Literature Review: Factors affecting the implementation of early initiation of breastfeeding (EIBF) in maternity and breastfeeding mothers

Background: Early initiation of breastfeeding (EIBF) is the process of direct skin contact between the mother and the baby within the ﬁrst hour after delivery. EIBF aﬀects the welfare and survival of newborns. Implementation of early breastfeeding initiation globally according to WHO is 42% and the low implementation of EIBF is inﬂuenced by several factors. Objectives: To identify factors that inﬂuence the implementation of EIBF in mothers who give birth and breastfeed based on empirical studies in the last


INTRODUCTION
out from August 2021 to March 2022 with secondary data. Research reference sources are 31 international articles using 3 databases, namely PubMed, Sciencedirect, and Springer. Results: The results of the study show that the mother's knowledge can be influenced by the availability of EIBF information, and the level of education of the mother. Parity has an influence on EIBF, because it is related to the mother's experience of breastfeeding. In caesarean delivery, it is influenced by post-delivery factors such as caesarean incision pain, the effect of anesthesia, and the mother's perception of milk production, whereas in normal delivery there are conditions of the mother's health that can affect the implementation of EIBF. Social support (husband, family and health workers) can encourage mother's confidence in the implementation of EIBF. Conclusions: There are several factors that influence and relate to the mother's knowledge, parity, type of delivery, social support, and health services on the success of EIBF in the implementation of EIBF in labor and breastfeeding mothers.

KEYWORD: early initiation of breastfeeding; maternity; breastfeeding mothers
Article Info : Article submitted on December 23, 2022 Article revised on January 19, 2023 Article received on February 01, 2023 Early initiation of breastfeeding (EIBF) is the process of placing a newborn baby on the mother's chest so that she can breastfeed immediately within the first hour after delivery.
Early breastfeeding can increase the bond between mother and baby, and encourage consistent breastfeeding. Early initiation of breastfeeding has been shown to increase the success and sustainability of exclusive breastfeeding (1).
EIBF has been carried out globally in various countries with a percentage of 42% '' (2). In 2017 approximately 78 million newborns experienced delayed EIBF for more than the first hour of birth, and the majority occurred in low-and middle-income countries '' (2). World Health Organization (WHO) and UNICEF are targeting 70% of newborns to initiate early breastfeeding by 2030 (3). Implementation of EIBF for more than 1 (one) first hour of birth has a negative impact, especially on the health of the baby. EIBF at 2-23 hours after birth increased the risk of death by 33% in the newborn, and the risk was increased twice as high for EIBF performed one day after birth '' (2). EIBF for more than 1 hour of birth can increase the risk of neonatal morbidity and mortality at the age of 0-28 days (4). In another study in Tanzania as many as more than 4,000 infants experienced delayed EIBF, with almost 50% increased risk of respiratory distress in the first six months of life (5).  Research in India shows that the mother's lack of knowledge about EIBF has a very strong influence on the delay in EIBF (9). Research in the Kilimanjaro region, Tanzania found that parity affected EIBF that the prevalence in mothers who gave birth to two children was higher than in those who gave birth once or were primiparous (10). Parity is considered to be a major factor in good mother-infant interactions for infant development ''' (11). The implementation of EIBF based on the type of delivery has a different effect between the type of cesarean delivery and normal delivery, that delivery by cesarean section is the main factor in inhibiting the practice of EIBF ' (12). Delivery by caesarean section is a very strong possibility of reducing EIBF in newborns, due to the recovery time needed by the mother to recover from the effects of anesthesia (13).
Implementation of early breastfeeding in normal delivery has been carried out quite well in the delivery room, but caesarean deliveries cannot be carried out because there is no Standard Operating Procedure (SOP) for mothers with caesarean deliveries or sectio caesaria (14). The husband's support is the main source of support that provides benefits to maternity and breastfeeding mothers ' (15).
Health workers are the main factor in the success of EIBF in the right breastfeeding position after delivery - (16). Family support is a factor that plays an important role in the practice of early initiation of breastfeeding (17). Family support is the main factor that influences a person's behavior (18). Health services are influenced by the availability of health workers, such as midwives and nurses who play an important role in health services by facilitating mothers to implement EIBF (19). Implementation of EIBF in mothers giving birth and breastfeeding in this study were mothers who gave birth to their babies who then carried out early breastfeeding to improve the future of breastfeeding for babies, because there were things that allowed mothers not to carry out EIBF processes and continue exclusive breastfeeding, such as sore nipples and complaints others that can be overcome with knowledge related to ASI and breastfeeding (20). Therefore, mothers who give birth and

RESULTS
The selection of articles begins with searching using keywords in the three databases used, then checking duplicate articles and finding titles that match the keywords, then checking articles based on title, abstract, and full text to meet the eligibility criteria. Furthermore, the feasibility of the articles was tested using Critical Appraisal, so  Table 1   Mother's knowledge regarding skin-to-skin contact with the baby immediately after birth can be increased by the information obtained by the mother during ANC counseling visits.      Based on Table 2 it was found that knowledge of maternity and breastfeeding mothers can influence on women who can start EIBF after delivery. Mother's knowledge can be influenced by the availability of EIBF information, and the mother's education.

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Information obtained by maternity and breastfeeding mothers can be through leaflets, posters, and banners, as well as from health workers (14). The delay in EIBF was caused by the mother's low knowledge due to the lack of socialization from health workers about care for newborns (22). Insufficient information regarding EIBF correctly can affect the mother's knowledge (22). The lower the level of education of the mother, the less knowledge of the mother in performing EIBF on newborns (23), so the higher the education level of the mother, the easier it is to receive information related to EIBF and the higher the knowledge possessed by the mother. Table 3 it was found that parity is closely related to the experience of breastfeeding the mother, both what happens to the primipara mother and the multipara mother. The mother's experience begins when a newborn baby sticks to the mother's chest, then does the suction immediately after birth, and it becomes the mother's skills related to breastfeeding (24). The more children who are born, it can improve the skills of mothers in doing EIBF appropriately - (25). Previous breastfeeding experiences can have a positive influence on the implementation of the EIBF that the mother has the confidence to succeed in giving breast milk to her baby (24).

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Negative breastfeeding experience can be caused by excessive pain experience and the mother's breast condition can hamper the mother's decision to do early breastfeeding in newborns (24). In primipara mothers with the first experience of breastfeeding, often still experiencing problems in breastfeeding.
Mothers who experience good attachment during the EIBF process can avoid breast nipples experiencing pain (16).
Based on Table 4 that the type of delivery between delivery by cesarean section and vaginal delivery (normal) has a different effect on the implementation of EIBF. In the type of vaginal delivery, there are maternal health conditions that can affect the implementation of early breastfeeding. Babies born with vaginal delivery can make skin contact with their mother immediately after birth if the health conditions of the mother and baby are in good health, unless the mother and baby are in unhealthy conditions such as the mother has anemia and the baby is hypothermic - (26). In the type of cesarean delivery, several factors can hinder the mother in implementing EIBF, namely the pain caused by the incision during the cesarean section making the mother in labor experience limited body movements, thus requiring assistance from health workers during cesarean delivery (27). Cesarean delivery influences delaying EIBF because the mother needs time to recover from the effects of anesthesia. The effect of anesthesia on the mother causes the mother to be unconscious to care for her baby in the first hour after birth and makes breastfeeding difficult (28). Mothers with cesarean deliveries often have perceptions related to lack of milk production, and this can affect mothers in implementing EIBF. The act of giving birth by cesarean section causes pain at the cesarean section (29), so it has an impact on the smooth production of breast milk where the milk production in mothers with cesarean deliveries is on average less than the milk production in mothers with vaginal deliveries.
Based on Table 5 it was found that the active role of the husband can increase the mother's confidence to start breastfeeding early ' (30). The implementation of the husband's support for maternity and breastfeeding in the implementation of EIBF.
The need for support from a husband who has an understanding of the importance of EIBF and the benefits of giving colostrum. The better the husband's support given to the mother during maternity can increase the motivation of the mother to do the EIBF as soon as the baby is born (31). Family support is very much needed during maternity to support the implementation of EIBF and motivate mothers to make direct contact with babies in the first hour after birth. Based on