Document Type : Original Article


Departments of Midwifery and Environmental Health, Poltekkes Kemenkes Pontianak, Pontianak, Indonesia


BACKGROUND: The decrease in coverage of exclusive breastfeeding for mothers who work
in Pontianak has an impact on the decline of the baby’s immune system. Prevention efforts can
be done by increasing knowledge about exclusive breastfeeding tips for mothers who work by
providing health education. This study aims to examine the effectiveness of the use of health
education media in increasing maternal knowledge about exclusive breastfeeding tips for working
MATERIALS AND METHODS: This is a quasi‑experiment study with a nonrandomized design
pretest and posttest control group design. The population of nursing mothers who have children
aged 0–6 months. The number of samples is 140, which is divided into four groups. Data collection
use direct interviews. Respondents filled out the pretest questionnaire to measure knowledge before
being given health education. Then, the first group was given treatment in the form of lectures, the
second group using leaflets, and the third group was given lectures first then given leaflets. After
that, his knowledge was measured again through a posttest. Data analysis were used to determine
the increase in the score of knowledge about exclusive breastfeeding tips for mothers who worked
on each media used repeated ANOVA and Kruskal–Wallis test, while one‑way ANOVA continued
with post hoc Bonferroni and Friedman followed by Mann–Whitney test used to compare score
differences knowledge on all three media.
RESULTS: there were significant differences in knowledge, before and after being given good health
education without media, with leaflets, electronic media, and electronic leaflets before. statistical
tests before and after used leaflets and electronic media without media 19.85 (P ≤ 0.001), leaflets
without media 8.42 (P ≤ 0.001). Electronic without media at 8.14 (P ≤ 0.001). In the pre‑ and
post‑test study, the experimental study was pseudo, 140 individuals with each group 35 individuals.
CONCLUSION: The most effective method in providing health education to increase the knowledge
of breastfeeding mothers about tips on exclusive breastfeeding for working mothers is electronic
leaflet media.


1. Schoetzau A, Filipiak‑Pittroff B, Franke K, Koletzko S, Von Berg A,
Gruebl A, et al. Effect of exclusive breast‑feeding and early solid
food avoidance on the incidence of atopic dermatitis in high‑risk
infants at 1 year of age. Pediatr Allergy Immunol 2002;13:234‑42.
2. Gdalevich M, Mimouni D, Mimouni M. Breast‑feeding and the
risk of bronchial asthma in childhood: A systematic review with
meta‑analysis of prospective studies. J Pediatr 2001;139:261‑6.
3. Kruse L, Denk CE, Feldman‑Winter L, Rotondo FM. Longitudinal
patterns of breastfeeding initiation. Matern Child Health J
4. Hanson L, Silfverdal SA, Strömbäck L, Erling V, Zaman S,
Olcén P, et al. The immunological role of breast feeding. Pediatr
Allergy Immunol 2001;12 Suppl 14:15‑9.
5. Alvarado BE, Zunzunegui MV. Growth trajectories are influenced
by breast‑feeding and infant health in an Afro‑Colombian
community. Community Int Nutr 2018;1:2171‑8.
6. Duong DV, Binns CW, Lee AH. Breast‑feeding initiation and
exclusive breast‑feeding in rural Vietnam. Public Health Nutr
7. Theofilogiannakou M, Skouroliakou M, Gounaris A,
Panagiotakos D, Markantonis SL. Breast‑feeding in Athens,
Greece: Factors associated with its initiation and duration.
J Pediatr Gastroenterol Nutr 2006;43:379‑84.
8. Brodribb W, Fallon A, Jackson C, Hegney D. The relationship
between personal breastfeeding experience and the breastfeeding
attitudes, knowledge, confidence and effectiveness of Australian
GP registrars. Matern Child Nutr 2008;4:264‑74.
9. Nakar S, Peretz O, Hoffman R, Grossman Z, Kaplan B, Vinker S. Attitudes and knowledge on breastfeeding among
paediatricians, family physicians, and gynaecologists in Israel.
Acta Paediatr 2007;96:848‑51.
10. Taveras EM, Capra AM, Braveman PA, Jensvold NG, Escobar GJ,
Lieu TA, et al. Clinician support and psychosocial risk factors
associated with breastfeeding discontinuation. Pediatrics
11. Oche MO, Umar AS, Ahmed H. Knowledge and practice of
exclusive breastfeeding in Kware, Nigeria. Afr Health Sci
12. Karkada S. Effectiveness of an informational leaflet on knowledge
regarding breast cancer among women of reproductive age. Nitte
University Journal of Health Science 2013;3:93‑5.
13. Roshan R, Sajjad S, Tanvir S. Impact of maternal education and
source of knowledge on breast feeding practices in Rawalpindi
city. MOJ Current Research & Reviews Research 2018;1:212‑4.
14. Mogre V, Dery M, Gaa PK. Knowledge, attitudes and
determinants of exclusive breastfeeding practice among Ghanaian
rural lactating mothers. Int Breastfeed J 2016;11:12.
15. Loss JN, Masthalina H, Agustina Z. Effect of nutrition counseling
knowledge and attitude toward mother breast feeding and baby
growth in Sub Lubuk Pakam. Nutr Weight Loss 2017;1:1‑5.
16. Sanadhya YK, Thakkar JP, Divakar DD, Pareek S, Rathore K,
Yousuf A, et al. Effectiveness of oral health education on
knowledge, attitude, practices and oral hygiene status among
12‑15‑year‑old schoolchildren of fishermen of Kutch district,
Gujarat, India. Int Marit Health 2014;65:99‑105.
17. DhandapanyG, BethouA, ArunagirinathanA, AnanthakrishnanS.
Antenatal counseling on breastfeeding – Is it adequate? A
descriptive study from Pondicherry, India. Int Breastfeed J
18. Kamran A, Shrifirad G, Mirkarimi SK, Farahani A. Effectiveness
of breastfeeding education on the weight of child and self‑efficacy
of mothers – 2011. J Educ Health Promot 2012;1:11.
19. Ahmed A, Hafez A, Entesar M, Mohammed O. Effect of antenatal
educational guidelines on mother ’s knowledge. IOSR Journal of
Nursing and Health Science 2018;7:21‑6.
20. Odesanya A, Hassan S, Olaluwoye D. Mass media and
maternal healthcare : A critical discourse. New Media and Mass
Communication 2015;3:63‑72.
21. Mona D, Azalea FW. Leaflet and pocketbook as an education tool
to change level of dental health knowledge. Bali Medical Journal
22. Al Bardaweel S, Dashash M. E‑learning or educational leaflet:
Does it make a difference in oral health promotion? A clustered
randomized trial. BMC Oral Health 2018;18:81.
23. Mokhtari F, Kazemi A, Ehsanpour S. Effect of educational
intervention program for parents on adolescents’nutritional
behaviors in Isfahan in 2016. J Educ Health Promot 2017;6:103.
24. Sharifirad GR, Rezaeian M, Jazini A, Etemadi ZS. Knowledge,
attitude and performance of academic members regarding
effective communication skills in education. J Educ Health Promot