Improving implementation of early initiation of breastfeeding through a standard procedure flowchart

Ahmad Syafiq, Ria Rizki Palupi, Sandra Fikawati, Alifani Faiz Faradhil

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Early initiation of breastfeeding could reduce infant mortality rate, as well as provide support to achieve 6 months exclusive breastfeeding. In Indonesia, to date, there has been no clear, practical and comprehensive standard procedure of early initiation implementation. This study aimed to evaluate improvement in early initiation implementation through provision of a flowchart and explanation of the early initiation implementation procedure. A study with quasi-experimental design was conducted in April to May 2018 with 42 midwives in East Jakarta, Indonesia. Subjects were divided into two groups, 21 midwives in the intervention group and 21 midwives in the control group. Midwives in the intervention group received the flowchart and an explanation of the procedure, while midwives in the control group did not receive the flowchart and were asked to practise as usual. Univariate and bivariate data analysis were applied. There was a significant difference in implementation scores between the intervention and control groups. The average score of early initiation in the intervention group was higher (97.4) than the average score in the control group (78.3). In conclusion, a flowchart of procedure significantly improved early initiation implementation and should be adapted and distributed to midwives to increase the success of early initiation implementation.

Original languageEnglish
Pages (from-to)15-25
Number of pages11
JournalBreastfeeding Review
Issue number2
Publication statusPublished - Jul 2021


  • Early initiation
  • Education intervention
  • Standard procedure flowcharmidwife practice
  • Successful breastfeeding


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