Breastfeeding Knowledge, Attitude, and Practice among White-Collar and Blue-Collar Workers in Indonesia

BACKGROUND: Working status is identified as a major risk factor of poor breastfeeding practices among workers. This study aimed to evaluate the knowledge, attitude, and factors associated with breastfeeding practice among white-collar and blue-collar workers in Indonesia. METHODS: A cross-sectional study was performed in two factories and three government offices in Jakarta from December 2015 to February 2016. Subjects were woman workers whose children were age 6 to 24 months old and actively working in the factory and/or office. The factors studied were selected socio-demographic and occupational characteristics, score on knowledge and attitude, and breastfeeding practice during working hours. RESULTS: From a total of 192 subjects, 73% of white-collar workers had good knowledge on breastfeeding, in contrast with 55% of blue-collar workers who had not good breastfeeding knowledge (P < 0.001). Most of the subjects were conducting breast pumping during working hours, however 15% of white-collar workers and 17% of blue-collar workers never breastfeed nor breast pumped at work. Working status (P = 0.005) and knowledge (P = 0.002) were factors associated with breastfeeding practice among workers. CONCLUSION: White-collar workers have a better knowledge, attitude, and practice toward breastfeeding. Knowledge improvement related to breastfeeding benefits and supports to working mothers are a key priority, however advocacy to employers, managers, and supervisors in providing breastfeeding facilitation and program support were also critical to successful breastfeeding practice among workers.

The Role of Two Human Milk Oligosaccharides, 2′-Fucosyllactose and Lacto-N-Neotetraose, in Infant Nutrition / 대한소아소화기영양학회지

Human breast milk contains numerous biomolecules. Human milk oligosaccharides (HMOs) are the third most abundant component of breast milk, after lactose and lipids. Amongst the synthetized HMOs, 2′-fucosyllactose (2′-FL) and lacto-N-neotetraose (LNnT) are widely studied and are considered safe for infant nutrition. Several studies have reported the health benefits of HMOs, which include modulation of the intestinal microbiota, anti-adhesive effect against pathogens, modulation of the intestinal epithelial cell response, and development of the immune system. The amount and diversity of HMOs are determined by the genetic background of the mothers (HMO secretors or non-secretors). The non-secretor mothers secrete lower HMOs than secretor mothers. The breastfed infants of secretor mothers gain more health benefit than those of non-secretor mothers. In conclusion, supplementation of infant formula with 2′-FL and LNnT is a promising innovation for infant nutrition.

A perspective on partially hydrolyzed protein infant formula in nonexclusively breastfed infants / 소아과

The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option to provide the nutrition needed. Infant formula is usually prepared from industrially modified cow's milk and processed to adjust for the nutritional needs of infants. However, cow's milk is one of the most common causes of food allergy, affecting 2%–5% of all formula-fed infants during their first year of life. One strategy to prevent cow's milk allergy in nonbreastfed infants is the use of partially hydrolyzed formula (pHF) in high-risk infants, which are infants born in families with atopic disease. However, based on an epidemiological study, approximately half of the infants who develop allergy are not part of the at-risk group. This is because the non-at-risk group is significantly larger than the at-risk group and the non-at-risk infants have approximately 15% risk of developing allergies. This study aimed to evaluate the effects of partially hydrolyzed whey formula (pHF-W) in nonbreastfed infants and determine whether pHF-W can prevent atopic disease in high-risk infants and can be used as routine starter formula regardless of the allergy risk status.

Challenges and Supports of Breastfeeding at Workplace in Indonesia / 대한소아소화기영양학회지

Due to increased number of women workers in Indonesia in the last decade, numbers of women living as a worker and a housewife have increased. This also increases the potential risk of breastfeeding discontinuation. Three months of maternal leave policy and inadequate lactation promotion support in workplace have been identified as factors that hinder lactating practices. The World Health Organization recommendation of 6 months of exclusive breastfeeding and joined regulation of three Indonesia ministers (Ministry of Health, Ministry of Labour, and Ministry of Women Empower) have failed to improve the exclusive breastfeeding rate among female workers in Indonesia due to the lack of a standardized guideline on lactation promotion at workplace. In addition, very limited or no studies have been conducted to evaluate the impact of workplace-based lactation intervention programs on exclusive breastfeeding rate among female workers. This is because the relationship of lactation with working performance and productivity could not motivate employer to invest in workplace-based lactation promotion facility or program.