Maternal Nutritional Adequacy and Breast Milk Production Among Lactating Mothers in a Rural Primary Health Care Setting in Indonesia
Abstract
Adequate maternal nutrition during lactation is essential for maintaining maternal health and supporting optimal breast milk production. However, evidence regarding the relationship between maternal nutritional adequacy and breast milk production in primary health care settings remains limited, particularly in rural areas of Indonesia. This study aimed to examine the association between maternal nutritional adequacy and breast milk production among lactating mothers in a primary health care setting in North Aceh, Indonesia. A descriptive analytic study with a cross-sectional design was conducted from June to August 2024 among lactating mothers in the catchment area of the Nisam Primary Health Center, North Aceh, Indonesia. Total sampling was employed, and all eligible lactating mothers were included, resulting in a final sample of 41 participants. Maternal nutritional adequacy was assessed as a composite variable encompassing dietary intake, meal patterns, nutritional knowledge, and socioeconomic conditions. Breast milk production was evaluated using validated maternal-report indicators and categorized as adequate or inadequate. Data were analyzed using descriptive statistics and the Chi-square test, with statistical significance set at p < 0.05. Complete data were obtained from all 41 participants. Lactating mothers with adequate maternal nutritional status were more likely to report adequate breast milk production than those with inadequate nutritional status. The Chi-square analysis demonstrated a statistically significant association between maternal nutritional adequacy and breast milk production (p < 0.05). Maternal nutritional adequacy was significantly associated with adequate breast milk production among lactating mothers in a rural primary health care setting in North Aceh. These findings suggest that integrating routine nutritional assessment and nutrition-focused counseling into maternal and child health services may support favorable breastfeeding outcomes. Further longitudinal studies using objective measures of breast milk production are warranted to clarify the temporal relationship between maternal nutritional adequacy and breastfeeding outcomes.
There is no Figure or data content available for this article
References
- 1. Smilowitz JT, Allen LH, Dallas DC, McManaman J, Raiten DJ, Rozga M, et al. Ecologies, synergies, and biological systems shaping human milk composition—a report from “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” Working Group 2. The American Journal of Clinical Nutrition. 2023 May 1;Breastmilk Ecology: Genesis of Infant Nutrition: BEGIN Project117:S28–42. doi:10.1016/j.ajcnut.2022.11.027
- 2. Froń A, Orczyk-Pawiłowicz M. Breastfeeding Beyond Six Months: Evidence of Child Health Benefits. Nutrients. 2024 Nov 14;16(22):3891. doi:10.3390/nu16223891 PubMed PMID: 39599677; PubMed Central PMCID: PMC11597163.
- 3. World Health Organization. who.int [Internet]. [cited 2025 Jul 1]. Infant and young child feeding. Available from: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding
- 4. Donovan SM, Aghaeepour N, Andres A, Azad MB, Becker M, Carlson SE, et al. Evidence for human milk as a biological system and recommendations for study design—a report from “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” Working Group 4. The American Journal of Clinical Nutrition. 2023 May 1;Breastmilk Ecology: Genesis of Infant Nutrition: BEGIN Project117:S61–86. doi:10.1016/j.ajcnut.2022.12.021
- 5. Jouanne M, Oddoux S, Noël A, Voisin-Chiret AS. Nutrient Requirements during Pregnancy and Lactation. Nutrients. 2021 Feb 21;13(2):692. doi:10.3390/nu13020692 PubMed PMID: 33670026; PubMed Central PMCID: PMC7926714.
- 6. Samuel TM, Zhou Q, Giuffrida F, Munblit D, Verhasselt V, Thakkar SK. Nutritional and Non-nutritional Composition of Human Milk Is Modulated by Maternal, Infant, and Methodological Factors. Front Nutr. 2020 Sep 16;7. doi:10.3389/fnut.2020.576133
- 7. Carretero-Krug A, Montero-Bravo A, Morais-Moreno C, Puga AM, Samaniego-Vaesken M de L, Partearroyo T, et al. Nutritional Status of Breastfeeding Mothers and Impact of Diet and Dietary Supplementation: A Narrative Review. Nutrients. 2024 Jan 19;16(2):301. doi:10.3390/nu16020301 PubMed PMID: 38276540; PubMed Central PMCID: PMC10818638.
- 8. Kinshella MLW, Prasad S, Hiwa T, Vidler M, Nyondo-Mipando AL, Dube Q, et al. Barriers and facilitators for early and exclusive breastfeeding in health facilities in Sub-Saharan Africa: a systematic review. Glob Health Res Policy. 2021 Jul 6;6(1):21. doi:10.1186/s41256-021-00206-2 PubMed PMID: 34229756; PubMed Central PMCID: PMC8259208.
- 9. Favara G, Maugeri A, Barchitta M, Lanza E, Magnano San Lio R, Agodi A. Maternal Lifestyle Factors Affecting Breast Milk Composition and Infant Health: A Systematic Review. Nutrients. 2024 Dec 27;17(1):62. doi:10.3390/nu17010062 PubMed PMID: 39796495; PubMed Central PMCID: PMC11723272.
- 10. Petersohn I, Hellinga AH, van Lee L, Keukens N, Bont L, Hettinga KA, et al. Maternal diet and human milk composition: an updated systematic review. Front Nutr. 2024 Jan 23;10:1320560. doi:10.3389/fnut.2023.1320560 PubMed PMID: 38352250; PubMed Central PMCID: PMC10862141.
- 11. Karlina D, Nasrullah N, Sufyan DL. Analysis of Differences in Breast Milk Production and Nutritional Status of Breastfeeding Mothers in Limo Subdistrict, Depok Before and After Consuming Food Bars Made from Katuk (Sauropus Androgynus) and Torbangun (Coleus Amboinicus) Leaves. Vol. 9. 2025;9(2).
- 12. Rachmadiani AP, Nadhiroh SR. The Nutritional Status of Breastfeeding Mothers and Breastfeeding Adequacy in Indonesia: A Systematic Review. Journal of Maternal and Child Health. 2024 Jul 16;9(4):450–61. doi:10.26911/thejmch.2024.09.04.02
- 13. Yoto M, Laksono AD, Devy SR, Luthviatin N, Nafikadini I, Nandini N, et al. Encouraging Healthcare Childbirth to Increase Exclusive Breastfeeding: Evidence from Madurese, Indonesia: Mendorong Persalinan di Pelayanan Kesehatan untuk Meningkatkan Pemberian ASI Eksklusif: Bukti dari Masyarakat Madura, Indonesia. AMNT. 2025 Mar 14;9(1):45–54. doi:10.20473/amnt.v9i1.2025.45-54
- 14. Basrowi RW, Darus F, Sundjaya T, Arumndari R. Maternal Nutrition: The Foundation of Breastfeeding and Beyond. Vol. 9. 2025;9(4).
- 15. Marshall NE, Abrams B, Barbour LA, Catalano P, Christian P, Friedman JE, et al. The importance of nutrition in pregnancy and lactation: lifelong consequences. Am J Obstet Gynecol. 2022 May;226(5):607–32. doi:10.1016/j.ajog.2021.12.035 PubMed PMID: 34968458; PubMed Central PMCID: PMC9182711.
- 16. Chouli M, Bothou A, Kyrkou G, Kaliarnta S, Dimitrakopoulou A, Diamanti A. An updated review of popular dietary patterns during pregnancy and lactation: Trends, benefits, and challenges. Metabolism Open. 2025 Mar 1;25:100353. doi:10.1016/j.metop.2025.100353
- 17. Ghabashi MA, Babateen AM, Zagzoog AM, Aljaadi AM. The Impact of Nutritional Knowledge of Mothers on Their Children’s Nutritional Knowledge and Weight Status. Healthcare. 2025 Jan;13(17):2226. doi:10.3390/healthcare13172226
- 18. Noor MS, Andrestian MD, Dina RA, Ferdina AR, Dewi Z, Hariati NW, et al. Analysis of Socioeconomic, Utilization of Maternal Health Services, and Toddler’s Characteristics as Stunting Risk Factors. Nutrients. 2022 Jan;14(20):4373. doi:10.3390/nu14204373
- 19. Alristina AD, Laili RD, Nagy É, Feith HJ. The Importance of Socioeconomic Factors Associated with Maternal Nutrition Knowledge and Undernutrition Among Children Under Five. Nutrients. 2025 Oct 24;17(21):3355. doi:10.3390/nu17213355 PubMed PMID: 41228428; PubMed Central PMCID: PMC12610531.
- 20. Kavle JA. Strengthening maternal nutrition counselling during routine health services: a gap analysis to guide country programmes. Public Health Nutr. 26(2):363–80. doi:10.1017/S1368980022002129 PubMed PMID: 36210775; PubMed Central PMCID: PMC13076078.
- 21. Dewidar O, John J, Baqar A, Madani MT, Saad A, Riddle A, et al. Effectiveness of nutrition counseling for pregnant women in low‐ and middle‐income countries to improve maternal and infant behavioral, nutritional, and health outcomes: A systematic review. Campbell Syst Rev. 2023 Nov 29;19(4):e1361. doi:10.1002/cl2.1361 PubMed PMID: 38034903; PubMed Central PMCID: PMC10687348.
How to Cite This
Copyright and Permissions

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Publishing your paper with Jurnal Kesehatan Ibu dan Anak means that the author or authors retain the copyright in the paper. Jurnal Kesehatan Ibu dan Anak granted an exclusive reuse license by the author(s), but the author(s) are able to put the paper onto a website, distribute it to colleagues, give it to students, use it in your thesis etc, even commercially. The author(s) can reuse the figures and tables and other information contained in their paper published by Jurnal Kesehatan Ibu dan Anak in future papers or work without having to ask anyone for permission, provided that the figures, tables or other information that is included in the new paper or work properly references the published paper as the source of the figures, tables or other information, and the new paper or work is not direct at the private monetary gain or commercial advantage.
Jurnal Kesehatan Ibu dan Anak provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. This journal is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. This license lets others remix, transform, and build upon the material for any purpose, even commercially.
Jurnal Kesehatan Ibu dan Anak Open Access articles are distributed under this Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA). Articles can be read and shared for All purposes under the following conditions:
- BY: You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- SA: If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
