•  
  •  
 

ORCID ID

Melviana Lubis: 0000-0003-4497-4467

Meisyah Putri Rozi: -

Abstract

Background: Exclusive breastfeeding provides substantial health benefits; however, disparities in knowledge and support persist. This study aimed to compare knowledge levels, attitudes, and motivation levels regarding exclusive breastfeeding between female medical and nonmedical students.

Methods: A cross-sectional survey was conducted at Universitas Muhammadiyah Sumatera Utara and involved 314 students from the 2023 cohort. A validated questionnaire was used to assess knowledge levels (16 items), attitude (IIFAS, 16 items), and motivation (15 items). Data were analyzed using the chi-square test, odds ratio (OR), and Spearman’s correlation.

Results: Medical students demonstrated significantly higher levels of knowledge (OR = 3.50; 95% CI: 1.93–6.33; p < 0.001), attitude (OR = 2.19; 95% CI: 1.34–3.58; p = 0.001), and motivation (OR = 2.81; 95% CI: 1.62–4.85; p < 0.001) toward exclusive breastfeeding than nonmedical students. However, misconceptions remain regarding the equivalence of formula to breast milk and the acceptability of breastfeeding in public. A moderate positive correlation was observed between knowledge and motivation levels (ρ = 0.375, p < 0.001).

Conclusion: Although structured health education enhances students’ breastfeeding perspectives, it does not completely address sociocultural and practical barriers. Broader, interdisciplinary education and supportive environments may better prepare students as future mothers and breastfeeding advocates.

References

  1. Lokossou GAG, Kouakanou L, Schumacher A, Zenclussen AC. Human breast milk: From food to active immune response with disease protection in infants and mothers. Front Immunol. 2022;13:1–19.
  2. Gertosio C, Meazza C, Pagani S, Bozzola M. Breastfeeding and its gamut of benefits. Minerva Pediatr. 2016;68:201–12.
  3. Hossain S, Mihrshahi S. Exclusive breastfeeding and childhood morbidity: A narrative review. Int J Environ Res Public Health. 2022;19(22):1–18.
  4. World Health Organization. World health fact sheets–infant and young child feeding. New York: World Health Organization, 2023.
  5. Kementerian Kesehatan. Survei Kesehatan Indonesia 2023. Jakarta: Kementerian Kesehatan, 2023. Indonesian.
  6. Hara LS, Afriwardi A, Desmawati D. Factors associated with exclusive breastfeeding at the Lubuk Buaya Health Center, Padang. Int J Res Rev. 2023;10:329–34.
  7. Assriyah H, Indriasari R, Hidayanti H, Thaha AR. Hubungan pengetahuan, sikap, umur, pendidikan, pekerjaan, psikologis dan inisiasi menyusui dini dengan pemberian ASI eksklusif di Puskesmas Sudiang. Jurnal Gizi Masyarakat Indonesia. 2021;9:30–8. Indonesian.
  8. Laksono AD, Wulandari RD, Ibad M, Kusrini I. The effects of mother’s education on achieving exclusive breastfeeding in Indonesia. BMC Public Health. 2021;21:14.
  9. Zahid I, Sheikh R, Ahmed A, Ladiwala ZFR, Lashkerwala SS, Memon AS. Knowledge and beliefs regarding breast-feeding in college students of Karachi. Australas Med J. 2016;9:386–95.
  10. Khresheh R, Suhaimat A, Jalamdeh F, Barclay L. Knowledge, attitude and practice of breastfeeding among women in the North of Jordan: A cross-sectional study. Int Breastfeed J. 2020;15:63.
  11. Leshi OO, Makanjuola MO. Breastfeeding knowledge, attitude and intention of nursing students in Nigeria. Open J Nurs. 2022;12:256–69.
  12. Mengestie ND, Yilma TM, Beshir MA, Paulos GK. Ehealth literacy of medical and health science students and factors affecting ehealth literacy in an Ethiopian university: A cross-sectional study. Appl Clin Inform. 2021;12:301–9.
  13. Dauletkaliyeva Z, Bolatova Z, Yerdessov N, Nukeshtayeva K, Zhamantayev O, Takuadina A, et al. Health literacy and influencing factors in university students across diverse educational fields in Kazakhstan. Sci Rep. 2025;15:3197.
  14. Zipora YC. Faktor-Faktor yang Berhubungan dengan Literasi Kesehatan Reproduksi Mahasiswa Program Sarjana Universitas Indonesia Tahun 2024 [Factors Associated with Reproductive Health Literacy of University of Indonesia Undergraduate Students in 2024] [thesis]. Depok: Universitas Indonesia; 2024. Indonesian.
  15. Butar HAB, Aryani L, Hartini E, Wulandari F. Perbandingan literasi kesehatan mahasiswa aktif Fakultas Kesehatan dengan non kesehatan Universitas Dian Nuswantoro Semarang. Afiasi Jurnal Kesehatan Masyarakat. 2024;9:146–54. Indonesian.
  16. Maki S, Al Awar S, Alhosani S, Alshamsi L, Alzaabi S, Alsaadi MA, et al. Awareness and knowledge about preconception healthcare: A cross-sectional study of early years UAE medical students. J Clin Med. 2025;14:181.
  17. Utami FS. Translasi dan validasi Iowa infants feeding attitude scale di Indonesia. Jurnal Kebidanan dan Keperawatan Aisyiyah. 2018;12:103–8. Indonesian.
  18. Hamade H, Naja F, Keyrouz S, et al. Knowledge, attitudes, and practices of Lebanese women regarding breastfeeding. Int Breastfeed J. 2014;9:19.
  19. Pereira SN, Pereira JP, Pereira JL, Gonçalves M, Machado MC. Attitudes of Portuguese university students towards breastfeeding. Midwifery. 2023;122:103627.
  20. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. PLoS Med. 2007;4:e296.
  21. Prastyoningsih A, Rohmantika D, Pratiwi EN, Maharani A, Rohmah AN. The effect of education breastfeeding on breastfeeding self-efficacy in Klaten, Central Java, Indonesia. Placentum: Jurnal Ilmiah Kesehatan dan Aplikasinya. 2021;9:1–5.
  22. Čatipović M, Puharić Z, Puharić D, Čatipović P, Grgurić J. Behaviour, attitudes, and knowledge of healthcare workers on breastfeeding. Children. 2022;9:1173.
  23. Froń A, Orczyk-Pawiłowicz M. Understanding the immunological quality of breast milk in maternal overweight and obesity. Nutrients. 2023;15:5016.
  24. Piwoz EG, Huffman SL. The impact of marketing of breast-milk substitutes on WHO- recommended breast-feeding practices. Food Nutr Bull. 2015;36:373–86.
  25. Ahmad RS, Sulaiman Z, Nik Hussain NH, Mohd Noor N. Working mothers' breastfeeding experience: A phenomenology qualitative approach. BMC Pregnancy Childbirth. 2022;22:85.
  26. Edemba PW, Irimu G, Musoke R. Knowledge, attitudes, and practice of breastmilk expression and storage among working mothers with infants under six months of age in Kenya. Int Breastfeed J. 2022;17:33.
  27. Basrowi RW, Sulistomo AB, Adi NP, Vandenplas Y. Benefits of a dedicated breastfeeding facility and support program for exclusive breastfeeding among workers in Indonesia. Pediatr Gastroenterol Hepatol Nutr. 2015;18:94–9.
  28. Campbell SH, Bernardes NO, Tharmaratnam T, Vieira FVM. Educational resources and curriculum on lactation for health undergraduate students: A scoping review. J Hum Lact. 2022;38:89–99.
  29. Moukarzel S, Mamas C, Farhat A, Abi Abboud A, Daly AJ. A qualitative examination of barriers against effective medical education and practices related to breastfeeding promotion and support in Lebanon. Med Educ Online. 2020;25:1723950.
  30. Gary AJ, Birmingham EE, Jones LB. Improving breast-feeding medicine in undergraduate medical education: A student survey and extensive curriculum review with suggestions for improvement. Educ Health (Abingdon). 2017;30:163–8.
  31. Ajzen I. The theory of planned behavior. Organ Behav Hum Dec. 1991;50:179–211.
  32. Newhook JT, Newhook LA, Midodzi WK, Goodridge JM, Burrage L, Gill N, et al. Poverty and breastfeeding: Comparing determinants of early breastfeeding cessation incidence in socioeconomically marginalized and privileged populations in the FiNaL study. Health Equity. 2017;1:96–102.
  33. Abegunde D, Hutchinson P, Anaba U, Oyedokun-Adebagbo F, Johansson EW, Feyisetan B, et al. Socioeconomic inequality in exclusive breastfeeding behavior and ideation factors for social behavioral change in three north-western Nigerian states: A cross-sectional study. Int J Equity Health. 2021;20:172.
  34. Glanz K, Rimer BK, Viswanath K. Health behavior and health education: Theory, research, and practice. 5th ed. San Francisco: Jossey-Bass, 2015.

Creative Commons License

Creative Commons Attribution-Share Alike 4.0 International License
This work is licensed under a Creative Commons Attribution-Share Alike 4.0 International License.

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.