Optimizing Breastfeeding Practices Through Lactation Education Among Postpartum Mothers After Cesarean Section to Support Exclusive Breastfeeding Success at Awet Muda Narmada Regional General Hospital
DOI:
https://doi.org/10.30994/jceh.v9i2.819Keywords:
Knowledge, Lactation Education, Lactation Massage, Postpartum Mothers, Skills.Abstract
among mothers recovering from caesarean section. Limited knowledge, confidence, and practical breastfeeding skills may contribute to suboptimal breastfeeding practices. This community service program aimed to improve the knowledge, attitudes, breastfeeding skills, and breastfeeding practices of postpartum mothers following caesarean section through structured lactation education. The program was conducted at Awet Muda Narmada Regional General Hospital, West Lombok, Indonesia, involving 30 postpartum mothers following caesarean section. The intervention consisted of interactive health education using posters and leaflets, question-and-answer discussions, demonstrations of proper breastfeeding techniques and lactation massage, and supervised hands-on practice. Program outcomes were evaluated using pre-test and post-test questionnaires and structured observation sheets. The results demonstrated improvements across all evaluated variables. Knowledge increased from a mean score of 5.73 to 8.96, representing an increase of 56.37%. Attitudes toward exclusive breastfeeding increased from 28.27 to 36.43 (28.86%), while breastfeeding skills improved from 5.13 to 9.03 (76.02%). Breastfeeding practices also increased from 4.56 to 7.63, representing an improvement of 67.32%. These findings indicate that structured lactation education incorporating practical demonstrations, lactation massage, supervised practice, and individualized guidance can improve breastfeeding knowledge, attitudes, skills, and practices among postpartum mothers following caesarean section. Integrating structured lactation education into routine postpartum care may support mothers in achieving successful exclusive breastfeeding.
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References
Ahmad, Khadija, Rabiah Mahwish, Mariam Mazhar, Momina Bashir, and Maryam Yousaf. 2023. “Determinants of Early Initiation of Breastfeeding after Caesarean Section in ATertiary Care Hospital.” https://doi.org/10.51273/esc23.251319321
Beyene, Belda Negesa, Wako Golicha Wako, Dureti Moti, Alo Edin, and Derese Eshetu Debela. 2025. “Postnatal Counseling Promotes Early Initiation and Exclusive Breastfeeding: A Randomized Controlled Trial.” Frontiers in Nutrition 12:1473086. doi: 10.3389/fnut.2025.1473086
Bookhart, Larelle H., Andrea B. Joyner, Kelly Lee, Nikkia Worrell, Denise J. Jamieson, and Melissa F. Young. 2021. “Moving beyond Breastfeeding Initiation: A Qualitative Study Unpacking Factors That Influence Infant Feeding at Hospital Discharge among Urban, Socioeconomically Disadvantaged Women.” Journal of the Academy of Nutrition and Dietetics 121(9):1704–20. https://doi.org/10.1016/j.jand.2021.02.005
Charlick, Samantha J., Lois McKellar, Andrea L. Gordon, and Jan Pincombe. 2019. “The Private Journey: An Interpretative Phenomenological Analysis of Exclusive Breastfeeding.” Women and Birth 32(1):e34–42. https://doi.org/10.1145/3491102.3517620
Colombo, Lorenzo, Beatrice Letizia Crippa, Dario Consonni, Maria Enrica Bettinelli, Viola Agosti, Giulia Mangino, Elena Nicoletta Bezze, Paola Agnese Mauri, Lidia Zanotta, and Paola Roggero. 2018. “Breastfeeding Determinants in Healthy Term Newborns.” Nutrients 10(1):48. https://doi.org/10.3390/nu10010048
Couto, Germano Rodrigues, Vanessa Dias, and Isabel de Jesus Oliveira. 2020. “Benefits of Exclusive Breastfeeding: An Integrative Review.” https://www.sid.ir/en/VEWSSID/J_pdf/H50005420200408.pdf
Emam, EAER, and Aml Sayed Ali. 2017. “Factors Influencing Breastfeeding Practice after Caesarean Section Delivery.” J Nurs Health Sci 6(5):63–70. https://www.researchgate.net/profile/Aml-Ali-2/publication/334031379_Factors_influencing_breastfeeding_practice_after_caesarean_section_delivery/links/5d134fc4299bf1547c7f9570/Factors-influencing-breastfeeding-practice-after-caesarean-section-delivery.pdf
Herawati, Ita, Budi Hermanto, Agnes Andika, Jumsinah Jumsinah, Lia Widiyanti, Ocha Gries Tika, and Yanti Marlita. 2026. “Caesarean Delivery and Early Breastfeeding Outcomes: A Cross-Sectional Study of EIBF and Early Postpartum Difficulties.” Journal of Applied Nursing and Health 8(1):788–97. https://doi.org/10.55018/janh.v8i1.487
Hoang Nguyen, Phung Thi, Colin W. Binns, Anh Vo Van Ha, Cong Luat Nguyen, Tan Khac Chu, Dat Van Duong, Dung Van Do, and Andy H. Lee. 2020. “Caesarean Delivery Associated with Adverse Breastfeeding Practices: A Prospective Cohort Study.” Journal of Obstetrics and Gynaecology 40(5):644–48. https://doi.org/10.1080/01443615.2019.1647519
Hooda, Reetu, Nisha Malik, Prachi Pathak, Hemant More, and Vikram Singh. 2023. “Impact of Postoperative Pain on Early Initiation of Breastfeeding and Ambulation after Caesarean Section: A Randomized Trial.” Breastfeeding Medicine 18(2):132–37. https://doi.org/10.1089/bfm.2022.0208
Hookway, Lyndsey, Amy Brown, and Aimee Grant. 2023. “Breastfeeding Sick Children in Hospital: Exploring the Experiences of Mothers in UK Paediatric Wards.” Maternal & Child Nutrition 19(2):e13489. https://doi.org/10.1111/mcn.13489
Huang, Li, Shangzhi Xu, Xi Chen, Qian Li, Lixia Lin, Yu Zhang, Duan Gao, Huanzhuo Wang, Miao Hong, and Xuefeng Yang. 2020. “Delayed Lactogenesis Is Associated with Suboptimal Breastfeeding Practices: A Prospective Cohort Study.” The Journal of Nutrition 150(4):894–900. https://academic.oup.com/jn/advance-article-abstract/doi/10.1093/jn/nxz311/5686879?redirectedFrom=fulltext&itm_medium=sidebar&itm_source=trendmd-widget&itm_campaign=The_Journal_of_Nutrition&itm_content=The_Journal_of_Nutrition_0
Huang, Pan, Jianrong Yao, Xinghui Liu, and Biru Luo. 2019. “Individualized Intervention to Improve Rates of Exclusive Breastfeeding: A Randomised Controlled Trial.” Medicine 98(47):e17822. 10.1097/MD.0000000000017822
Jama, Abdiasis, Hailay Gebreyesus, Tewolde Wubayehu, Tsigehana Gebregyorgis, Mebrahtu Teweldemedhin, Tesfay Berhe, and Negasi Berhe. 2020. “Exclusive Breastfeeding for the First Six Months of Life and Its Associated Factors among Children Age 6-24 Months in Burao District, Somaliland.” International Breastfeeding Journal 15(1):5. https://doi.org/10.1186/s13006-020-0252-7
Kassianos, Angelos P., Emma Ward, Antonio Rojas-Garcia, Allison Kurti, Fiona C. Mitchell, Dian Nostikasari, Jamie Payton, Julian Pascal-Saadi, Claire Adams Spears, and Caitlin Notley. 2019. “A Systematic Review and Meta-Analysis of Interventions Incorporating Behaviour Change Techniques to Promote Breastfeeding among Postpartum Women.” Health Psychology Review 13(3):344–72. https://doi.org/10.1080/17437199.2019.1618724
Khan, Md Nuruzzaman, and M. Mofizul Islam. 2017. “Effect of Exclusive Breastfeeding on Selected Adverse Health and Nutritional Outcomes: A Nationally Representative Study.” BMC Public Health 17(1):889. https://doi.org/10.1186/s12889-017-4913-4
Khatib, Mahalaqua Nazli, Abhay Gaidhane, Shilpa Upadhyay, Shital Telrandhe, Deepak Saxena, Padam Prasad Simkhada, Shailendra Sawleshwarkar, and Syed Zahiruddin Quazi. 2023. “Interventions for Promoting and Optimizing Breastfeeding Practices: An Overview of Systematic Review.” Frontiers in Public Health 11:984876. https://doi.org/10.3389/fpubh.2023.984876
Lawrence, Ruth A., and Robert M. Lawrence. 2021. Breastfeeding: A Guide for the Medical Professional. Elsevier Health Sciences. https://www.google.com/books?hl=id&lr=&id=uwkqEAAAQBAJ&oi=fnd&pg=PP1&dq=Lawrence,+Ruth+A.,+and+Robert+M.+Lawrence.+2021.+Breastfeeding:+A+Guide+for+the+Medical+Professional.+Elsevier+Health+Sciences.&ots=6b7xeX7S70&sig=9znkSe_rov4O7V5R03DtU8UxkBY
Li, Leixi, Wenlin Wan, and Chan Zhu. 2021. “Breastfeeding after a Caesarean Section: A Literature Review.” Midwifery 103:103117. https://doi.org/10.1016/j.midw.2021.103117
Lojander, Jaana, Anna Axelin, and Hannakaisa Niela-Vilén. 2024. “Breastfeeding Exclusivity, Difficulties, and Support in the First Days after Hospital Discharge: A Correlational Study.” European Journal of Obstetrics & Gynecology and Reproductive Biology 296:76–82. https://doi.org/10.1016/j.ejogrb.2024.02.029
Organization, World Health. 2021. “Implementation Guidance on Counselling Women to Improve Breastfeeding Practices.” https://iris.who.int/bitstreams/c79d2ab6-94d5-4c80-94f0-9398c2e097a2/download
Paksoy Erbaydar, Nüket, and Tuğrul Erbaydar. 2020. “Relationship between Caesarean Section and Breastfeeding: Evidence from the 2013 Turkey Demographic and Health Survey.” BMC Pregnancy and Childbirth 20(1):55. https://doi.org/10.1186/s12884-020-2732-6
Pérez-Escamilla, Rafael, Cecília Tomori, Sonia Hernández-Cordero, Phillip Baker, Aluisio J. D. Barros, France Bégin, Donna J. Chapman, Laurence M. Grummer-Strawn, David McCoy, and Purnima Menon. 2023. “Breastfeeding: Crucially Important, but Increasingly Challenged in a Market-Driven World.” The Lancet 401(10375):472–85. https://doi.org/10.1016/S0140-6736(22)01932-8
Schliep, Karen C., Daniel Denhalter, Lisa H. Gren, Katherine A. Panushka, Tejinder Pal Singh, and Michael W. Varner. 2019. “Factors in the Hospital Experience Associated with Postpartum Breastfeeding Success.” Breastfeeding Medicine 14(5):334–41. https://doi.org/10.1089/bfm.2018.0039
Smith, Emily R., Lisa Hurt, Ranadip Chowdhury, Bireshwar Sinha, Wafaie Fawzi, Karen M. Edmond, and Neovita Study Group. 2017. “Delayed Breastfeeding Initiation and Infant Survival: A Systematic Review and Meta-Analysis.” PloS One 12(7):e0180722. https://doi.org/10.1371/journal.pone.0180722
Spencer, Jeanne, S. A. Abrams, and A. G. Hoppin. 2019. “Patient Education: Common Breastfeeding Problems (Beyond the Basics).” https://www.misurgeon.com.au/wp-content/uploads/2020/05/Patient-education_-Common-breastfeeding-problems-Beyond-the-Basics-UpToDate.pdf
Ulfa, Yunefit, Naoko Maruyama, Yumiko Igarashi, and Shigeko Horiuchi. 2023. “Women’s Experiences of Breastfeeding after a Caesarean Section: A Meta‐synthesis.” Japan Journal of Nursing Science 20(3):e12534.
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