DESCRIPTION OF KNOWLEDGE IN EXCLUSIVE BREASTFEEDING MOTHERS AT SUKOMULYO

Introduction: Exclusive breastfeeding is essential in fulfilling children's nutritional status. Exclusive breastfeeding is closely related to the mother's knowledge about breastfeeding. Thus, it is necessary to identify the level of understanding of mothers about exclusive breastfeeding. This study aimed to describe the knowledge of mothers who breastfeed exclusively at Sukomulyo community health centre, Gresik. Methods: This study used a retrospective descriptive research design. This study's population were mothers with babies aged >6 to 12 months at the Sukomulyo community health centre. The sample in this study was 35 samples obtained through the purposive sampling technique. The data were collected by filling out questionnaires and analyzed using a frequency distribution table. Results: Mothers who gave exclusive breastfeeding found that the majority of mothers aged 20-35 years were 26 people (74.29%), the education level of mothers who graduated from high school was 18 people (51.43%), and mothers worked as housewives as many as 25 people (71.43%). Most of the mothers had a good level of knowledge, as many as 27 people (77%) and only one mother with less knowledge. Mothers with good knowledge mainly were owned by mothers aged 20-35, as many as 21 people (77.78%), mothers with a college education last as many as 15 people (55.56%), and housewives as many as 21 people (77.78%). Conclusions: Mothers aged 20-35 years with a university education background and housewives tend to breastfeed exclusively.


INTRODUCTION
Breast milk is a nutrient-rich food that is beneficial for baby growth and protects babies from infection (Wong et al., 2021). Exclusive breastfeeding can reduce infant mortality (WHO/UNICEF, 2012), also plays a role in preventing stunting in the first 1000 days of birth (HPK) (Djauhari, 2017). Breast milk contains many ingredients that cannot be found in formula milk. The content of leptin in breast milk is useful in preventing obsession. Other ingredients such as the hormones insulin, adiponectin, and ghrelin also play a role in the growth and development of babies. (Pico et al., 2020). Breastfeeding is also associated with a reduced risk of chronic disease in both mother and baby, especially in small, sick, and premature babies. Breastfeeding can reduce the risk of sepsis, necrotizing enterocolitis, and pneumonia in premature infants (Theurich et al., 2020). Therefore, exclusive breastfeeding should be given until the baby is 6 months old and continued with complementary foods until the baby is 2 years old.
According to WHO (2021), there are 44% of infants aged 0-6 months worldwide who are exclusively breastfed in the 2015-2020 period. This figure still does not meet the WHO achievement target where the rate of exclusive breastfeeding is expected to reach 50% (WHO/UNICEF, 2014). The coverage rate of infants aged 0-6 months who received exclusive breastfeeding in Indonesia from 2018 to 2020 decreased, namely 68.74% (2018), increased by 69.60% (2019), 70.53% (2020), and 74.8% (2021). The results of a preliminary study at the Sukomulyo community health center, the coverage of infants aged 0-6 months who received exclusive breastfeeding fluctuated from 58.55% in 2019 down to 57.9% in 2020, and increased to 72.4% in 2021.
Mother's knowledge is one of the important factors that play a role in exclusive breastfeeding (Hamze et al., 2019). One of the barriers to exclusive breastfeeding that is most often experienced by mothers is misperceptions about breastfeeding. This can be overcome through the provision of education so that mother's knowledge about exclusive breastfeeding increases. Good knowledge will encourage the mother's attitude to breastfeed until the baby is 6 months old, thus affecting the success of exclusive breastfeeding (Zhang et al., 2018). Good knowledge also affects the self-confidence and the duration of exclusive breastfeeding (Little et al., 2019).
Exclusive breastfeeding is closely related to the mother's knowledge about breastfeeding, this means that knowledge affects the success of exclusive breastfeeding. Thus, it is necessary to identify the level of the mother's knowledge about exclusive breastfeeding.

MATERIALS AND METHODS
This study used a retrospective descriptive research design. The population in this study were all mothers who had babies aged >6 to 12 months at the Sukomulyo community health center. From the total population, 35 samples were determined through the purposive sampling technique with the inclusion criteria of this study being mothers who had babies aged >6 months to 12 months, mothers who gave exclusive breastfeeding and were willing to be research respondents. The variable in this study was the knowledge of mothers who exclusively breastfeed. Data collection techniques in this study used a questionnaire. The data analysis method in this study used a frequency distribution table in accordance with the research objectives to identify a description of the mother's knowledge about exclusive breastfeeding, then narrated and carried out a discussion in accordance with the existing literature.  Table 1 shows that the majority of mothers aged 20-35 years were 26 people (74.29%) and only 1 mother was <20 years old. While the education level of the mother was mostly high school graduates as many as 18 (51.43%), and most of the mothers work as housewives as many as 25 people (71.43%). Based on table 2, it was found that almost all mothers with a good level of knowledge were 27 people (77.14%) and there was only 1 mother with less knowledge.  Table 3 shows that almost all mothers aged 20-35 years had a good level of knowledge as many as 21 people (77.78%). While 1 mother with less knowledge was owned by a mother aged <20 years. Mothers with the most recent college education had good knowledge of as many as 15 people (55.56%). Mothers with sufficient knowledge were mostly owned by 5 people with the latest high school education (71.43%) and for all mothers with high school education as many as 1 person (100%) had less knowledge. Almost all mothers with good knowledge were housewives as many as 21 people (77.78%). Meanwhile, mothers with sufficient knowledge were also housewives and private employees/laborers, namely 3 people each (43%) and mothers who had less knowledge were housewives as much as 1 person (100%).

Mother's characteristics based on age
The results of the study show that most mothers aged 20-35 years are in line with the theory put forward by (Sukma & Sari, 2020) that the age of 20-35 years is a healthy reproductive age and has the right psychological maturity to get pregnant and give birth and become a mother. A healthy reproductive age as a mother will have a big responsibility in caring for her baby so that she is able to maintain exclusive breastfeeding for babies until the age of 24 months. Based on (Rapingah et al., 2021) study, mothers aged 20-35 years had five times more likelihood of providing exclusive breastfeeding. Age is related to knowledge and awareness of health (B. S. et al., 2020). The older you are, the higher your cognitive power will be to receive information and increase your knowledge. According to (Suwaryo & Yuwono, 2017), the older a person is, the better their way of thinking and comprehension will be compared to younger people.

Mother's characteristics based on education
The results of the study which show that most of the mothers education level are high school graduates are in line with the research of Hastuti et al., (2015) that more breast milk is given to mothers with higher education (junior and high school). Firmansyah & Mahmudah (2012) reveals that education is a series of activities taken by humans to obtain information so that they can improve their quality of life. mothers with higher levels of education have better awareness and readiness. Mothers who have a higher education level have better initial knowledge it can significantly improve the memory process in obtaining the required knowledge (Kiftia et al., 2022).
Someone with a high level of education is easier to capture information so that more knowledge is possessed, on the contrary, someone with a low level of knowledge can inhibit receiving the values and information provided. Mothers with higher education are able to sort out what is good or bad for the health of their babies, so mothers with higher education tend to give exclusive breastfeeding.

Mother's characteristics based on profession
The results of the study show that most mothers are housewives in line with Sari et al., (2014) that the proportion of breastfeeding is more to housewives than to working mothers. Someone who works will be busy and focused on what is being done so that people who work do not have time to get information, which causes limitation of the knowledge. Meanwhile, someone who does not work has more free time to seek and obtain information. According to researchers, work affects mother's knowledge. Mothers who do not work have more time to seek information and have the opportunity to meet new people and establish relationships such as by attending posyandu (integrated service post) activities so that they get more sources of information and knowledge (Lisa, 2019).

Description of knowledge on exclusive breastfeeding mothers
Mothers with good knowledge tend to exclusively breastfeed their babies (Amir et al., 2018). Knowledge is one of the factors that have the opportunity to influence the success of exclusive breastfeeding (Mardhika et al., 2022). Knowledge is the basis for someone to behave or act. Behavior that is based on knowledge is better than behavior that is not based on knowledge. The higher the mother's knowledge, the more positive the mindset and actions are taken. According to Lisa (2019) One of the factors that influence knowledge is age, education, and profession.
Mother's knowledge level at healthy reproductive age between the ages of 20-35 years is better (Sukma & Sari, 2020). The length of time spent throughout life affects one's knowledge. Mothers of sufficient age have better cognitive abilities than mothers of younger ages. However, with increasing age, the mother will get older and will have an impact on the reduced ability to think and remember (Lisa, 2019). in addition, healthy reproductive age also tends to give exclusive breastfeeding because at that age they have better lactation abilities than those aged > 35 years. Meanwhile, at the age of <20 years, generally, psychologically they are not ready to accept the presence of a baby so it can cause depression and difficulty to produce breast milk (Gemilang, 2020).
This study shows that mothers with higher education have better knowledge about exclusive breastfeeding. This is in line with research conducted by Legy (2021) that someone with higher education has better knowledge. The majority of good knowledge is owned by mothers with the latest college education (Sarumpaet, 2020). The higher education taken, the higher knowledge possessed by the mother because mothers with higher education tend to have good cognitive abilities. So it is easy to capture information well. Information that is successfully received by the mother will change the attitude and behavior of the mother so that she can give exclusive breastfeeding to her baby.
The results of this study indicate that most mothers who have good knowledge are housewives. This is in line with research conducted by Sarumpaet (2020) which states that the majority of mothers with good knowledge are housewives. While working mothers have challenges in the practice of exclusive breastfeeding, including limited time availability, separate distances between mother and baby, mother's physical factors (working mothers are more easily fatigued), unavailability of breastfeeding rooms or no facilities for storing breast milk, and unsupportive work environment (Agustina, 2016). Acording to Okawary (2015) Working mothers tend not to give exclusive breastfeeding because there is little available time to give exclusive breastfeeding which is in conflict with working time and mothers prefer to give formula milk because it is considered more practical. In contrast to mothers who do not work, they can give breast milk anytime and anywhere with a more frequent frequency than working mothers because they have more time and are always with their children. In this study, mothers have better knowledge because as housewives they have more free time to seek and obtain information to increase knowledge.

CONCLUSIONS
Mothers who are in the age group 20-35 years, have a higher education background and work as housewives have a tendency to exclusively breastfeed with a good level of education compared to other groups. Education related to the importance of exclusive breastfeeding and strategies for exclusive breastfeeding must be intensively carried out to increase mother's knowledge of exclusive breastfeeding, so that the number of exclusive breastfeeding in Indonesia is increasing and able to achieve the targets that have been set.