Knowledge and attitudes of midwives significantly influence the implementation of early initiation of breastfeeding

Abstract

Early Initiation of Breastfeeding is a critical neonatal intervention proven to reduce morbidity and mortality during the first days of life. Despite national efforts to increase Early Initiation of Breastfeeding coverage, implementation remains inconsistent across health facilities, particularly at the primary care level. Midwives play a central role in facilitating Early Initiation of Breastfeeding; therefore, their knowledge and attitudes are essential determinants of successful practice. This study aims to analyze the relationship between midwives’ knowledge and attitudes and their implementation of Early Initiation of Breastfeeding in community health centers in Manggarai Regency. This analytical observational study employed a cross‑sectional design involving all 46 midwives working in community health centers across Manggarai Regency. Total population sampling was used. Data were collected through structured questionnaires measuring knowledge, attitudes, and Early Initiation of Breastfeeding implementation. Descriptive and bivariate analyses were conducted using the Chi‑square test. The majority of respondents demonstrated fair knowledge (60.86%) and positive attitudes (81.6%). Early Initiation of Breastfeeding implementation was higher among midwives with good knowledge (72.3%) and positive attitudes (81.6%). Statistical analysis showed significant associations between knowledge and Early Initiation of Breastfeeding implementation (p = 0.015) and between attitude and Early Initiation of Breastfeeding implementation (p = 0.021). These findings indicate that both cognitive and affective factors strongly influence midwives’ adherence to Early Initiation of Breastfeeding procedures. In conclusion, midwives’ knowledge and attitudes are significantly associated with the implementation of Early Initiation of Breastfeeding. Strengthening professional competence through continuous training, supportive supervision, and improved facility readiness is essential to enhance Early Initiation of Breastfeeding coverage and contribute to reducing neonatal mortality.

Keywords: Early Initiation of Breastfeeding; midwives; knowledge; attitude; neonatal care