did not infants of respondents (11.7%)

experience stunted growth, and 9 of 77 experienceed stunt growth.

Knowledge

Cumulative
Frequency Percent Valid Percent Percent

Valid Had good

and
11 14.3 14.3 14.3
adequate
knowledge

Did not have

good and
66 85.7 85.7 100.0
adequate
knowledge

Total 77 100.0 100.0

Tabel 2. Frequency distribution of respondents based on mother's knowledge

Table 2 above shows that only 11 of 77 respondents (14.3%)

among 77 respondents, the majority of were considered having good and

them (66 respondents/ 85.7%) did not adequate knowledge about exclusive

have good and adequate knowledge breastfeeding.

about exclusive breastfeeding, and

Practices
 Cumulative
Frequency Percent Valid Percent Percent

Valid Good
57 74.0 74.0 74.0
Practices

Bad
20 26.0 26.0 100.0
Practices

Total 77 100.0 100.0

Table 3. Frequency distribution of respondents based on mother's actions

Table 3 above shows that breastfeeding, while 20 of 77

among 77 respondents, the majority of respondents (26.0%) were considered

them (57 of 77 respondents/ 74.0%) conducting bad practices of exclusive

conducted good practices of exclusive breastfeeding.

Attitude

Cumulative
Frequency Percent Valid Percent Percent

Valid Positive 27 35.1 35.1 35.1

Negative 50 64.9 64.9 100.0

Total 77 100.0 100.0

Table 4. Frequency distribution of respondents based on mother's attitude

Table 4 above shows that breastfeeding, while the number of

among 77 respondents, the majority of subjects who had positive attitude in

them (50 of 77 respondents/ 64.9%) exclusive breastfeeding were 27

had negative attitude in exclusive

respondents (35, 1%).

Bivariate Analysis

Crosstab

Stunting

Did not
Experienced experience
stunted growth stunted growth Total

Knowledge Had good Count 3 8 11

and
adequate % of Total
3.9% 10.4% 14.3%
knowledge

Did not have Count 6 60 66

good and
adequate % of Total
7.8% 77.9% 85.7%
knowledge

Total Count 9 68 77

% of Total 11.7% 88.3% 100.0%

Table 5. Relationship of knowledge with the incidence of stunting

Table 5 above shows that stunted growth and 60 infants who did

among 11 respondents who had good not experience stunted growth.

and adequate knowledge about Therefore, the highest incidence of

exclusive breastfeeding, there were 3 stunting among infants with

infants who experienced stunted inadequately informed mothers was 6

growth and 8 normal infants. Whereas cases, while the number of normal

among 66 respondents who did not infants among inadequately-informed

have good and adequate knowledge mother was 60 infants.

about exclusive breastfeeding, there

were 6 infants who experienced

 Crosstab

Stunting

Did Not
Experienced Experience
Stunted Growth Stunted Growth Total

Practices Good Count 4 53 57

Practices
% of Total 5.2% 68.8% 74.0%

Bad Count 5 15 20
Practices
% of Total 6.5% 19.5% 26.0%

Total Count 9 68 77

% of Total 11.7% 88.3% 100.0%

Table 6. Relationship between mother's actions and the incidence of stunting

Table 6 above shows that who experienced stunted growth and

among 57 respondents that conducted 15 infants with normal gorwth.

good practices of exclusive Therefore, the highest incidence of

breastfeeding, there were 4 infants stunting among infants whose mothers

who experienced stunted growth and did not conducted good practices of

53 infants with normal growth. exclusive breastfeeding was 6 cases,

Whereas among 20 respondents who while there were 60 normal infants

conducted bad practices of exclusive among those who conducted good

breastfeeding, there were 5 infants practices in exclusive breastfeeding.

 Crosstab

Stunting

Did Not
Experienced Experience
Stunted Growth Stunted Growth Total

Attitude Positive Count 3 24 27

% of Total 3.9% 31.2% 35.1%

Negative Count 6 44 50

% of Total 7.8% 57.1% 64.9%

Total Count 9 68 77

% of Total 11.7% 88.3% 100.0%

Table 7. Relationship between mother's attitude and the incidence of

stunting
growth and 44 infants with normal

Table above shows that among

53/5000 growth. Therefore, the highest number
Table
27 respondents with7. Relationship
positive attitudes between mother's
of stunting (6 infants) occurred among
attitude
in exclusive andthere
breastfeeding, thewereincidence of stunting
the infants who had mother with

3 infants53/5000
who experienced stunted negative attitudes in breastfeeding,
Table
growth and 7. Relationship
24 infants with normal between mother's
growth. attitude
Whereas and the incidence
among 50 of highest
while the stunting
number of subjects

respondents with negative attitudes in with normal growth among mother

Table 7. Relationship betweenwith negative
mother's
attitudes was 44 infants.
exclusive breastfeeding, there were 6
attitude and the incidence of stunting
infants who experienced stunted
showed that the maternal knowledge is
Discussions significantly correlated with the
The Relationship Between Maternal incidence of stunting among infants
Knowledge on Exclusive aged under five years. This findings
Breastfeeding and Stunting indicate that the knowledge about
Incidence nutrition and exclusive breastfeeding
The results of this research are is the initial process in the changes of
in accordance with the research behavior to improve nutritional status,
conducted by Aridiyah, Rohmawati, and therefore, the knowledge is an
and Ririanty, (2015: 164), which internal factor that influences
behavioral changes. Maternal by the variables of exclusive
knowledge on nutrition and exclusive breastfeeding. It can be comprehended
breastfeeding will determine the that the inadequate level of exclusive
maternal behavior in the provision of breastfeeding can be one of the
foods for their children. Mothers with triggers of stunting in infants aged
good nutritional knowledge are tend to under five, which will negatively
be able to provide foods with the right affect the future of the children.
type and amount to support the growth Otherwise, proper exclusive
and development of their infants aged breastfeeding will help to maintain the
under five years. In addition, proper nutritional balance in children and
practices of exclusive breastfeeding helping them to reach normal
for infants aged 0-6 months can development.
strengthen their immunity to protect Additionally, the result of the
them from infectious diseases. research conducted by Ahmad et al.
(Rohmatun: 2014) showed that
The Relationship Between the stunting tend to affect non-exclusively
Quality of Practices in Exclusive breastfed infants compared to those
Breastfeeding and the Incidence of who are exclusively-breastfed.
Stunting Children who are inadequately-
The result of this research is in breastfed as well as those who are
accordance with result of research introduced to foods or infants formula
conducted by Indrawati (2016), which too early are more prone to infectious
showed that there was a relationship diseases such as diarrhea and
between exclusive breastfeeding and respiratory diseases. Breast milk
the incidence of stunting among contains anti-infection agents, and the
infants aged 2-3 years, with the ρ- lack of breast milk will make infants
value of (0,000 <0,05). In addition, more prone to experience stunted
the research conducted by Aridiyah, growth.
Rohmawati and Ririanty (2015: 164) Breast milk contains anti-
showed that the incidence of stunting infection agents, and it makes the
in infants aged under five both in practices of exclusive breastfeeding
rural and urban areas was influenced has significant impact on the status of
stunting. Based on the results of usually disturbed. However, the
interviews, the researchers found that antibody substances contained in
there were infants-rearing women who formula milk/ infants formula do not
did not exclusively breastfeed their have the same level of quality of the
children, and some of them feed their antibody substances contained in
children with infants formula breast milk, and therefore, non-
combined with breast milk. Combined exclusively breastfed infants can be
breast milk and infants formula can more susceptible to disease (Rahayu,
provide the nutritional needs of the 2011; Anugraheni, 2012).
infants, and their growth will not be

The Relationship Between Maternal defined as the adequate provision of

Attitude in Exclusive Breastfeeding
and Incidence of Stunting
The proper and adequate
healthy nutritional intake for infants
(0-24 months) is Exclusive Breast
Milk. Exclusive breastfeeding can be
only breast milk from immediately
after birth until the age of 6 months.
Exclusive breastfeeding for the first 6
months can make the infants reach
their optimal height growth (Gibney et
al, 2009).
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