{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:43:39Z","timestamp":1783100619473,"version":"3.54.6"},"reference-count":58,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:00:00Z","timestamp":1701129600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014538","name":"Indonesia Endowment Fund for Education","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100014538","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Early initiation of breastfeeding (EIBF) is key to reducing neonatal morbidity and mortality, however, little is known about the determinants of the trends of EIBF prevalence in Indonesia. This study aims to assess the contributing factors to the changes in the prevalence of EIBF between 2007 and 2017.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>We analysed data from the 2007, 2012, and 2017 Indonesia Demographic and Health Surveys to estimate the trends in EIBF. A multivariate logistic decomposition model was fitted to examine variables associated with changes in the percentage of EIBF from 2007 to 2017. The contributing factors to changes in EIBF prevalence were categorized into either compositional or behavioural changes, with each of them divided into portions or percentages of contribution (pct) of the independent variables. The former refers to the changes in the distribution of samples, while the latter refers to the changes in the behavioural responses toward EIBF in both surveys. All analyses accounted for the complex study design and potential confounding factors.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>An increase in the prevalence of EIBF from 49.9% to 56.5% was recorded between 2012 and 2017, with an overall increase of 16.9 percentage points from 2007 to 2017. At the aggregate level, the compositional differences did not significantly contribute to the changes in the percentage of EIBF, while 98.3pct (p &lt; 0.001) was associated with changes in mothers\u2019 behavioural response towards EIBF. The composition changes in the geographical region of Sumatra, and caesarean delivery negatively contributed to the changes in EIBF prevalence with -0.6pct and -14.2pct, respectively. However, the compositional differences in those living in Kalimantan &amp; Sulawesi, first-time mothers, and small-born infants positively contributed to the change. Behaviour changes in mothers with higher education (8.8pct), from higher income households (-17.5pct), and those residing in Sumatra (-8.2pct) and Kalimantan &amp; Sulawesi (-10.2pct) significantly contributed to the upward trend in EIBF prevalence.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>Almost half of the newborns experienced delayed breastfeeding initiation despite the improvement in the prevalence of EIBF. Therefore, further research and interventions on behaviour change in mother\u2019s attitudes towards EIBF, especially among those undergoing caesarean delivery, living in Kalimantan or Sulawesi, and from wealthier households, are recommended to close this gap.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0294900","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T19:11:32Z","timestamp":1701198692000},"page":"e0294900","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Trends and determinants of early initiation of breastfeeding in Indonesia: A multivariate decomposition analysis"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5431-9151","authenticated-orcid":true,"given":"Siti","family":"Nurokhmah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5500-4410","authenticated-orcid":true,"given":"Lucinda","family":"Middleton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judhiastuty","family":"Februhartanty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aryono","family":"Hendarto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,11,28]]},"reference":[{"key":"pone.0294900.ref001","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S0140-6736(03)13811-1","article-title":"How many child deaths can we prevent this year?","volume":"362","author":"G Jones","year":"2003","journal-title":"The Lancet"},{"key":"pone.0294900.ref002","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S0140-6736(15)01024-7","article-title":"Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect","volume":"387","author":"CG Victora","year":"2016","journal-title":"Lancet Lond Engl"},{"key":"pone.0294900.ref003","volume-title":"Global strategy for infant and young child feeding.","author":"World Health Organization and the United Nations Children\u2019s Fund (UNICEF), UNICEF","year":"2003"},{"key":"pone.0294900.ref004","first-page":"30","article-title":"Early Initiation of Breastfeeding Related to Exclusive Breastfeeding and Breastfeeding Duration in Rural and Urban Areas in Subang, West Java, Indonesia.","volume":"5","author":"TAE Permatasari","year":"2016","journal-title":"Journal of Health Research"},{"key":"pone.0294900.ref005","volume-title":"Implementation guidance: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: the revised baby-friendly hospital initiative.","author":"World Health Organization, United Nations Children\u2019s Fund (UNICEF).","year":"2018"},{"key":"pone.0294900.ref006","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1007\/s10995-014-1526-8","article-title":"Timing of Breastfeeding Initiation and Exclusivity of Breastfeeding During the First Month of Life: Effects on Neonatal Mortality and Morbidity\u2014A Systematic Review and Meta-analysis.","volume":"19","author":"J Khan","year":"2015","journal-title":"Matern Child Health J."},{"key":"pone.0294900.ref007","doi-asserted-by":"crossref","first-page":"e1002904","DOI":"10.1371\/journal.pmed.1002904","article-title":"Early initiation of breastfeeding and severe illness in the early newborn period: An observational study in rural Bangladesh.","volume":"16","author":"S Raihana","year":"2019","journal-title":"PLOS Med."},{"issue":"Suppl 3","key":"pone.0294900.ref008","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1186\/1471-2458-13-S3-S19","article-title":"Time to initiation of breastfeeding and neonatal mortality and morbidity: a systematic review.","volume":"13","author":"AK Debes","year":"2013","journal-title":"BMC Public Health"},{"key":"pone.0294900.ref009","doi-asserted-by":"crossref","first-page":"e0180722","DOI":"10.1371\/journal.pone.0180722","article-title":"Delayed breastfeeding initiation and infant survival: A systematic review and meta-analysis.","volume":"12","author":"ER Smith","year":"2017","journal-title":"PLOS ONE."},{"key":"pone.0294900.ref010","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1016\/j.midw.2015.07.008","article-title":"Does skin-to-skin contact and breast feeding at birth affect the rate of primary postpartum haemorrhage: Results of a cohort study.","volume":"31","author":"A Saxton","year":"2015","journal-title":"Midwifery"},{"key":"pone.0294900.ref011","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0140-6736(07)61693-6","article-title":"What works? Interventions for maternal and child undernutrition and survival","volume":"371","author":"ZA Bhutta","year":"2008","journal-title":"Lancet Lond Engl"},{"key":"pone.0294900.ref012","volume-title":"On my mind: promoting, protecting and caring for children\u2019s mental health.","author":"UNICEF","year":"2021"},{"key":"pone.0294900.ref013","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/S0140-6736(22)01932-8","article-title":"Breastfeeding: crucially important, but increasingly challenged in a market-driven world","volume":"401","author":"R P\u00e9rez-Escamilla","year":"2023","journal-title":"The Lancet"},{"key":"pone.0294900.ref014","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/S0140-6736(22)01931-6","article-title":"Marketing of commercial milk formula: a system to capture parents, communities, science, and policy","volume":"401","author":"N Rollins","year":"2023","journal-title":"The Lancet"},{"key":"pone.0294900.ref015","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/S0140-6736(22)01933-X","article-title":"The political economy of infant and young child feeding: confronting corporate power, overcoming structural barriers, and accelerating progress","volume":"401","author":"P Baker","year":"2023","journal-title":"The Lancet"},{"key":"pone.0294900.ref016","doi-asserted-by":"crossref","DOI":"10.21109\/kesmas.v16i2.4283","article-title":"Prevalence and Determinants of Pre-lacteal Feeding: Insights from the 2017 Indonesia Demographic and Health Survey.","volume":"16","author":"S Nurokhmah","year":"2021","journal-title":"Kesmas Natl Public Health J."},{"issue":"Suppl 3","key":"pone.0294900.ref017","doi-asserted-by":"crossref","first-page":"e13368","DOI":"10.1111\/mcn.13368","article-title":"Impact of prelacteal feeds and neonatal introduction of breast milk substitutes on breastfeeding outcomes: A systematic review and meta-analysis.","volume":"18","author":"R P\u00e9rez-Escamilla","year":"2022","journal-title":"Matern Child Nutr"},{"key":"pone.0294900.ref018","author":"Ministry of Health (Kemenkes).","year":"2004","journal-title":"Decree of the Minister of Health of the Republic of Indonesia No 450\/MENKES\/SK\/VI\/2004 on Exclusive Breastfeeding in Indonesia."},{"key":"pone.0294900.ref019","author":"Ministry of Health (Kemenkes).","year":"1997","journal-title":"Decree of the Minister of Health of the Republic of Indonesia No. 237\/Menkes\/SK\/IV\/1997 on Marketing of Breast Milk Substitutes"},{"key":"pone.0294900.ref020","author":"Government of the Republic Indonesia","year":"2012","journal-title":"Government Regulation No. 33\/2012 on Exclusive Breastfeeding."},{"key":"pone.0294900.ref021","first-page":"17","volume-title":"Legal System in Indonesia 2005.","author":"ASEAN Law Association","year":"2019"},{"key":"pone.0294900.ref022","doi-asserted-by":"crossref","first-page":"5976","DOI":"10.3390\/ijerph18115976","article-title":"Delayed Initiation of Breastfeeding and Role of Mode and Place of Childbirth: Evidence from Health Surveys in 58 Low- and Middle- Income Countries (2012\u20132017).","volume":"18","author":"S Raihana","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0294900.ref023","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.jpeds.2018.08.008","article-title":"Factors Associated with Breastfeeding Initiation and Continuation: A Meta-Analysis","volume":"203","author":"SS Cohen","year":"2018","journal-title":"J Pediatr"},{"key":"pone.0294900.ref024","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s13006-016-0076-7","article-title":"Early initiation of breastfeeding: a systematic literature review of factors and barriers in South Asia.","volume":"11","author":"IK Sharma","year":"2016","journal-title":"Int Breastfeed J"},{"key":"pone.0294900.ref025","doi-asserted-by":"crossref","first-page":"2034","DOI":"10.1093\/jn\/nxz167","article-title":"Information Diffusion and Social Norms Are Associated with Infant and Young Child Feeding Practices in Bangladesh","volume":"149","author":"PH Nguyen","year":"2019","journal-title":"J Nutr"},{"key":"pone.0294900.ref026","volume-title":"Indonesia Demographic and Health Survey 2007","author":"Statistics Indonesia (Badan Pusat Statistik\u2014BPS), Macro International","year":"2008"},{"key":"pone.0294900.ref027","volume-title":"Indonesia Demographic and Health Survey 2012","author":"National Population and Family Planning Board (BKKBN), Statistics Indonesia (BPS), Ministry of Health (Kemenkes), ICF","year":"2012"},{"key":"pone.0294900.ref028","volume-title":"Indonesia Demographic and Health Survey 2017","author":"National Population and Family Planning Board (BKKBN), Statistics Indonesia (BPS), Ministry of Health (Kemenkes), ICF","year":"2018"},{"key":"pone.0294900.ref029","volume-title":"Indicators for assessing infant and young child feeding practices: definitions and measurement methods","author":"World Health Organization, United Nations Children\u2019s Fund (UNICEF).","year":"2021"},{"key":"pone.0294900.ref030","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1177\/1536867X1201100404","article-title":"Mvdcmp: Multivariate Decomposition for Nonlinear Response Models.","volume":"11","author":"DA Powers","year":"2012","journal-title":"The Stata Journal"},{"key":"pone.0294900.ref031","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1016\/j.pedn.2020.08.004","article-title":"Women\u2019s Empowerment and Determinants of Early Initiation of Breastfeeding: A Scoping Review.","volume":"56","author":"S Hadisuyatmana","year":"2021","journal-title":"J Pediatr Nurs"},{"key":"pone.0294900.ref032","doi-asserted-by":"crossref","first-page":"182","DOI":"10.3961\/jpmph.21.448","article-title":"Determinants of Optimal Breastfeeding Practices in Indonesia: Findings From the 2017 Indonesia Demographic Health Survey.","volume":"55","author":"S Nurokhmah","year":"2022","journal-title":"J Prev Med Pub Health."},{"key":"pone.0294900.ref033","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s13006-022-00496-3","article-title":"Association between place of birth and timely breastfeeding initiation among Cambodian women: a population-based study.","volume":"17","author":"RM Harriott","year":"2022","journal-title":"Int Breastfeed J"},{"key":"pone.0294900.ref034","author":"Global Breastfeeding Collective, UNICEF, WHO","year":"2022","journal-title":"Global breastfeeding scorecard 2022: protecting breastfeeding through further investments and policy actions"},{"key":"pone.0294900.ref035","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1177\/084456211304500303","article-title":"Infant-Feeding among Low-Income Women: The Social Context that Shapes their Perspectives and Experiences","volume":"45","author":"JT Newhook","year":"2013","journal-title":"Can J Nurs Res"},{"key":"pone.0294900.ref036","first-page":"5","article-title":"Factors associated with the initiation and duration of breastfeeding: a review of the literature.","volume":"7","author":"JA Scott","year":"1999","journal-title":"Breastfeed Rev Prof Publ Nurs Mothers Assoc Aust"},{"key":"pone.0294900.ref037","doi-asserted-by":"crossref","first-page":"308","DOI":"10.9745\/GHSP-D-20-00361","article-title":"Initiation of Breastfeeding in Low- and Middle-Income Countries: A Time-to-Event Analysis.","volume":"9","author":"L Mallick","year":"2021","journal-title":"Glob Health Sci Pract"},{"key":"pone.0294900.ref038","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/S0140-6736(18)31928-7","article-title":"Global epidemiology of use of and disparities in caesarean sections","volume":"392","author":"T Boerma","year":"2018","journal-title":"The Lancet"},{"key":"pone.0294900.ref039","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s13052-021-01032-5","article-title":"Trends and determinants of breastfeeding within one hour in Ethiopia, further analysis of Ethiopian Demographic and Health Survey: multivariate decomposition analysis","volume":"47","author":"TY Birhan","year":"2021","journal-title":"Ital J Pediatr"},{"key":"pone.0294900.ref040","doi-asserted-by":"crossref","first-page":"e260","DOI":"10.1016\/S2214-109X(15)70094-X","article-title":"Use of the Robson classification to assess caesarean section trends in 21 countries: a secondary analysis of two WHO multicountry surveys","volume":"3","author":"JP Vogel","year":"2015","journal-title":"Lancet Glob Health"},{"key":"pone.0294900.ref041","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1186\/s12884-022-04992-6","article-title":"Rural\u2013urban disparities in caesarean deliveries in sub-Saharan Africa: a multivariate non-linear decomposition modelling of Demographic and Health Survey data.","volume":"22","author":"BO Ahinkorah","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"pone.0294900.ref042","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1186\/s12978-020-00983-y","article-title":"Reducing unnecessary caesarean sections: scoping review of financial and regulatory interventions.","volume":"17","author":"N Opiyo","year":"2020","journal-title":"Reprod Health"},{"key":"pone.0294900.ref043","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1007\/s13312-018-1376-3","article-title":"Improving First-hour Breastfeeding Initiation Rate After Cesarean Deliveries: A Quality Improvement Study.","volume":"55","author":"S Dudeja","year":"2018","journal-title":"Indian Pediatr."},{"key":"pone.0294900.ref044","doi-asserted-by":"crossref","first-page":"825","DOI":"10.3390\/nu13030825","article-title":"Understanding the Enablers and Barriers to Appropriate Infants and Young Child Feeding Practices in India: A Systematic Review.","volume":"13","author":"on behalf of the Global Maternal and Child Health Research Collaboration (GloMACH).","year":"2021","journal-title":"Nutrients"},{"key":"pone.0294900.ref045","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1071\/NB05013","article-title":"Factors affecting breastfeeding practices: applying a conceptual framework.","volume":"16","author":"D Hector","year":"2005","journal-title":"New South Wales Public Health Bull"},{"key":"pone.0294900.ref046","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1891\/1946-6560.24.2.119","article-title":"An Integrative Review of Factors Influencing Breastfeeding in Adolescent Mothers.","volume":"24","author":"S Kanhadilok","year":"2015","journal-title":"J Perinat Educ."},{"key":"pone.0294900.ref047","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s13006-021-00400-5","article-title":"Effectiveness of peer counseling and membership in breastfeeding support groups in promoting optimal breastfeeding behaviors in the Philippines.","volume":"16","author":"OP Saniel","year":"2021","journal-title":"Int Breastfeed J."},{"key":"pone.0294900.ref048","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/978-3-031-11840-1","volume-title":"Fertility Transition in the Developing World.","author":"J Bongaarts","year":"2022"},{"issue":"Suppl 4","key":"pone.0294900.ref049","doi-asserted-by":"crossref","first-page":"e12698","DOI":"10.1111\/mcn.12698","article-title":"Trends and predictors of optimal breastfeeding among children 0\u201323 months, South Asia: Analysis of national survey data.","volume":"14","author":"RK Benedict","year":"2018","journal-title":"Matern Child Nutr"},{"key":"pone.0294900.ref050","doi-asserted-by":"crossref","first-page":"e0239515","DOI":"10.1371\/journal.pone.0239515","article-title":"Determinants of breastfeeding practices in Myanmar: Results from the latest nationally representative survey.","volume":"15","author":"Y Yadanar","year":"2020","journal-title":"PloS One."},{"key":"pone.0294900.ref051","doi-asserted-by":"crossref","first-page":"2689","DOI":"10.1017\/S1368980018001453","article-title":"Barriers to exclusive breast-feeding in Indonesian hospitals: a qualitative study of early infant feeding practices.","volume":"21","author":"VJ Flaherman","year":"2018","journal-title":"Public Health Nutr"},{"key":"pone.0294900.ref052","doi-asserted-by":"crossref","first-page":"354","DOI":"10.4094\/chnr.2021.27.4.354","article-title":"Kangaroo mother care practices for low birthweight newborns in a district hospital in Indonesia.","volume":"27","author":"S Choirunisa","year":"2021","journal-title":"Child Health Nurs Res"},{"key":"pone.0294900.ref053","first-page":"91","article-title":"Socio-economic factors and use of maternal health services are associated with delayed initiation and non-exclusive breastfeeding in Indonesia: secondary analysis of Indonesia Demographic and Health Surveys 2002\/2003 and 2007.","volume":"23","author":"CR Titaley","year":"2014","journal-title":"Asia Pac J Clin Nutr"},{"key":"pone.0294900.ref054","first-page":"18","article-title":"Regional Regulation (PERDA) concerning Amendment to Klaten Regency Regional Regulation Number 7 Year 2008 on Early Initiation of Breastfeeding and Exclusive Breastfeeding.","author":"Klaten Regency","year":"2019","journal-title":"LD.2019\/NO.6 Aug 12"},{"key":"pone.0294900.ref055","doi-asserted-by":"crossref","first-page":"23779608211040287","DOI":"10.1177\/23779608211040287","article-title":"What Mother, Midwives, and Traditional Birth Helper Said About Early Initiation of Breastfeeding in Buginese-Bajo Culture.","volume":"7","author":"A Syam","year":"2021","journal-title":"SAGE Open Nurs"},{"key":"pone.0294900.ref056","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1257\/pol.20190245","article-title":"Cumulative Impacts of Conditional Cash Transfer Programs: Experimental Evidence from Indonesia.","volume":"12","author":"N Cahyadi","year":"2020","journal-title":"Am Econ J Econ Policy"},{"key":"pone.0294900.ref057","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/156482658100300304","article-title":"Perspectives on Infant Feeding: Decision-Making and Ecology.","volume":"3","author":"GH Pelto","year":"1981","journal-title":"Food Nutr Bull"},{"key":"pone.0294900.ref058","volume-title":"ASEAN Food and Nutrition Security Report 2021.","author":"ASEAN, UNICEF, WFP","year":"2022"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0294900","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T04:54:12Z","timestamp":1730696052000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0294900"}},"subtitle":[],"editor":[{"given":"Veincent Christian","family":"Pepito","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,11,28]]},"references-count":58,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0294900","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,28]]}}}