The Influence of Fathers’ Knowledge and Readiness on the Success of Early Breastfeeding Initiation Implementation Through Arja Muani-Based Health Education in Buleleng Regency, Bali
DOI:
https://doi.org/10.56294/hl2025737Keywords:
Fathers, Health education, Infant, MothersAbstract
Background: Early breastfeeding initiation (EBI) is the process of allowing a newborn to nurse immediately after birth, during which the baby is placed on the mother’s chest to find and latch onto the nipple within the first hour of life without external assistance. The success of EBI is greatly influenced by the father’s level of knowledge and readiness to support EBI, particularly with the backing of close family members. This study aims to determine the success rate of EBI implementation based on the father’s knowledge and readiness through health education using the traditional Arja Muani performing arts in Buleleng Regency, Bali.
Methods: This was a quantitative study using a quasi-experimental design with a post-test-only approach. A total of 60 respondents were selected using multistage random sampling based on sample size calculations. Data collection was conducted between February and March 2025 using structured questionnaires and observation sheets. Data were analyzed using SPSS software. Due to non-normal data distribution, Spearman’s Rank Bivariate Correlation Test was used, followed by multiple linear regression analysis at p<0,05 to assess the relationship between knowledge, readiness, and EBI success.
Results: There was a significant correlation between fathers’ knowledge and readiness regarding EBI after receiving Arja Muani-based health education. Linear regression results (r=0,600; R²=0,360; p=0,000) were all statistically significant.
Conclusion: There is a combined multiple correlation between the father’s knowledge and readiness in supporting EBI and the successful implementation of EBI through Arja Muani-based health education.
References
1. Gavine A., Shinwell SC., Buchanan P., et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev 2022;2022:CD001141. https://doi.org/10.1002/14651858.CD001141.pub6.
2. Wayan N., Hardiyani N., Made N., et al. Correlation between History Early Breastfeeding Initiation and Exclusive Breastfeeding among Mothers of Infants Aged. Warmadewa Med Journal) 2024;9:2527–4627. https://doi.org/10.22225/wmj.9.2.9963.79-88.
3. Karnasih IGA. Effectiveness of Leininger’s Transcultural-based GATHER Counseling Model on Exclusive Breastfeeding. Heal Notions 2021;5:156–62. https://doi.org/10.33846/hn50503.
4. Wahyuni S., Prabandari YS., Julia M., et al. Prenatal breastfeeding education (PBE) and breastfeeding counseling (BC) influence the prenatal exclusive breastfeeding (EBF) preparation. Basic Appl Nurs Res J 2024;4:125–32. https://doi.org/10.11594/banrj.04.02.09.
5. Khofiyah N., C FE. Determinants of Successful Implementation of Early Breastfeeding Initiation in RSU PKU Muhammadiyah Gamping , Yogyakarta. J EduHealth 2023;14:238–44.
6. Juanamasta IG., Wati NMN., Widana AAGOGO. Covid-19: A balinese viewpoint. Belitung Nurs J 2020;6:143–4. https://doi.org/10.33546/BNJ.1133.
7. Yunitasari E., Narendra YH., Pradanie R. Factors associated with exclusive breastfeeding based on transcultural nursing. EurAsian J Biosci Eurasia J Biosci 2020;14:2757–66.
8. Suardana IW., Yusuf A., Hargono R., et al. Spiritual Coping “Tri Hita Karana” among Older Adults during Pandemic COVID-19: A Perspective of Balinese Culture. Univers J Public Heal 2023;11:297–304. https://doi.org/10.13189/ujph.2023.110303.
9. Suardana IW., Yusuf A., Hargono R., et al. Spiritual coping “tri hita karana” and depression prevention behavior among the elderly during the Covid-19 pandemic. Healthc Low-Resource Settings 2024. https://doi.org/10.4081/hls.2024.13025.
10. Namasivayam V., Dehury B., Prakash R., et al. Association of prenatal counselling and immediate postnatal support with early initiation of breastfeeding in Uttar Pradesh, India. Int Breastfeed J 2021;16:1–12. https://doi.org/10.1186/s13006-021-00372-6.
11. Wagner S., Kersuzan C., Gojard S., et al. Breastfeeding initiation and duration in France: The importance of intergenerational and previous maternal breastfeeding experiences — results from the nationwide ELFE study. Midwifery 2019;69:67–75. https://doi.org/10.1016/j.midw.2018.10.020.
12. Tseng J-F., Chen S-R., Au H-K., et al. Effectiveness of an integrated breastfeeding education program to improve self-efficacy and exclusive breastfeeding rate: A single-blind, randomised controlled study. Int J Nurs Stud 2020;111:103770. https://doi.org/10.1016/j.ijnurstu.2020.103770.
13. Nielsen C., Li Y., Lewandowski M., et al. Breastfeeding initiation and duration after high exposure to perfluoroalkyl substances through contaminated drinking water: A cohort study from Ronneby, Sweden. Environ Res 2022;207:112206. https://doi.org/10.1016/j.envres.2021.112206.
14. Azza A., Susilo C. the Application of Transcultural Nursing Model in Perspective of Madura Culture Improving Breastfeeding Mother’S Behavior in Jember. Indones Nurs J Educ Clin 2017;2:9. https://doi.org/10.24990/injec.v2i1.122.
15. Vázquez-Sánchez MÁ., Casals C., Casals-Vázquez A., et al. Cultural adaptation and validation of the Transcultural Self-Efficacy Tool for use with undergraduate nursing students in Spain. Nurse Educ Today 2021;107:105106. https://doi.org/10.1016/j.nedt.2021.105106.
16. Woldeamanuel BT. Trends and factors associated to early initiation of breastfeeding, exclusive breastfeeding and duration of breastfeeding in Ethiopia: Evidence from the Ethiopia Demographic and Health Survey 2016. Int Breastfeed J 2020;15. https://doi.org/10.1186/s13006-019-0248-3.
17. Kuswara K., Knight T., Campbell KJ., et al. Breastfeeding and emerging motherhood identity: An interpretative phenomenological analysis of first time Chinese Australian mothers’ breastfeeding experiences. Women and Birth 2021;34:e292–301. https://doi.org/10.1016/j.wombi.2020.03.005.
18. Bowdler S., Nielsen W., Meedya S., et al. Applying Legitimation Code Theory to teach breastfeeding in nurse education: A case study. Nurse Educ Pract 2023;72:103780. https://doi.org/10.1016/j.nepr.2023.103780.
19. Dib S., Fair FJ., McCann LJ., et al. Effects of Exclusive Breastfeeding Promotion Interventions on Child Outcomes: A Systematic Review and Meta-Analysis. Ann Nutr Metab 2023;80:57–73. https://doi.org/10.1159/000535564.
20. Zuryani N., Erviantono T. Gender Dualism as Degendering Cosmic Multicultural Tolerance of Wargas: Community Security Practices in North Bali. In: Vandenberg A, Zuryani N, editors. Security, Democracy, and Society in Bali: Trouble with Protection. Singapore: Springer Singapore; 2020. p. 233–52.
21. Nyoman N., Suryani M. Cultural Values in the Role of Mantri Manis at the Arja Show. Int J Arts Humanit Soc Sci Stud 2021;6:2582–1601.
22. Vargas-Pérez S., Hernández-Martínez C., Canals-Sans J., et al. Factors influencing breastfeeding initiation, duration, and early cessation: a focus on maternal and infant characteristics. Int Breastfeed J 2025;20:49. https://doi.org/10.1186/s13006-025-00741-5.
23. Marsiglia FF., Booth JM. Cultural Adaptation of Interventions in Real Practice Settings. Res Soc Work Pract 2015;25:423–32. https://doi.org/10.1177/1049731514535989.
24. Runiari N., Ruspawan IDM., Candra IW., et al. Disaster Risk Management Model for Enhancing the Preparedness of Pregnant Women in Response to the Eruption of Mount Agung: A Quasi-Experimental Study. J Nurs Midwifery Sci 2024;11. https://doi.org/10.5812/jnms-146003.
25. Muthmainnah M., Salim LA., Nurmala I., et al. Enhancing Health Education Using Edutainment: A Quantitative Study in Malang Regency, Indonesia. Media Publ Promosi Kesehat Indones 2025;8:326–36. https://doi.org/10.56338/mppki.v8i5.7134.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Ni Wayan Dewi Tarini, Esti Yunitasari, Ilya Krisnana, Nursalam (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.