Meta-Analysis: The Effect of Lactation Education by Midwives on Exclusive Breastfeeding Behavior in Mothers and Pregnant Women

Amanda Kesli Ramadhani, Akbar Suryananda


Background: Exclusive breastfeeding has a good impact on the baby's growth and development. Therefore, the role of health workers, especially midwives, is needed to provide an education about the importance of exclusive breastfeeding for babies. The purpose of this study was to determine the effect of lactation education conducted by midwives related to exclusive breastfeeding behavior for mothers and pregnant women.

Subjects and Method: This study is a meta-analysis study with Population: Mothers and pregnant women, Intervention: lactation education by midwives, Comparation: without midwife lactation education and Output: Exclusive breastfeeding behavior. The article search process is carried out through the Pubmed web search engine and is a research article published from 2017-2022. The articles obtained will be filtered using the stages according to the PRISMA flow diagram.

Results: A total of 9 articles used in this study were reviewed and met the requirements for a meta-analysis, the research conducted in these articles was carried out in various countries such as Indonesia, Bangladesh, Euthiopia, and Spain. Where from the meta-analysis of 9 cross-sectional articles, it is known that there is an influence between lactation education by midwives and exclusive breastfeeding behavior for mothers and pregnant women (aOR= 1.60; 95% CI= 1.37 to 1.88; p= 0.008).

Conclusion: Lactation education by midwives increases exclusive breastfeeding behavior for mothers and pregnant women.

Keywords: lactation education, exclusive breastfeeding, midwives, mothers, pregnant women, meta-analysis.


Amanda Kesli Ramadhani. Universitas Muhammadiyah Surakarta, Jl. A. Yani Mendungan, Kartasura, Sukoharjo, Central Java. Email: Mobile: 085692832776.

Journal of Health Promotion and Behavior (2022), 07(02): 86-96


Full Text:



Azene ZN, Mulunesh A, Alamneh TS. (2021). Delayed breast feeding initia-tion increases the odds of colostrum avoidance among mothers in North-west Ethiopia: a community-based cross-sectional study. Int J Pediatr. 1: 1–11. doi: 10.1155/2019/1483024.

Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. (2013). Maternal and child under nutrition and overweight in low-income and middle-income countries. Lancet. 382(9890): 427–451. doi: 10.1016/S0140-6736(13)-60937-X.

Bouras G, Mexi-Bourna P, Bournas N, Chris¬todoulou C, Daskalaki A, Tasio-poulou I, et al. (2013). Mothers’ expectations and other factors affecting breastfeeding at six months in Greece. J Child Health Care. 17(4): 387–396. doi: 10.3390/ijerph18168729.

Bosi ATB, Eriksen KG, Sobko T, Wijnhoven TM, Breda J. (2016). Breastfeeding practices and policies in WHO Euro-pean region member states. Public Health Nutr. 19(4): 753–764. doi: 10.1017/S1368980015001767.

Castillejos BA, Gómez SJ, Rodríguez AJ, Ortiz, EI, Hernández MA (2020). Factors that influence mothers’ pre-natal decision to breastfeed in Spain. Int Breastfeed J. 15(1): 97.

Cox KN, Giglia RC, Binns CW. (2015). The influence of infant feeding attitudes on breastfeeding duration: evidence from a cohort study in rural Western Australia. Int Breastfeed J. 10(1): 1–9. doi: 10.1186/s13006-015-0048-3.

Gaki E, Papamichael D, Sarafidou J, Pana-giotopoulos T, Antoniadou-Koumatou I. Athens, Greece. (2009). National survey of prevalence and determinants of maternal breastfeeding. Re¬port of the Institute of Children’s Health or National School of Public Health– Sector of Children’s Health. (article in Greek).

Ghanbarnejad A, Ghanbarnejad S, Taqipoor L (2014). Exclusive breast-feeding and its related factors among infants in Bandar Abbas city, Iran. J Babol Univ Med Sci. 16(1): 85–91.

Gebremeskel SG, Gebru TT, Gebrehiwot BG, Meles HN, Tafere BB, Gebre-slassie GW, Welay FT, Mengesha MB, Weldegeorges DA (2019). Early initia-tion of breastfeeding and associated factors among mothers of aged less than 12 months children in rural eastern zone, Tigray, Ethiopia: cross-sectional study. BMC Res Notes. 12(1): 671. doi: 10.1186/s13104-019-4718-x.

Hossain M, Islam A, Kamarul T, Hossain G (2018). Exclusive breastfeeding prac¬-tice during first six months of an infant’s life in Bangladesh: a country based cross-sectional study. BMC Pediatr. 18(1): 93.

Heydarpour S, Golboni F, Heydarpour F, Timareh M (2011). Factors associated with exclusive breast-feeding in Kermanshah in 2007. Behbood J. 15(3): 227–230.

Hockenberry MJ, Wilson D (2014). Study Guide for Wong’s Nursing Care of Infants and Children-E-Book. Elsevier Health Sciences.

Innis SM (2003). Perinatal biochemistry and physiology of long-chain poly-un-saturated fatty acids. J Pediatr. 143 (4): 1–8. doi: 10.1067/S0022-3476 (03) 00396-2.

Inoue M, Binns CW, Otsuka K, Jimba M, Matsubara M. (2012). Infant feeding practices and breastfeeding duration in Japan: a review. Int Breastfeed J. 7(1): 1–15. doi: 10.1186/1746-4358-7-15.

Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS (2003). Bellagio Child Survival Study Group. How many child deaths can we prevent this year?. Lancet. 362(9377): 65–71.

Ladomenou F, Kafatos A, Galanakis E (2007). Risk factors related to intention to breastfeed, early weaning and suboptimal duration of breast¬feed-ing. Acta Paediatr. 96(10): 1441–1444. doi: 10.1111/j.1651-2227.2007.0047-2.x.

Mamo K, Dengia T, Abubeker A, Girmaye E.(2020). Assessment of Exclusive Bre¬astfeeding Practice and Associated Factors among Mothers in West Shoa Zone, Oromia, Ethiopia. Obstet Gyne-col Int. doi: 10.1155/2020/3¬965873.

Nurfatimah N, Entoh C, Ramadhan K. (2019). Pengaruh Konseling Laktasi Terhadap Pemberian Asi Eksklusif Di Wilayah Kerja Puskesmas Mapane Kabupaten Poso. J Publ Kesehat Masy Indones. 6(1): 1–6. doi: 10.20527/-jpkmi.v6i1.6869.

Olang B, Heidarzadeh A, Strandvik B, Yngve A (2012). Reasons given by mothers for discontinuing breastfeed¬ing in Iran. Int Breastfeed J. 7(1): 1–7. doi: 10.1186/1746-4358-7-7.

Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, Group TLBS. (2016). Why invest, and what it will take to improve breast-feeding practices?. Lancet. 387 (10-017): 491–504.

Svensson J (2015). Antenatal breastfeeding education: Strategies for mid-wives. Women and Birth. 28: S29. doi: 10.1016/j.wombi.2015.07.097.

Scott JA, Kwok YY, Synnott K, Bogue J, Amarri S, Norin E, et al. (2015). A comparison of maternal attitudes to breastfeeding in public and the association with breastfeeding duration in four European countries: Results of a cohort study. Birth. 42 (1): 78–85. doi: 10.1111/birt.12138.

Taylor SE, Sherman DK, Kim HS, Jarcho J, Takagi K, Dunagan MS. (2004). Culture and social support: who seeks it and why?. J Pers Soc Psychol. 87(3): 354. doi: 10.1037/0022-3514.87.3.354.

Titaley CR, Dibley MJ, Ariawan I, Mu’a-syaroh A, Alam A, Damayanti R, Do TT, Ferguson E, Htet K, Li M (2021). Determinants of low breastfeeding self-efficacy amongst mothers of children aged less than six months: re¬sults from the BADUTA study in East Java, Indonesia. Int Breastfeed J. 16(1): 12. doi: 10.1186/s13006-021-00357-5.

Theofilogiannakou M, Skouroliakou M, Gounaris A, Panagiotakos D, Markan-tonis SL (2006). Breast-feeding in Athens, Greece: factors associated with its initiation and duration. J Pediatr Gastroenterol Nutr. 43(3): 379–384.

Yirdaw BW, Yimer SA, Badi MB. (2018). Adherence to Exclusive Breastfeeding and its Associated Factors among HIV-Positive Mothers in Referral Hospitals of Amhara 12, 12. Regional State, Northwest Ethiopia. Iran J Neonatol. 12(2). doi: 10.22038/ijn.2021.51074.1903.

World Health Organization (2014). Global Nutrition Targets 2025: Breastfeeding Policy Brief. (WHO/NMH/NHD14. 7). Geneva World Health Organ.

World Health Organization. (2013). World Health Statistics.

Whitney EN, Rolfes SR. (2018). Cengage Learning. Understanding nutrition.

Walker A. (2010). Breast milk as the gold standard for protective nutrients. J Pediatr. 156(2): S3–S7. doi: 10.1016/-j.jpeds.2009.11.021.


  • There are currently no refbacks.