# Barriers and facilitators to exclusive breastfeeding among formally employed mothers in urban Indonesia

## TL;DR

This study explores why working mothers in urban Indonesia struggle with exclusive breastfeeding, highlighting both personal and workplace-related challenges and solutions.

## Contribution

The study identifies specific internal and external factors influencing exclusive breastfeeding among working mothers in Indonesia.

## Key findings

- Internal factors like self-efficacy and knowledge support exclusive breastfeeding, while fatigue and self-doubt hinder it.
- External factors such as workplace support and lactation facilities facilitate breastfeeding, whereas inflexible schedules and stigma act as barriers.
- Policy changes like extended maternity leave and workplace accommodations are crucial for sustaining exclusive breastfeeding.

## Abstract

Despite global and national recommendations, exclusive breastfeeding (EBF) remains suboptimal among formally employed mothers in Indonesia. Although legal protections exist, real-world barriers persist that complicate the breastfeeding journey for working women. This study explored factors barriers or facilitators to exclusive breastfeeding among formally employed mothers in urban Indonesia.

A qualitative exploratory design was employed using a constructivist paradigm to explore the experiences of formally employed mothers in sustaining exclusive breastfeeding while working. A total of 12 participants were interviewed through theoretical sampling. They were aged 25–36 years and had infants aged 6–12 months. Data collection was conducted via in-depth semi-structured interviews held online. The interviews were analyzed using inductive thematic analysis with the aid of ScreenQ (qualitative analysis software), which generated 131 initial codes, 23 categories, 7 subthemes, and two overarching themes: internal and external factors influencing breastfeeding continuation.

Internal facilitators included maternal knowledge, self-efficacy, and adaptive breastfeeding practices, while internal barriers involved fatigue, self-doubt, and difficulty translating knowledge into practice. External facilitators encompassed partner and coworker support, flexible workplace policies, and lactation-friendly facilities. Conversely, barriers included inflexible schedules, short maternity leave, stigma, and inconsistent caregiving.

Exclusive breastfeeding (EBF) among working mothers is shaped by complex interactions between individual strengths and structural conditions. Supportive policies and environments are essential to help bridge the gap between mothers’ intentions and practical realities. Implementation of enforceable workplace protections and extension of maternity leave are essential to sustain EBF in Indonesia. It is equally important to establish employer accountability mechanisms—such as government monitoring and enforcement of workplace lactation rooms and breastfeeding breaks—that can be implemented in the short term.

The online version contains supplementary material available at 10.1186/s12889-025-25214-6.

• What is already known:

Exclusive breastfeeding rates are lower among working mothers due to occupational andstructural challenges.

• What this paper adds:

This study identifies both internal (e.g., self-efficacy, knowledge) and external (e.g., workplacesupport, caregiver reliability) factors that act as barriers or facilitators to EBF among formallyemployed mothers in Indonesia.

• Implications for practice and policy:

Workplace accommodations, extended maternity leave, consistent caregiver training, andculturally sensitive breastfeeding education are essential to sustain EBF in working mothers.

Stakeholders must prioritize breastfeeding as a collective societal responsibility, not just amaternal task.

The online version contains supplementary material available at 10.1186/s12889-025-25214-6.