Determinants of Formula Feeding among Mothers in Indonesia: The Role of Digital Media and Microeconomic Factors
Abstract
Background: Maternal decision‑making regarding the use of infant formula milk in Indonesia is shaped by a complex interplay of social, economic, and informational factors. This study aimed to elucidate the determinants of mothers’ choices when selecting formula milk in Sorong City, Indonesia, addressing gaps in previous research that overlooked the role of digital media and microeconomic factors in maternal decision‑making. Materials and Methods: This study employed a cross‑sectional observational design and was conducted from January to June 2024. A cohort of 180 mothers with children aged 0–24 months was selected using stratified random sampling. Data were collected using the Maternal Infant Nutrition Questionnaire (MIN‑Q). Multivariate logistic regression analysis was performed to identify the significant factors contributing to the decision to use formula milk. Results: The findings indicated that most respondents [88 (48.90%)] exclusively used formula milk, while 92 (51.10%) adopted a mixed feeding pattern. Logistic regression analysis revealed that the use of digital media for nutritional information was significantly associated with formula milk use (β = 0.21, P = 0.022), as were microeconomic factors such as savings or financial assistance (β = 0.18, P = 0.035). Conclusions: These findings highlight the need for government‑led interventions, including digital literacy programs and targeted financial subsidies for low‑income breastfeeding mothers, to promote exclusive breastfeeding. Therefore, credible digital education programs and more stringent regulations on formula milk
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Pérez Escamilla R, Tomori C, Hernández Cordero S, Baker P, Barros AJD, Bégin F, et al. Breastfeeding: Crucially important, but increasingly challenged in a market driven world. Lancet 2023;401:472 85.
Lokossou GAG, Kouakanou L, Schumacher A, Zenclussen AC. Human breast milk: From food to active immune response with disease protection in infants and mothers. Front Immunol 2022;13:849012.
World Health Organization. Infant and Young Child Feeding. Geneva: WHO; 2023. Available from: https://www.who.int/ news room/fact sheets/detail/infant and young child feeding.
World Health Organization. Breastfeeding. Geneva: WHO; 2023. Available from: https://www.who.int/health topics/ breastfeeding#tab=tab_1. [Last accessed on 2025 Mar 9].
World Health Organization. Exclusive Breastfeeding for Optimal Growth, Development and Health of Infants. Geneva: WHO; 2023. Available from: https://www.who.int/tools/ elena/interventions/exclusive breastfeeding. [Last accessed on 2025 Mar 9].
Indonesian Ministry of Health. Hasil Utama SKI 2023. Jakarta: BKPK Kemenkes; 2023. Available from: https://www.badankebijakan.kemkes. go.id/daftar frequently asked question seputar hasil utama ski 2023/ hasil utama ski 2023/. [Last accessed on 2025 Mar 9].
Central Bureau of Statistics. Persentase penduduk berumur 0 23 bulan yang pernah diberi ASI dan rata rata lama pemberian ASI menurut karakteristik di Kota Sorong, 2024. Sorong: BPS; 2024. Available from: https://sorongkota.bps.go.id/id/statistics table/1/NTM4IzE=/ persentase penduduk berumur 023 bulan baduta yang pernah diberi asi dan rata rata lama pemberian asi menurut karakteristik di kota sorong 2024.html. [Last accessed on 2025 Mar 9].
Central Bureau of Statistics. Percentage of Children Aged 0 23 Months who were ever Breastfed and the Average Duration of Breastfeeding by Characteristics in Sorong City, 2023. Sorong: Statistics Indonesia (BPS); 2023. Available from: https://sorongkota.bps.go.id/id/statisti cs table/1/NDQ2IzE=/persentase penduduk umur 0 23 bulan baduta yang pernah diberi asi dan rata rata lama pe mberian asi bulan menurut karakteristik di kota sorong 2023. html. [Last accessed on 2025 Mar 9].
Hidayana I, Prawindarti L, Umar N, Ambarwati K, Rosatriani F. Marketing of commercial milk formula during COVID 19 in Indonesia. Matern Child Nutr 2023;19:e13491.
National Legal Documentation and Information Network. Ministry of Health Legal Documentation and Information System (JDIH). Jakarta: Ministry of Health; 2024. Available from: https://jdih.kemkes.go.id. [Last accessed on 2025 Mar 9].
Paramashanti BA, Dibley MJ, Huda TM, Prabandari YS, Alam NA. Factors influencing breastfeeding continuation and formula feeding beyond six months in rural and urban households in Indonesia: A qualitative investigation. Int Breastfeed J 2023;18:48.
Topothai C, Tan GPP, van der Eijk Y. Commercial milk formula marketing following increased restrictions in Singapore: A qualitative study. Matern Child Nutr 2023;20:e13562.
Horwood C, Mapumulo S, Haskins L, Doherty T, Kingston G, Rollins N, et al. Women’s exposure to commercial milk formula marketing: A WHO multi country market research study. Glob Health 2024;20:85.
Zhu Z, Narayan A, Zhang S, Wang L, Zhu Y, Yang W, et al. How the marketing practices of commercial milk formula companies impact infant breastfeeding practices in China. BMJ Glob Health 2023;8:e012803.
Scarpa G, Berrang Ford L, Twesigomwe S, Kakwangire P, Galazoula M, Zavaleta Cortijo C, et al. Socio economic and environmental factors affecting breastfeeding and complementary feeding practices among Batwa and Bakiga communities in south western Uganda. PLoS Glob Public Health 2022;2:e0000144.
Kopp SJ, Kelly EA, DeFranco EA. Influence of social determinants of health on breastfeeding intent in the United States. Birth 2023;50:858 67.
Wood NK, Odom Maryon T, Smart DA. Factors associated with exclusive direct breastfeeding in the first 3 months. Nurs Womens Health 2022;26:299 307.
Thompson GH, Sefa E, Deshpande AS, Mensah R, Lenzi Weisbecker R, Wilder R, et al. Factors associated with exclusive breastfeeding for the first six months among caregivers of children under five years in northern Ghana: A cross sectional study. PLoS Glob Public Health 2024;4:e0003887.
Central Bureau of Statistics. Poverty Line (GK) in Sorong City. Sorong: BPS; 2024. Available from: https://sorongkota.bps.go.id/id/ statistics table/2/MzY2IzI=/garis kemiskinan gk di kota sorong. html. [Last accessed on 2025 Mar 9].
Central Bureau of Statistics. Sorong City in Figures 2023. Sorong: BPS; 2023. Available from: https://sorongkota.bps. go.id/id/publication/2023/02/28/bb6baf507c092797f3879308/ kota sorong dalam angka 2023.html. [Last accessed on 2025 Mar 9].
Central Bureau of Statistics. Percentage of Population Aged 0 17 Years with Birth Certificates by Characteristics in Sorong City, 2024. Sorong: BPS; 2024. Available from: https://sorongkota.bps.go.id/id/statistics table/1/NTI5IzE=/ persentase penduduk berumur 017 tahun yang memi liki akta kelahiran menurut karakteri stik di kota sorong 2024. html. [Last accessed on 2025 Mar 9].
Tahir M. Sorong City and Regency Social Service Ensures Effective Poverty Alleviation. Jakarta: RRI.co.id; 2023. Available from: https://www.rri.co.id/daerah/882328/dinas sosial kota dan kabupaten sorong pastikan pengentasan kemis kinan efektif. [Last accessed on 2025 Mar 9].
Gifelem M, Masinambow VAJ, Tumangkeng SYL. The effect of economic growth and inflation rate on poverty levels in Sorong City. J Berk Ilm Efisiensi 2023;23:25 36.
Central Bureau of Statistics. Economic Growth of Sorong City 2023. Sorong: BPS; 2023. Available from: https:// sorongkota.bps.go.id/id/pressrelease/2024/03/01/284/ pertumbuhan ekonomi kota sorong 2023.html. [Last accessed on 2025 Mar 9].
Pugu MR. Free from stunting as an indicator of human security for communities in Southwest Papua Province from the perspective of international relations. Syntax Lit J Ilm Indones 2023;8:6236 51.
Ramli U, Hasbi H, Basri L. The role of women in achieving family resilience in Klamana Village, East Sorong District, Sorong City. J Noken Ilmu Ilmu Sos 2022;8:111 21.
Alshowair A, Bail J, AlSuwailem F, Mostafa A, Abdel Azeem A. Use of virtual reality exercises in disaster preparedness training: A scoping review. SAGE Open Med 2024;12:20503121241241936.
Baker P, Smith JP, Garde A, Grummer Strawn LM, Wood B, Sen G, et al. The political economy of infant and young child feeding: Confronting corporate power, overcoming structural barriers, and accelerating progress. Lancet 2023;401:503 24.
Rollins N, Piwoz E, Baker P, Kingston G, McCoy D, Murukutla N, et al. Marketing of commercial milk formula: A system to capture parents, communities, science, and policy. Lancet 2023;401:486 502.
Neves PAR, Barros AJD, Gatica Domínguez G, Vaz JS, Baker P, Lutter CK. Maternal education and equity in breastfeeding: Trends and patterns in 81 low and middle income countries between 2000 and 2019. Int J Equity Health 2021;20:20.
Yue A, Cui M, Yang Z, Shi Y, Guo C, Song Q. Formula feeding: Evidence for health, nutrition and early childhood development during the critical first 1000 days from rural China. J Asian Econ 2023;85:101580.
Ali MS, Zegeye AF, Workneh BS, Zeleke GA, Mekonen EG, Aemro A, et al. Determinants of formula feeding among mothers with infants and young children in six Sub Saharan African countries: Multilevel analysis of demographic and health survey data. PLoS One 2024;19:e0311945.
He J, Yimyam S, Namprom N. Breastfeeding self efficacy, social support, and breastfeeding among Chinese mothers with late preterm infants. J Neonatal Nurs 2022;28:21 5.
Isiguzo C, Mendez DD, Demirci JR, Youk A, Mendez G, Davis EM, et al. Stress, social support, and racial differences: Dominant drivers of exclusive breastfeeding. Matern Child Nutr 2022;19:e13459.
Ekholuenetale M, Mistry SK, Chimoriya R, Nash S, Doyizode AM, Arora A. Socioeconomic inequalities in early initiation and exclusive breastfeeding practices in Bangladesh: Findings from the 2018 demographic and health survey. Int Breastfeed J 2021;16:73.
Hunt L, Thomson G, Whittaker K, Dykes F. Adapting breastfeeding support in areas of socio economic deprivation: A case study approach. Int J Equity Health 2021;20:83.
Fernandez P, Velasco S, Araujo A, Castillo V, Ruiz RB, Jimenez MF, et al. Demographic, socioeconomic, and sociocultural factors associated with any breastfeeding in homeless mothers. Matern Child Nutr 2021;17:e13167.
Maramag CC, Samaniego JAR, Castro MC, Zambrano P, Nguyen TT, Cashin J, et al. Maternity protection policies and the enabling environment for breastfeeding in the Philippines: A qualitative study. Int Breastfeed J 2023;18:60.
Hentges M, Pilot E. Making it “work”: Mothers’ perceptions of workplace breastfeeding and pumping at Dutch universities. Int Breastfeed J 2021;16:87.
Ickes SB, Sanders H, Denno DM, Myhre JA, Kinyua J, Singa B, et al. Exclusive breastfeeding among working mothers in Kenya: Perspectives from women, families and employers. Matern Child Nutr 2021;17:e13194.
Mgongo M, Ickes SB, Leyaro BJ, Mboya IB, Grounds S, Seiger ER, et al. Early infant feeding practices among women engaged in paid work in Africa: A systematic scoping review. Adv Nutr 2024;15:100179.
Ickes SB, Lemein HS, McKay A, Arensen K, Singa B, Kinyua J, et al. Mothers’ willingness to use workplace lactation supports: Evidence from formally employed mothers in Central Kenya. Curr Dev Nutr 2023;7:102032.
Topothai C, Topothai T, Suphanchaimat R, Waleewong O, Putthasri W, Patcharanarumol W, et al. Exclusive breastfeeding experiences of Thai mothers in metropolitan Bangkok. Int J Womens Health 2022;14:155 66.
Payán DD, Zahid N, Glenn J, Tran HT, Huong TTT, Moucheraud C. Implementation of two policies to extend maternity leave and further restrict marketing of breast milk substitutes in Vietnam: A qualitative study. Health Policy Plan 2022;37:472 82.
Flynn MA, Rodriguez Lainz A, Lara J, Rosales C, Feldstein F, Dominguez K, et al. An innovative United States Mexico community outreach initiative for Hispanic and Latino people in the United States: A collaborative public health network. Public Health Rep 2021;136:287 94.
Grubesic TH, Durbin KM. The complex geographies of telelactation and access to community breastfeeding support in the state of Ohio. PLoS One 2020;15:e0242457.
Doherty T, Pereira Kotze CJ, Luthuli S, Haskins L, Kingston G, Dlamini Nqeketo S, et al. They push their products through me: Health professionals’ perspectives on and exposure to marketing of commercial milk formula in Cape Town and Johannesburg, South Africa – A qualitative study. BMJ Open 2022;12:e055872.
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