Providing education from adolescence to promote exclusive breastfeeding: a retrospective study

Providing education from adolescence to promote exclusive breastfeeding: a retrospective study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Providing education from adolescence to promote exclusive breastfeeding: a retrospective study Luh Mertasari, Luh Seri Ani, Luh Nyoman Sumiati, Ni Kadek Ayu dwi Utami Ds This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3481359/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Although providing education regarding exclusive breastfeeding can increase the exclusive breastfeeding coverage in infants aged 0-6 months, studies investigating this association are limited. This study aimed to prove that providing education from adolescence could increase exclusive breastfeeding in infants aged 0-6 months. This retrospective study included mothers of toddlers aged 6-24 months. In total, 144 mothers from five regions were selected in two stages. First, primary healthcare centers were selected using purposive sampling, and then mothers of toddlers were selected using a simple random sampling method. Data was collected via interviews. Exclusive breastfeeding data were based on the history of breastfeeding of the mothers when the babies were 0-6 months old. A logistic progression test was performed to determine the role of providing education from adolescence and other variables in increasing the coverage of exclusive breastfeeding. The proportion of exclusive breastfeeding was 47.2%. Mothers who received education as adolescents and who underwent cesarean section showed a low tendency for exclusive breastfeeding (p=0.004 and p=0.036, respectively). Meanwhile, mothers receiving breastfeeding education during pregnancy were 5.2 times more likely to exclusively breastfeed than those not receiving it (p=0.001). Mothers who received family support were 6.6 times more likely to exclusively breastfeed than those who did not receive it (p=0.002). The provision of education from adolescence has not been proven to increase the coverage of exclusive breastfeeding in 0-6-month-old infants. However, this study suggests providing education from adolescence and support from the family and social environment to perform exclusive breastfeeding successfully. Adolescent Pregnancy Female Breastfeeding Health Education 1 Introduction Exclusive breastfeeding refers to a source of food obtained only from breast milk, without the consumption of any other food or liquids.(1) The World Health Organization (WHO) recommends exclusively breastfeeding babies from 1 h after birth to the first 6 months of life.(2) Breastfeeding has many health benefits for both mothers and infants.(3,4) Optimal breastfeeding can save the lives of more than 820,000 children every year under the age of 5.(1,5) Breastfeeding was found to reduce the risk of allergic rhinitis and gastrointestinal infections.(6–8) Additionally, mothers who breastfed exclusively reported rapid post-partum weight loss, delayed return of the menstrual cycle, and increased hormone production.(7) Breastfeeding education involves providing information about exclusive breastfeeding to mothers and their families to promote and encourage mothers to breastfeed their babies.(9) Educating mothers regarding exclusive breastfeeding can help them make decisions when facing the challenges of the commercial milk formula products market.(10) It is known that the quality of commercial formula products cannot be compared with that of breast milk. Breast milk has several unique properties and long-term health benefits. Maternal educational factors contribute to reduced breastfeeding.(11–14) A study found that factors associated with exclusive breastfeeding included maternal occupation, family income, and support for exclusive breastfeeding from family and friends.(15) Exclusive breastfeeding is more common in housewives than working mothers.(16) This finding was confirmed by a study conducted on health workers in Ghana's Upper Eastern region, which found that health workers have poor breastfeeding behavior due to the mother's inability to exclusively breastfeed.(10,17) Although exclusive breastfeeding education efforts have long been conducted, the scope of exclusive breastfeeding has not yet reached its target. The WHO reports that approximately 44% of babies aged 0-6 months were exclusively breastfed between 2015 and 2020 worldwide. This proportion is below the WHO target of increasing exclusive breastfeeding during the first 6 months to at least 50% by 2025.(1) The rate of exclusive breastfeeding varies in different countries. The average prevalence of exclusive breastfeeding in low- and middle-income countries from 2010 to 2018 was 45.7%. (18) The prevalence of exclusive breastfeeding was 20.47% in Burao district, Somaliland,(19) 38.1% in rural Sichuan, China,(20) 53% in Iran, (21) and 60.42% in Ethiopia.(22) In contrast, an increase in the rate of exclusive breastfeeding by 1.29 points each year has been reported in high-income countries.(23) The proportion of exclusive breastfeeding for infants aged 0-6 months in Indonesia has reached the target of 52.3%.(24) However, the coverage rate of exclusive breastfeeding in several regions of Indonesia still varies. Buleleng Regency is one of the regions in Indonesia showing variations in the rate of exclusive breastfeeding. The coverage of toddlers receiving exclusive breastfeeding in the Buleleng district fluctuated from 69% to 78.9% from 2016 to 2020, respectively.(25) This coverage rate of exclusive breastfeeding was relatively lower than that reported overall for Bali and Indonesia (64.9-89.2% and 11.9-86.7%, respectively). Providing education during pregnancy and childbirth did not help to achieve the target set for exclusive breastfeeding.(26,27) This could be because the knowledge imparted did not forge a strong attitude in the mothers to provide exclusive breastfeeding.(28) Lack of knowledge can hinder the readiness of mothers to breastfeed their babies. Usually, mothers are not ready to breastfeed because of a lack of milk production and less prominent nipple anatomy. Breastfeeding barriers increase under the influence of culture factors. Some countries have implemented a culture that renders mothers powerless to make decisions about caring for their babies, including those regarding breastfeeding.(29) Notably, education can be an effective measure to empower women to exclusively breastfeed their babies.(29) Breastfeeding education during adolescence makes it possible to overcome the obstacles in exclusive breastfeeding. Usually, the decision to breastfeed exclusively is already made before conception, namely during adolescence.(30) Providing breastfeeding education to adolescents in schools reportedly improves the knowledge, attitude, and intentions regarding breastfeeding. The early provision of exclusive breastfeeding knowledge provides an opportunity for adolescents to understand the various obstacles. Moreover, physical and social problems are not only identified early but also managed in time before breastfeeding.(30,31) Providing education during adolescence may provide support to breastfeeding mothers. The WHO reported that every year, 21 million adolescents aged 15-19 years become pregnant in low-income countries, and approximately 12 million have had babies.(32) Adolescent pregnancy causes adolescents to become mothers without the knowledge and readiness required for exclusively breastfeeding their babies. Moreover, providing education during preconception, including the adolescent period, significantly reduces morbidity and mortality in both mothers and babies.(33) Therefore, this study aimed to analyze the effectiveness of providing education from adolescence to increase the coverage of exclusive breastfeeding in infants aged 0-6 months. 2 Methods Design and sampling method This retrospective study measured exclusive breastfeeding based on the history of breastfeeding in babies aged 0-6 months. The participants were mothers of babies aged 6-24 months. Maternal participants were selected based on the limits of exclusive breastfeeding and breastfeeding. Exclusive breastfeeding is defined as giving only breast milk without additional food/liquid to infants from birth to 6 months of age and continuing breastfeeding with the introduction of appropriate complementary foods until the infant is 24 months old. This study included mothers living in the areas of the selected primary healthcare centers (PHCs) and willing to be interviewed. In total, 144 mothers from five regions participated in the study. The sample selection was performed in two stages. In the first stage, the PHCs were chosen using a purposive method based on the highest and lowest coverage of exclusive breastfeeding. Sukasada I, Sukasada II, and Buleleng I were the PHCs selected. The second stage involved selecting mothers with babies aged 6-24 months using a simple sampling method. Each selected PHC had a sample quota of 48 mothers. Furthermore, the objectives, benefits, and procedures of the study were explained to the mothers who fulfilled the inclusion criteria. Mothers who are willing to participate are asked to provide written informed consent. Informed consent has been obtained from all mothers of infants involved in this study. Data collection Data collection was conducted in May and June 2023 in Buleleng Regency, Bali, Indonesia. Data was collected at each respondent’s home via interviews. The interview was conducted for approximately 30 min for each participant. The questionnaire used was developed by the researchers themselves and was subjected to validity and reliability tests. The validity test using the product moment test revealed a calculated r-value of 0.413 and a table r-value of 0.195. The reliability test revealed a Cronbach alpha value >0.6 (0.614). The data collected included information regarding the characteristics of the mothers and babies, exclusive breastfeeding, history of receiving information about exclusive breastfeeding, sources of information regarding exclusive breastfeeding, knowledge of exclusive breastfeeding, attitude toward exclusive breastfeeding, and support from health workers, husbands, family, and friends. Data on exclusive breastfeeding were collected via interviews. The babies were considered exclusively breastfed if they were only given breast milk without additional food/liquid at 0-6 months of age. Data analysis The research data were subjected to univariate, bivariate, and multivariate analyses. Univariate analysis was performed to determine the proportion of each research variable. Variate tests were conducted to analyze the differences in the proportion of exclusive breastfeeding based on independent variables. Bivariate analysis was performed using the chi-square test, with a significance level of 95%. Multivariate logistic regression analysis was conducted to determine the variables influencing exclusive breastfeeding. The multivariate model only included variables with p-values <0.25 based on the chi-square test. 3 Results Table 1 describes the characteristics of the mothers and infants in this study. Most mothers were aged 20-30 years (89.6%), had a low education level (42.4%), were unemployed (51.4%), had two or more surviving children (77.8%), underwent normal delivery (70.1%), and had babies with birth weight ≥2500 g (97.2%). Moreover, most of them had good knowledge (56.3%) and a positive attitude (54.2%) regarding exclusive breastfeeding and had support from their husbands (53.5%). Table 1. Characteristics of the mothers in the study Characteristics N=144 % Mother's age (years) 35 14 9.7 Education level Low 61 42.4 Middle 41 28.5 High 42 29.2 Employed No 74 51.4 Yes 70 48.6 Number of surviving children 2 112 77.8 2 32 22.2 Delivery method Normal 101 70.1 Cesarean 43 29.9 Baby birth weight <2500 g 4 2.8 2500 g 140 97.2 Mother’s knowledge regarding the benefits of exclusive breastfeeding Good 81 56.3 Enough 40 27.8 Less 23 16.0 Mother’s attitude regarding exclusive breastfeeding Positive 78 54.2 Neutral 42 29.2 Negative 24 16.7 Support in providing exclusive breastfeeding Health workers 61 42.4 Husband 77 53.5 Family 61 42.4 Friends 61 42.4 Table 2 shows that 47.2% of mothers in this study performed exclusive breastfeeding. Almost 100% of mothers received education on breastfeeding, while only a small percentage received education as adolescents (13.2%). The most common source of information was from health workers (93.1%). Table 2. Education, sources of information, knowledge, attitude, and sources of support for exclusive breastfeeding Variables n % Exclusive breastfeeding Yes 68 47.2 No 76 52.8 Received breastfeeding education Yes 144 100% Not 0 0% Received education about exclusive breastfeeding Since adolescence (n=144) 19 13.2 During pregnancy (n=144) 101 70.1 Sources of information about exclusive breastfeeding Health workers (n=144) 134 93.1 Printed media (n=144) 60 41.7 Internet (n=144) 49 34 Table 3 shows that exclusive breastfeeding is found in only one mother aged <20 years. Among exclusively breastfed mothers, 32.3% had a high level of education, 53.0% were unemployed, 17.7% had two or more surviving children, 83.8% had vaginal births, and 100% had babies with a birth weight of ≥2500 g. Notably, most exclusive breastfeeding mothers did not receive exclusive breastfeeding information from adolescents (94.1%). However, 92.6% of exclusively breastfeeding mothers received information from health workers, 69.1% had good knowledge, and 67.6% had a positive attitude towards exclusive breastfeeding. In addition, 54.4%, 64.7%, 60.3%, and 55.9% of them received support from health workers, husbands, family, and friends, respectively. This finding shows that exclusive breastfeeding is influenced by education received since adolescence, education received during pregnancy, information received from print media, delivery methods, knowledge, and attitudes of mothers regarding breastfeeding, and support from health workers, husbands, family, and friends (p<0.05). Table 3. History and resources of breastfeeding education and characteristics of mothers Variables Exclusive breastfeeding No (n=76) Yes (n=68) p-value n % n % Have been educated when adolescence Yes 15 19.7 4 5.9 0.014 No 61 80.3 64 94.1 Have been educated during pregnancy Yes 44 57.9 57 88.8 0.001 No 32 42.1 11 11.2 Resources from health workers Yes 71 93.4 63 92.6 0.855 No 5 6.6 5 7.4 Resources from print media Yes 38 50.0 22 32.3 0.032 No 38 50.0 46 67.7 Resources from the internet Yes 28 36.8 21 30.9 0.451 No 48 63.2 47 69.1 Age of the mother (years) 35 10 13.2 4 6.1 Education level High 20 26.3 22 32.3 0.714 Middle 23 30.3 18 26.5 Low 33 43.4 28 41.2 Occupation Employed 38 50.0 32 47.0 0.724 Unemployed 38 50.0 36 53.0 Number of surviving children 2 56 73.7 56 82.3 0.212 2 20 26,3 12 17,7 Delivery method Normal 44 57.9 57 83.8 0.001 Cesarean 32 42.1 11 16.2 Baby birth weight <2500 g 4 5.3 0 0.0 0.055 2500 g 72 94.7 68 100 Knowledge Good 34 44.7 47 69,1 0.013 Enough 27 35.5 13 19.1 Less 15 19.8 8 11.8 Attitude Positive 2 2.6 46 67.6 0.001 Neutral 24 31.6 18 26.3 Negative 20 65.8 4 6.1 Health worker support Good 24 31.6 37 54.4 0.009 Enough 14 18.4 13 19.1 Less 38 50.0 18 26.5 Husband support Good 33 43.4 44 64.7 0.029 Enough 29 38.1 14 20.6 Less 14 18.5 10 14.7 Family support Good 0 0 41 60.3 0.000 Enough 36 47.4 21 30.9 Less 20 52.6 6 8.8 Friend support Good 29 38.2 38 55.9 0.032 Enough 18 23.7 17 25.0 Less 29 38.1 13 19.1 Table 4 shows that mothers who received education as adolescents and who underwent cesarean section showed a low tendency for exclusive breastfeeding (adjusted odds ratio [AOR]=0.136; 95% confidence interval [CI]=0.035-0.526; p=0.004 and AOR=0.372; 95%CI=0.146-0.950; p=0.036, respectively). Mothers who received education during pregnancy were 5.2 times more likely to exclusively breastfeed their babies than those who did not receive education during pregnancy (AOR=5.201; 95%CI=2.054-13.168; p=0.001). Mothers who received good family support were 6.6 times more likely to exclusively breastfeed their babies than those who did not receive family support (AOR=6.626; 95%CI= 2.030-21.628; p=0.002). Table 4. Results of logistic regression test for exclusive breastfeeding Variables Exclusive breastfeeding AOR 95%CI p-value Received education since adolescence No Yes (Ref) 0.136 0.035-0.526 0.004 Received education during pregnancy No Yes (Ref) 5.201 2.054-13.168 0.001 Family support Less Enough Good (Ref) 2.394 6.626 0.716-8.004 2.030-21.628 0.156 0.002 Delivery method Normal Cesarean (Ref) 0.372 0.146-0.950 0.039 (AOR= adjusted odds ratio; CI= confidence interval; Ref= reference) 4 Discussion Exclusive breastfeeding was observed in 47.2% of mothers in this study. This exclusive breastfeeding rate is relatively higher than that reported for infants under 6 months in rural China and Malawi (38.1% and 35.9%, respectively).(20,33) The Institute of Child Mother Health in Dhaka, Bangladesh, reported that the proportion of exclusive breastfeeding was 50.0%.(34) However, several other studies reported a relatively high proportion of exclusive breastfeeding, ranging from 63% to 95.7%.(12,14,35–37) This variation in the proportion of exclusive breastfeeding may be due to differences in research participants and the methods of determining the prevalence of exclusive breastfeeding. The participants in this study were breastfeeding mothers of children aged 6-24 months. A study conducted in rural Malawi included school-aged children, (33) while one in Colombia assessed exclusive breastfeeding in infants aged <6 months. (36) Meanwhile, a study conducted in China assessed exclusive breastfeeding in infants aged 4 months.(38) A study in Zanjan assessed exclusive breastfeeding in postpartum mothers visiting the obstetrics and gynecology departments of two main hospitals.(12) Considering the data sources used, the exclusive breastfeeding data in this study were obtained via interviews using the 24-h recall method. Some previous studies used demographic surveillance secondary data.(33,35) The quality of data collected using the 24-h recall method depended on the participant’s memory of the exclusive breastfeeding behavior experienced. Nevertheless, this method showed good validity. The maternal memory sensitivity in the last 12 months was 98.3%, specificity was 70.0%, and accuracy was 77.9%.(39) Thus, information regarding the proportion of exclusive breastfeeding in this study can be used as basic data for evaluating exclusive breastfeeding programs. Receiving education about exclusive breastfeeding as an adolescent was found to reduce the tendency of exclusive breastfeeding. Mothers who have been informed since adolescence tend not to breastfeed exclusively. This could be due to the long interval between education and breastfeeding, which reduces the knowledge possessed. Other factors also influence exclusive breastfeeding, such as maternal employment status, delivery method, and support for exclusive breastfeeding from family and friends.(15) Non-working mothers have more opportunities to provide exclusive breastfeeding than working mothers.(16) Mothers who are health workers tend to have poor breastfeeding behavior because of their inability to exclusively breastfeed.(10,17) Furthermore, the inability to exclusively breastfeed could be attributed to inhibiting factors, such as swollen breasts, pain in the nipples, and insufficient milk production.(34,40) Mothers delivering via cesarean section showed a reduced tendency for exclusive breastfeeding. Post-cesarean section mothers experience two times more obstacles in exclusive breastfeeding than post-vaginal delivery mothers.(13,41–43) The proportion of breastfeeding initiation in post-cesarean section mothers ranges from 4.8% to 40.1%.(44,45) Generally, newborns are kept separate from the mothers after cesarean section; hence, early initiation of breastfeeding is delayed.(43) To prevent the negative consequences of late breastfeeding, efforts to promote and strengthen the capacity of healthcare providers are needed to increase early breastfeeding initiation, especially for infants delivered via cesarean section.(46) The factors influencing the success of exclusive breastfeeding are support for mothers from health workers, family, and friends. This study found that mothers of toddlers who received good family support tended to be 6.6 times more likely to exclusively breastfeed than those who did not receive enough family support. Family support was found to be associated with exclusive breastfeeding among young mothers in Thailand.(47) The mother's family and friends supporting breastfeeding as well as the external environment supporting breastfeeding when the mother resumes work activities outside the home are associated with exclusive breastfeeding.(15) This finding shows that breastfeeding is not only the mother’s responsibility but also requires support from the social environment.(36) Therefore, efforts to increase knowledge about exclusive breastfeeding need to be pursued from adolescence.(48)(49) The intention of toddler mothers to exclusively breastfeed requires support from their family and the environment. Young mothers find it difficult to achieve breastfeeding targets. Therefore, they require support, promotional activities, and health education based on individuals and communities.(50–53) Therefore, exclusive breastfeeding education should be introduced during adolescence. This study is limited to only one district; therefore, its results may be less representative. However, the research area was chosen based on variations in the coverage of exclusive breastfeeding. 5 Conclusion Providing education during adolescence did not increase the coverage of exclusive breastfeeding. Nevertheless, this study suggests providing exclusive breastfeeding education from adolescence and increasing support from the family and social environment for mothers to ensure exclusive breastfeeding. Abbreviations WHO: World Health Organization PHCs: Primary Healthcare Center Declarations Acknowledgment The authors would like to thank the Head of the Primary Health Center Buleleng District, Bali Province, who allowed conduct research in their area of work. Author contributions LM and LSA play a role in designing research studies, writing drafts, reviewing, and editing manuscripts. LNS and NKADUD play a role in analyzing research data, writing drafts, reviewing, and editing manuscripts. All authors have read and approved the final manuscript. Funding No funding was received for this study. Data Availability The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests The authors declare no competing interests. Ethics approval This study received ethical approval from the Research Ethics Commission of the Faculty of Medicine, Udayana University (No: I 393AJN l4.2.2.Vll.l 4/I-T /2023). This research was conducted in accordance with ethical provisions and research guidelines applicable in the research area. Mothers who are willing to participate are asked to provide written informed consent. Informed consent has been obtained from all mothers of infants. Consent for publication This is not applicable. References WHO. Breastfeeding [Internet]. 2021. 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Nutrients [Internet]. 2019 Nov 10;11(11):2723. Available from: https://www.mdpi.com/2072-6643/11/11/2723 Getaneh T, Negesse A, Dessie G, Desta M, Temesgen H, Getu T, et al. Impact of cesarean section on timely initiation of breastfeeding in Ethiopia: a systematic review and meta-analysis. Int Breastfeed J [Internet]. 2021 Dec 5;16(1):51. Available from: https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13006-021-00399-9 Ayesha U, Mamun ASMA, Sayem MA, Hossain MG. Factors associated with duration of breastfeeding in Bangladesh: evidence from Bangladesh demographic and health survey 2014. BMC Public Health. 2021;21(1):1–13. Thaithae S, Yimyam S, Polprasarn P. Prevalence and Predictive Factors for Exclusive Breastfeeding at Six Months among Thai Adolescent Mothers. Children. 2023;10(4):1–12. Salarvand S, Ghazvineh S, Mousivand F, Ahmadi Gharaei H, Bitaraf S. Health literacy and its related factors as predictors for the breastfeeding self-efficacy in a western province in Iran. BMC Public Health [Internet]. 2023;23(1):1–9. Available from: https://doi.org/10.1186/s12889-023-15522-0 Ghotbizadeh F, Panahi Z, Manshadi AT, Soltani S, Akbari R, Parsapur M. Maternal Health Literacy and Pregnancy Outcomes: Does any Association Exist? J Obstet Gynecol Cancer Res. 2023;8(1):68–75. Dykes C, Ny P, Hauck YL, Kuliukas L, Gallagher L, Brady V, et al. Women’s perceptions of factors needed to encourage a culture of public breastfeeding: a cross-sectional study in Sweden, Ireland and Australia. Int Breastfeed J. 2023;18(1):1–8. Salem M, Ertz M. “Better start”: promoting breastfeeding through demarketing. BMC Public Health. 2023;23(1):1–13. Seyyedi N, Rahmatnezhad L, Mesgarzadeh M, Khalkhali H, Seyyedi N, Rahimi B. Effectiveness of a smartphone-based educational intervention to improve breastfeeding. Int Breastfeed J. 2021;16(1):1–8. Yu M, Xu M, Liu Z, Ying Y, Weng Q, Subhi NO. Nurse Education in Practice Effectiveness of an optional breastfeeding course for multidisciplinary undergraduate healthcare students : A quasi-experimental study. Nurse Educ Pract [Internet]. 2023;69(March):103609. Available from: https://doi.org/10.1016/j.nepr.2023.103609 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3481359","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":242805027,"identity":"fd0bf6a7-4af5-4c28-9062-8cec6b301f7e","order_by":0,"name":"Luh Mertasari","email":"","orcid":"","institution":"Universitas Pendidikan Ganesha","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Luh","middleName":"","lastName":"Mertasari","suffix":""},{"id":242805028,"identity":"4559adda-30c4-4f00-829e-bdee0623b631","order_by":1,"name":"Luh Seri Ani","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyklEQVRIiWNgGAWjYJCCAwwMEnIghgSIYGNIIE6LMWlaQCCxAaaFgZAW+fbehwd+7rBI33C7x/AGQ40dAx87AS0GZ44bHOw9I5G74c4ZYwuGY8kMbDwPCGiRSGM4wNsG1HIjx0yCge0AA5sEIYfNf8Zw8G+bRLoBWMs/IrQw3GBjOAy0JQGshbGNCC0GZ9IYDsu2SRjOvJFWbJHYl8xD0C/y7ceYP75tq5Pnu5G88caHb3Zy8u2EHIYCgIp5SFE/CkbBKBgFowAHAACdMT63rIv5xAAAAABJRU5ErkJggg==","orcid":"","institution":"Udayana University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Luh","middleName":"Seri","lastName":"Ani","suffix":""},{"id":242805029,"identity":"9b5397f7-b16f-4ab3-82a0-49c85cd3c36c","order_by":2,"name":"Luh Nyoman Sumiati","email":"","orcid":"","institution":"Udayana University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Luh","middleName":"Nyoman","lastName":"Sumiati","suffix":""},{"id":242805030,"identity":"9a0aa747-9438-41bb-a997-1b1855e96ebb","order_by":3,"name":"Ni Kadek Ayu dwi Utami Ds","email":"","orcid":"","institution":"Triatma Mulia University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ni","middleName":"Kadek Ayu dwi Utami","lastName":"Ds","suffix":""}],"badges":[],"createdAt":"2023-10-23 11:29:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3481359/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3481359/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":45552944,"identity":"ff325dd8-d5af-47ab-92a0-0b0a8ddf0572","added_by":"auto","created_at":"2023-10-31 13:15:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":343243,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3481359/v1/32168b7c-d37d-4bbd-a93a-d547802e92ff.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Providing education from adolescence to promote exclusive breastfeeding: a retrospective study","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eExclusive breastfeeding refers to a source of food obtained only from breast milk, without the consumption of any other food or liquids.(1) The World Health Organization (WHO) recommends exclusively breastfeeding babies from 1 h after birth to the first 6 months of life.(2) Breastfeeding has many health benefits for both mothers and infants.(3,4) Optimal breastfeeding can save the lives of more than 820,000 children every year under the age of 5.(1,5) Breastfeeding was found to reduce the risk of allergic rhinitis and gastrointestinal infections.(6\u0026ndash;8) Additionally, mothers who breastfed exclusively reported rapid post-partum weight loss, delayed return of the menstrual cycle, and increased hormone production.(7)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBreastfeeding education involves providing information about exclusive breastfeeding to mothers and their families to promote and encourage mothers to breastfeed their babies.(9) \u0026nbsp;Educating mothers regarding exclusive breastfeeding can help them make decisions when facing the challenges of the commercial milk formula products market.(10) It is known that the quality of commercial formula products cannot be compared with that of breast milk. Breast milk has several unique properties and long-term health benefits.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMaternal educational factors contribute to reduced breastfeeding.(11\u0026ndash;14) A study found that factors associated with exclusive breastfeeding included maternal occupation, family income, and support for exclusive breastfeeding from family and friends.(15) \u0026nbsp;Exclusive breastfeeding is more common in housewives than working mothers.(16) This finding was confirmed by a study conducted on health workers in Ghana\u0026apos;s Upper Eastern region, which found that health workers have poor breastfeeding behavior due to the mother\u0026apos;s inability to exclusively breastfeed.(10,17)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAlthough exclusive breastfeeding education efforts have long been conducted, the scope of exclusive breastfeeding has not yet reached its target. The WHO reports that approximately 44% of babies aged 0-6 months were exclusively breastfed between 2015 and 2020 worldwide. This proportion is below the WHO target of increasing exclusive breastfeeding during the first 6 months to at least 50% by 2025.(1) The rate of exclusive breastfeeding varies in different countries. The average prevalence of exclusive breastfeeding in low- and middle-income countries from 2010 to 2018 was 45.7%. (18) The prevalence of exclusive breastfeeding was 20.47% in Burao district, Somaliland,(19) 38.1% in rural Sichuan, China,(20) 53% in Iran, (21) and 60.42% in Ethiopia.(22) In contrast, an increase in the rate of exclusive breastfeeding by 1.29 points each year has been reported in high-income countries.(23)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe proportion of exclusive breastfeeding for infants aged 0-6 months in Indonesia has reached the target of 52.3%.(24) However, the coverage rate of exclusive breastfeeding in several regions of Indonesia still varies. Buleleng Regency is one of the regions in Indonesia showing variations in the rate of exclusive breastfeeding. The coverage of toddlers receiving exclusive breastfeeding in the Buleleng district fluctuated from 69% to 78.9% from 2016 to 2020, respectively.(25) This coverage rate of exclusive breastfeeding was relatively lower than that reported overall for Bali and Indonesia (64.9-89.2% and 11.9-86.7%, respectively).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eProviding education during pregnancy and childbirth did not help to achieve the target set for exclusive breastfeeding.(26,27) This could be because the knowledge imparted did not forge a strong attitude in the mothers to provide exclusive breastfeeding.(28) Lack of knowledge can hinder the readiness of mothers to breastfeed their babies. Usually, mothers are not ready to breastfeed because of a lack of milk production and less prominent nipple anatomy. Breastfeeding barriers increase under the influence of culture factors. Some countries have implemented a culture that renders mothers powerless to make decisions about caring for their babies, including those regarding breastfeeding.(29) Notably, education can be an effective measure to empower women to exclusively breastfeed their babies.(29)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBreastfeeding education during adolescence makes it possible to overcome the obstacles in exclusive breastfeeding. Usually, the decision to breastfeed exclusively is already made before conception, namely during adolescence.(30) Providing breastfeeding education to adolescents in schools reportedly improves the knowledge, attitude, and intentions regarding breastfeeding. The early provision of exclusive breastfeeding knowledge provides an opportunity for adolescents to understand the various obstacles. Moreover, physical and social problems are not only identified early but also managed in time before breastfeeding.(30,31)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eProviding education during adolescence may provide support to breastfeeding mothers. The WHO reported that every year, 21 million adolescents aged 15-19 years become pregnant in low-income countries, and approximately 12 million have had babies.(32) Adolescent pregnancy causes adolescents to become mothers without the knowledge and readiness required for exclusively breastfeeding their babies. Moreover, providing education during preconception, including the adolescent period, significantly reduces morbidity and mortality in both mothers and babies.(33)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTherefore, this study aimed to analyze the effectiveness of providing education from adolescence to increase the coverage of exclusive breastfeeding in infants aged 0-6 months.\u003c/p\u003e"},{"header":"2 Methods ","content":"\u003cp\u003e\u003cstrong\u003eDesign and sampling method\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis retrospective study measured exclusive breastfeeding based on the history of breastfeeding in babies aged 0-6 months. The participants were mothers of babies aged 6-24 months. Maternal participants were selected based on the limits of exclusive breastfeeding and breastfeeding. Exclusive breastfeeding is defined as giving only breast milk without additional food/liquid to infants from birth to 6 months of age and continuing breastfeeding with the introduction of appropriate complementary foods until the infant is 24 months old.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study included mothers living in the areas of the selected primary healthcare centers (PHCs) and willing to be interviewed. In total, 144 mothers from five regions participated in the study. The sample selection was performed in two stages. In the first stage, the PHCs were chosen using a purposive method based on the highest and lowest coverage of exclusive breastfeeding. Sukasada I, Sukasada II, and Buleleng I were the PHCs selected. The second stage involved selecting mothers with babies aged 6-24 months using a simple sampling method. Each selected PHC had a sample quota of 48 mothers. Furthermore, the objectives, benefits, and procedures of the study were explained to the mothers who fulfilled the inclusion criteria. Mothers who are willing to participate are asked to provide written informed consent. Informed consent has been obtained from all mothers of infants involved in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData collection was conducted in May and June 2023 in Buleleng Regency, Bali, Indonesia. Data was collected at each respondent\u0026rsquo;s home via interviews. The interview was conducted for approximately 30 min for each participant. The questionnaire used was developed by the researchers themselves and was subjected to validity and reliability tests. The validity test using the product moment test revealed a calculated r-value of 0.413 and a table r-value of 0.195. The reliability test revealed a Cronbach alpha value \u0026gt;0.6 (0.614).\u003c/p\u003e\n\u003cp\u003eThe data collected included information regarding the characteristics of the mothers and babies, exclusive breastfeeding, history of receiving information about exclusive breastfeeding, sources of information regarding exclusive breastfeeding, knowledge of exclusive breastfeeding, attitude toward exclusive breastfeeding, and support from health workers, husbands, family, and friends. Data on exclusive breastfeeding were collected via interviews. The babies were considered exclusively breastfed if they were only given breast milk without additional food/liquid at 0-6 months of age.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research data were subjected to univariate, bivariate, and multivariate analyses. Univariate analysis was performed to determine the proportion of each research variable. Variate tests were conducted to analyze the differences in the proportion of exclusive breastfeeding based on independent variables. Bivariate analysis was performed using the chi-square test, with a significance level of 95%. Multivariate logistic regression analysis was conducted to determine the variables influencing exclusive breastfeeding. The multivariate model only included variables with p-values \u0026lt;0.25 based on the chi-square test.\u0026nbsp;\u003c/p\u003e"},{"header":"3 Results","content":"\u003cp\u003eTable 1 describes the characteristics of the mothers and infants in this study. Most mothers were aged 20-30 years (89.6%), had a low education level (42.4%), were unemployed (51.4%), had two or more surviving children (77.8%), underwent normal delivery (70.1%), and had babies with birth weight \u0026ge;2500 g (97.2%). Moreover, most of them had good knowledge (56.3%) and a positive attitude (54.2%) regarding exclusive breastfeeding and had support from their husbands (53.5%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1. Characteristics of the mothers in the study\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003eN=144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eMother\u0026apos;s age (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;20\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003e20-35\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e89.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;35\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eEducation level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e42.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e28.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e29.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eEmployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e51.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e48.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eNumber of surviving children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e77.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e22.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eDelivery method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e70.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eCesarean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e29.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eBaby birth weight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;2500 g\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003e2500 g\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e140\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e97.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eMother\u0026rsquo;s knowledge regarding the benefits of exclusive breastfeeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e56.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eEnough\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e27.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eLess\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e16.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eMother\u0026rsquo;s attitude regarding exclusive breastfeeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e54.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eNeutral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e29.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eSupport in providing exclusive breastfeeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eHealth workers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e42.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eHusband\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e53.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eFamily\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e42.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"51.039697542533084%\" valign=\"top\"\u003e\n \u003cp\u003eFriends\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95274102079395%\" valign=\"top\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.00756143667297%\" valign=\"top\"\u003e\n \u003cp\u003e42.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 2 shows that 47.2% of mothers in this study performed exclusive breastfeeding. Almost 100% of mothers received education on breastfeeding, while only a small percentage received education as adolescents (13.2%). The most common source of information was from health workers (93.1%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Education, sources of information, knowledge, attitude, and sources of support for exclusive breastfeeding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"66.91871455576559%\" valign=\"top\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.879017013232515%\" valign=\"top\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.20226843100189%\" valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"66.91871455576559%\" valign=\"top\"\u003e\n \u003cp\u003eExclusive breastfeeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.879017013232515%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.20226843100189%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"66.91871455576559%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.879017013232515%\" valign=\"top\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.20226843100189%\" valign=\"top\"\u003e\n \u003cp\u003e47.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"66.91871455576559%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.879017013232515%\" valign=\"top\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.20226843100189%\" valign=\"top\"\u003e\n \u003cp\u003e52.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"66.91871455576559%\" valign=\"top\"\u003e\n \u003cp\u003eReceived breastfeeding education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.879017013232515%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.20226843100189%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"66.91871455576559%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.879017013232515%\" valign=\"top\"\u003e\n \u003cp\u003e144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.20226843100189%\" valign=\"top\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"66.91871455576559%\" valign=\"top\"\u003e\n \u003cp\u003eNot\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.879017013232515%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.20226843100189%\" valign=\"top\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eReceived education about exclusive breastfeeding\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"66.91871455576559%\" valign=\"top\"\u003e\n \u003cp\u003eSince adolescence (n=144)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.879017013232515%\" valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.20226843100189%\" valign=\"top\"\u003e\n \u003cp\u003e13.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"66.91871455576559%\" valign=\"top\"\u003e\n \u003cp\u003eDuring pregnancy (n=144)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.879017013232515%\" valign=\"top\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.20226843100189%\" valign=\"top\"\u003e\n \u003cp\u003e70.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eSources of information about exclusive breastfeeding\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"66.91871455576559%\" valign=\"top\"\u003e\n \u003cp\u003eHealth workers (n=144)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.879017013232515%\" valign=\"top\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.20226843100189%\" valign=\"top\"\u003e\n \u003cp\u003e93.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"66.91871455576559%\" valign=\"top\"\u003e\n \u003cp\u003ePrinted media (n=144)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.879017013232515%\" valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.20226843100189%\" valign=\"top\"\u003e\n \u003cp\u003e41.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"66.91871455576559%\" valign=\"top\"\u003e\n \u003cp\u003eInternet (n=144)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.879017013232515%\" valign=\"top\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.20226843100189%\" valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 3 shows that exclusive breastfeeding is found in only one mother aged \u0026lt;20 years. Among exclusively breastfed mothers, 32.3% had a high level of education, 53.0% were unemployed, 17.7% had two or more surviving children, 83.8% had vaginal births, and 100% had babies with a birth weight of \u0026ge;2500 g. Notably, most exclusive breastfeeding mothers did not receive exclusive breastfeeding information from adolescents (94.1%). However, 92.6% of exclusively breastfeeding mothers received information from health workers, 69.1% had good knowledge, and 67.6% had a positive attitude towards exclusive breastfeeding. In addition, 54.4%, 64.7%, 60.3%, and 55.9% of them received support from health workers, husbands, family, and friends, respectively. This finding shows that exclusive breastfeeding is influenced by education received since adolescence, education received during pregnancy, information received from print media, delivery methods, knowledge, and attitudes of mothers regarding breastfeeding, and support from health workers, husbands, family, and friends (p\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. History and resources of breastfeeding education and characteristics of mothers\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.52029520295203%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"52.398523985239855%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eExclusive breastfeeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.177121771217712%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.952029520295203%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.952029520295203%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.0958904109589%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eNo (n=76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.71232876712329%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eYes (n=68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.19178082191781%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.789473684210527%\" valign=\"top\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.42105263157895%\" valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94736842105263%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.31578947368421%\" valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.526315789473685%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eHave been educated when adolescence\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e19.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e80.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e94.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eHave been educated during pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e57.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e88.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e42.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eResources from health workers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e93.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e92.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.855\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e7.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eResources from print media\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e32.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.032\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e67.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eResources from the internet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e36.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e30.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.451\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e63.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e69.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003eAge of the mother (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;20\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.201\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003e20-35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e86.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e92.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.57486136783734%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;35\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.602587800369685%\" valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.939001848428836%\" valign=\"top\"\u003e\n \u003cp\u003e13.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.569316081330868%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.384473197781885%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.929759704251385%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eEducation level\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e26.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e32.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.714\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e30.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e26.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e43.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e41.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eOccupation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eEmployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e47.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.724\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e53.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eNumber of surviving children\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e73.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e82.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.212\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e26,3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e17,7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eDelivery method\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e57.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e83.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eCesarean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e42.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e16.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eBaby birth weight\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;2500 g\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e2500 g\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e94.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eKnowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e44.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e69,1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eEnough\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e35.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e19.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eLess\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e19.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eAttitude\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e67.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eNeutral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e31.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e26.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e65.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eHealth worker support\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e31.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e54.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eEnough\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e18.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e19.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eLess\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e26.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eHusband support\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e43.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e64.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.029\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eEnough\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e38.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e20.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eLess\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e14.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eFamily support\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e60.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eEnough\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e47.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e30.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eLess\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e52.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e8.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003eFriend support\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e38.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e55.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.032\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eEnough\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e23.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e25.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003eLess\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.62962962962963%\" valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.962962962962964%\" valign=\"top\"\u003e\n \u003cp\u003e38.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.333333333333334%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.481481481481481%\" valign=\"top\"\u003e\n \u003cp\u003e19.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.962962962962962%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cbr\u003e\n\u003cp\u003eTable 4 shows that mothers who received education as adolescents and who underwent cesarean section showed a low tendency for exclusive breastfeeding (adjusted odds ratio [AOR]=0.136; 95% confidence interval [CI]=0.035-0.526; p=0.004 and AOR=0.372; 95%CI=0.146-0.950; p=0.036, respectively). Mothers who received education during pregnancy were 5.2 times more likely to exclusively breastfeed their babies than those who did not receive education during pregnancy (AOR=5.201; 95%CI=2.054-13.168; p=0.001). Mothers who received good family support were 6.6 times more likely to exclusively breastfeed their babies than those who did not receive family support (AOR=6.626; 95%CI= 2.030-21.628; p=0.002).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Results of logistic regression test for exclusive breastfeeding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"520\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.69230769230769%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"67.3076923076923%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eExclusive breastfeeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.714285714285715%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"38%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e95%CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.285714285714285%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eReceived education since adolescence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.69230769230769%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003e(Ref)\u003c/p\u003e\n \u003cp\u003e0.136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.576923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.035-0.526\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.73076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eReceived education during pregnancy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.69230769230769%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003e(Ref)\u003c/p\u003e\n \u003cp\u003e5.201\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.576923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.054-13.168\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.73076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.69230769230769%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily support\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.576923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.73076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.69230769230769%\" valign=\"top\"\u003e\n \u003cp\u003eLess\u003c/p\u003e\n \u003cp\u003eEnough\u003c/p\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003e(Ref)\u003c/p\u003e\n \u003cp\u003e2.394\u003c/p\u003e\n \u003cp\u003e6.626\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.576923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.716-8.004\u003c/p\u003e\n \u003cp\u003e2.030-21.628\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.73076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.156\u003c/p\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.69230769230769%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDelivery method\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.576923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.73076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.69230769230769%\" valign=\"top\"\u003e\n \u003cp\u003eNormal\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCesarean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\" valign=\"top\"\u003e\n \u003cp\u003e(Ref)\u003c/p\u003e\n \u003cp\u003e0.372\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.576923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.146-0.950\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.73076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.039\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e(AOR= adjusted odds ratio; CI= confidence interval; Ref= reference)\u003c/p\u003e"},{"header":"4 Discussion ","content":"\u003cp\u003eExclusive breastfeeding was observed in 47.2% of mothers in this study. This exclusive breastfeeding rate is relatively higher than that reported for infants under 6 months in rural China and Malawi (38.1% and 35.9%, respectively).(20,33) The Institute of Child Mother Health in Dhaka, Bangladesh, reported that the proportion of exclusive breastfeeding was 50.0%.(34) However, several other studies reported a relatively high proportion of exclusive breastfeeding, ranging from 63% to 95.7%.(12,14,35\u0026ndash;37) \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis variation in the proportion of exclusive breastfeeding may be due to differences in research participants and the methods of determining the prevalence of exclusive breastfeeding. The participants in this study were breastfeeding mothers of children aged 6-24 months. A study conducted in rural Malawi included school-aged children, (33) while one in Colombia assessed exclusive breastfeeding in infants aged \u0026lt;6 months. (36) Meanwhile, a study conducted in China assessed exclusive breastfeeding in infants aged 4 months.(38) A study in Zanjan assessed exclusive breastfeeding in postpartum mothers visiting the obstetrics and gynecology departments of two main hospitals.(12)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsidering the data sources used, the exclusive breastfeeding data in this study were obtained via interviews using the 24-h recall method. Some previous studies used demographic surveillance secondary data.(33,35) The quality of data collected using the 24-h recall method depended on the participant\u0026rsquo;s memory of the exclusive breastfeeding behavior experienced. Nevertheless, this method showed good validity. The maternal memory sensitivity in the last 12 months was 98.3%, specificity was 70.0%, and accuracy was 77.9%.(39) Thus, information regarding the proportion of exclusive breastfeeding in this study can be used as basic data for evaluating exclusive breastfeeding programs.\u003c/p\u003e\n\u003cp\u003eReceiving education about exclusive breastfeeding as an adolescent was found to reduce the tendency of exclusive breastfeeding. Mothers who have been informed since adolescence tend not to breastfeed exclusively. This could be due to the long interval between education and breastfeeding, which reduces the knowledge possessed. Other factors also influence exclusive breastfeeding, such as maternal employment status, delivery method, and support for exclusive breastfeeding from family and friends.(15) Non-working mothers have more opportunities to provide exclusive breastfeeding than working mothers.(16) Mothers who are health workers tend to have poor breastfeeding behavior because of their inability to exclusively breastfeed.(10,17) Furthermore, the inability to exclusively breastfeed could be attributed to inhibiting factors, such as swollen breasts, pain in the nipples, and insufficient milk production.(34,40)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMothers delivering via cesarean section showed a reduced tendency for exclusive breastfeeding. Post-cesarean section mothers experience two times more obstacles in exclusive breastfeeding than post-vaginal delivery mothers.(13,41\u0026ndash;43) \u0026nbsp;The proportion of breastfeeding initiation in post-cesarean section mothers ranges from 4.8% to 40.1%.(44,45) Generally, newborns are kept separate from the mothers after cesarean section; hence, early initiation of breastfeeding is delayed.(43) To prevent the negative consequences of late breastfeeding, efforts to promote and strengthen the capacity of healthcare providers are needed to increase early breastfeeding initiation, especially for infants delivered via cesarean section.(46) \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe factors influencing the success of exclusive breastfeeding are support for mothers from health workers, family, and friends. This study found that mothers of toddlers who received good family support tended to be 6.6 times more likely to exclusively breastfeed than those who did not receive enough family support. Family support was found to be associated with exclusive breastfeeding among young mothers in Thailand.(47) The mother\u0026apos;s family and friends supporting breastfeeding as well as the external environment supporting breastfeeding when the mother resumes work activities outside the home are associated with exclusive breastfeeding.(15) This finding shows that breastfeeding is not only the mother\u0026rsquo;s responsibility but also requires support from the social environment.(36)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTherefore, efforts to increase knowledge about exclusive breastfeeding need to be pursued from adolescence.(48)(49)\u0026nbsp;The intention of toddler mothers to exclusively breastfeed requires support from their family and the environment. Young mothers find it difficult to achieve breastfeeding targets. Therefore, they require support, promotional activities, and health education based on individuals and communities.(50\u0026ndash;53)\u0026nbsp;Therefore, exclusive breastfeeding education should be introduced during adolescence.\u003c/p\u003e\n\u003cp\u003eThis study is limited to only one district; therefore, its results may be less representative. However, the research area was chosen based on variations in the coverage of exclusive breastfeeding.\u0026nbsp;\u003c/p\u003e"},{"header":"5 Conclusion","content":"\u003cp\u003eProviding education during adolescence did not increase the coverage of exclusive breastfeeding. Nevertheless, this study suggests providing exclusive breastfeeding education from adolescence and increasing support from the family and social environment for mothers to ensure exclusive breastfeeding.\u0026nbsp;\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eWHO: World Health Organization\u003c/p\u003e\n\u003cp\u003ePHCs: Primary Healthcare Center\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the Head of the Primary Health Center Buleleng District, Bali Province, who allowed conduct research in their area of work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLM and LSA play a role in designing research studies, writing drafts, reviewing, and editing manuscripts. \u0026nbsp;LNS and NKADUD play a role in analyzing research data, writing drafts, reviewing, and editing manuscripts. \u0026nbsp;All authors have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study received ethical approval from the Research Ethics Commission of the Faculty of Medicine, Udayana University (No: I 393AJN l4.2.2.Vll.l 4/I-T /2023). This research was conducted in accordance with ethical provisions and research guidelines applicable in the research area. Mothers who are willing to participate are asked to provide written informed consent. Informed consent has been obtained from all mothers of infants. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis is not applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eWHO. Breastfeeding [Internet]. 2021. Available from: https://www.who.int/health-topics/breastfeeding#tab=tab_1\u003c/li\u003e\n \u003cli\u003eWHO. Infant and young child feeding [Internet]. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding\u003c/li\u003e\n \u003cli\u003eMashayekh-amiri S, Hosseinzadeh M, Jafarabadi MA, Soltani S. Examining psychometric properties of the Iranian version of exclusive breastfeeding social support scale ( EBFSS ). 2023;1\u0026ndash;11.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eOberfichtner K, Oppelt P, Fritz D, Hrauda K, Fritz C, Schildberger B, et al. Breastfeeding in primiparous women \u0026ndash; expectations and reality : a prospective questionnaire survey. BMC Pregnancy Childbirth [Internet]. 2023;1\u0026ndash;9. Available from: https://doi.org/10.1186/s12884-023-05971-1\u003c/li\u003e\n \u003cli\u003ePillay L, Moodley D, Emel LM, Nkwanyana NM, Naidoo K. Growth patterns and clinical outcomes in association with breastfeeding duration in HIV exposed and unexposed infants: a cohort study in KwaZulu Natal, South Africa. BMC Pediatr. 2021;21(1):1\u0026ndash;9.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eHoang MP, Samuthpongtorn J, Seresirikachorn K, Snidvongs K. 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East Afr Heal Res J. 2021;5(1):82\u0026ndash;90.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eEsp\u0026iacute;n ID, C\u0026aacute;ceres \u0026Aacute;L, \u0026Aacute;lava A, Ayala J, Figueroa K, Loor V, et al. skin contact and other strong determinants of exclusive breastfeeding in an urban population : a prospective study. 2021;1\u0026ndash;8.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eP\u0026eacute;rez-Escamilla R, Tomori C, Hern\u0026aacute;ndez-Cordero S, Baker P, Barros AJD, B\u0026eacute;gin F, et al. Breastfeeding: crucially important, but increasingly challenged in a market-driven world. Lancet [Internet]. 2023 Feb;401(10375):472\u0026ndash;85. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0140673622019328\u003c/li\u003e\n \u003cli\u003eArtzi-Medvedik R, Mariani I, Valente EP, Lazzerini M, Chertok IA. Factors associated with exclusive breastfeeding in Israel during the COVID-19 pandemic: a subset of the IMAgiNE EURO cross-sectional study. 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Prevalence of exclusive breastfeeding practice in the first six months of life and its determinants in Iran : a systematic review and meta-analysis. 2019;1\u0026ndash;10.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eWake GE. Prevalence of exclusive breastfeeding practice and its association with maternal employment in Ethiopia : a systematic review and meta-analysis. 2021;1\u0026ndash;14.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eNeves PAR, Vaz JS, Maia FS, Baker P, Gatica-dom\u0026iacute;nguez G, Piwoz E, et al. Articles Rates and time trends in the consumption of breastmilk , formula , and animal milk by children younger than 2 years from 2000 to 2019 : analysis of 113 countries. 2021;619\u0026ndash;30.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eGayatri M. Exclusive Breastfeeding Practice in Indonesia : A Population-Based Study. 2021;395\u0026ndash;402.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBali DKP. Rancangan akhir perubahan Renstra Semesta Berencana Dinas Kesehatan Provinsi Bali tahun 2018-2023. 2023;1. Available from: https://e-renggar.kemkes.go.id/file_performance/1-220006-2tahunan-762.pdf\u003c/li\u003e\n \u003cli\u003eAboul-Enein BH, Dodge E, Benajiba N, Mabry RM. Interventions and Programs to Promote Breastfeeding in Arabic-Speaking Countries: A Scoping Review. Matern Child Health J [Internet]. 2023;27(5):774\u0026ndash;94. Available from: https://doi.org/10.1007/s10995-023-03595-7\u003c/li\u003e\n \u003cli\u003ePratiwi DN, Ernawaty. Implementation of an Exclusive Breastfeeding Policy in Wonogiri Regency. Indones J Public Heal. 2023;18(1):21\u0026ndash;33.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAxelin A, Kolari T. 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EFFECTS OF A BREASTFEEDING EDUCATIONAL INTERVENTION ON SECONDARY SCHOOL STUDENTS AFTER 6 MONTHS. 2021;569\u0026ndash;78.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eWHO. Adolescent pregnancy [Internet]. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy\u003c/li\u003e\n \u003cli\u003eMohammed S, Webb EL, Calvert C, Glynn JR, Sunny BS, Crampin AC, et al. Effects of exclusive breastfeeding on educational attainment and longitudinal trajectories of grade progression among children in a 13-year follow-up study in Malawi. Sci Rep [Internet]. 2023;13(1):11413. Available from: https://doi.org/10.1038/s41598-023-38455-5\u003c/li\u003e\n \u003cli\u003eTasnim S, Roy SK, Jahan K, Nazmeen S, Debnath SC, Islam ABMM. Difficulties in breastfeeding: Easy solution by oketani breast massage. Bangladesh Med Res Counc Bull. 2019;45(3):149\u0026ndash;54.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eDarboe ML, Jeyakumar A, Mansour SMA, Valawalkar S. 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Children. 2023;10(4):1\u0026ndash;12.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eSalarvand S, Ghazvineh S, Mousivand F, Ahmadi Gharaei H, Bitaraf S. Health literacy and its related factors as predictors for the breastfeeding self-efficacy in a western province in Iran. BMC Public Health [Internet]. 2023;23(1):1\u0026ndash;9. Available from: https://doi.org/10.1186/s12889-023-15522-0\u003c/li\u003e\n \u003cli\u003eGhotbizadeh F, Panahi Z, Manshadi AT, Soltani S, Akbari R, Parsapur M. Maternal Health Literacy and Pregnancy Outcomes: Does any Association Exist? J Obstet Gynecol Cancer Res. 2023;8(1):68\u0026ndash;75.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eDykes C, Ny P, Hauck YL, Kuliukas L, Gallagher L, Brady V, et al. Women\u0026rsquo;s perceptions of factors needed to encourage a culture of public breastfeeding: a cross-sectional study in Sweden, Ireland and Australia. Int Breastfeed J. 2023;18(1):1\u0026ndash;8.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eSalem M, Ertz M. \u0026ldquo;Better start\u0026rdquo;: promoting breastfeeding through demarketing. BMC Public Health. 2023;23(1):1\u0026ndash;13.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eSeyyedi N, Rahmatnezhad L, Mesgarzadeh M, Khalkhali H, Seyyedi N, Rahimi B. Effectiveness of a smartphone-based educational intervention to improve breastfeeding. Int Breastfeed J. 2021;16(1):1\u0026ndash;8.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eYu M, Xu M, Liu Z, Ying Y, Weng Q, Subhi NO. Nurse Education in Practice Effectiveness of an optional breastfeeding course for multidisciplinary undergraduate healthcare students : A quasi-experimental study. Nurse Educ Pract [Internet]. 2023;69(March):103609. Available from: https://doi.org/10.1016/j.nepr.2023.103609\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Adolescent, Pregnancy, Female, Breastfeeding, Health Education","lastPublishedDoi":"10.21203/rs.3.rs-3481359/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3481359/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Although providing education regarding exclusive breastfeeding can increase the exclusive breastfeeding coverage in infants aged 0-6 months, studies investigating this association are limited. This study aimed to prove that providing education from adolescence could increase exclusive breastfeeding in infants aged 0-6 months. This retrospective study included mothers of toddlers aged 6-24 months. In total, 144 mothers from five regions were selected in two stages. First, primary healthcare centers were selected using purposive sampling, and then mothers of toddlers were selected using a simple random sampling method. Data was collected via interviews. Exclusive breastfeeding data were based on the history of breastfeeding of the mothers when the babies were 0-6 months old. A logistic progression test was performed to determine the role of providing education from adolescence and other variables in increasing the coverage of exclusive breastfeeding. The proportion of exclusive breastfeeding was 47.2%. Mothers who received education as adolescents and who underwent cesarean section showed a low tendency for exclusive breastfeeding (p=0.004 and p=0.036, respectively). Meanwhile, mothers receiving breastfeeding education during pregnancy were 5.2 times more likely to exclusively breastfeed than those not receiving it (p=0.001). Mothers who received family support were 6.6 times more likely to exclusively breastfeed than those who did not receive it (p=0.002). The provision of education from adolescence has not been proven to increase the coverage of exclusive breastfeeding in 0-6-month-old infants. However, this study suggests providing education from adolescence and support from the family and social environment to perform exclusive breastfeeding successfully.","manuscriptTitle":"Providing education from adolescence to promote exclusive breastfeeding: a retrospective study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-10-27 04:36:58","doi":"10.21203/rs.3.rs-3481359/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4e6069ea-72e0-4ef4-ac98-ec86f893aa38","owner":[],"postedDate":"October 27th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-10-31T13:14:41+00:00","versionOfRecord":[],"versionCreatedAt":"2023-10-27 04:36:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3481359","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3481359","identity":"rs-3481359","version":["v1"]},"buildId":"FbvkV6FR0MCFSLy54lSbu","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}