JurnalPost.com The dawn had not yet broken when the boats docked at the pier. Fishermen's wives were already waiting with basins and baskets. They sorted, cleaned, and dried the fish before selling them at the market. Among them were mothers who had given birth just two or three months prior. Their babies were left at home with their grandmothers. When the infants cried, they were often given sugar water, formula, or mashed bananas.
This scene is familiar to midwives working in fishing villages. It is here that exclusive breastfeeding faces its own set of challenges. It is not merely because mothers do not want to breastfeed, but because the family's economic demands require them to return to work immediately.
Amidst the coastal activities that never truly cease, the infant's need for exclusive breastfeeding during the first six months of life often clashes with the social and economic realities faced by fishing families.
Rising Numbers, Coastal Areas Left Behind
Nationally, exclusive breastfeeding shows positive long-term progress. Data from the Indonesian Breastfeeding Mothers Association (AIMI) indicates that exclusive breastfeeding coverage for infants under six months increased from 32 percent in 2007 to 68.6 percent in 2023.
Based on the 2023 Indonesian Health Survey (SKI), the proportion of exclusive breastfeeding for infants aged 0–5 months reached 68.6 percent. When viewed by place of residence, coverage in rural areas reached 72.9 percent, higher than the 65.3 percent in urban areas.
However, these average figures do not fully capture the challenges faced by specific community groups. National achievements do not directly reflect the situation of exclusive breastfeeding in fishing families, who face different work conditions and income levels compared to the general population.
Based on the exclusive breastfeeding indicator for ages 0–5 months, about three in ten infants still do not receive exclusive breastfeeding. Meanwhile, another indicator in the 2023 SKI, which measures the history of exclusive breastfeeding over six months, shows a national achievement of 55.5 percent.
Coastal women bear a unique workload. They not only manage households and children but are also involved in various family economic activities, ranging from preparing for fishing trips to processing and marketing the catch.
The People's Coalition for Fisheries Justice (KIARA) notes that approximately 3.9 million women are involved in the fisheries production chain in Indonesia. However, their work has not always received equal recognition.
In many cases, women working in the fisheries sector are still recorded as housewives in population documents. Consequently, their economic contribution risks being unreflected in employment data or access to social protection.
They work and help support the family economy, yet they are not always recognized as workers.
Why is Exclusive Breastfeeding Interrupted in Fishing Villages?
From a midwifery perspective, there are at least four factors that can hinder the success of exclusive breastfeeding in fishing families.
First, mothers must return to work immediately after giving birth.
The income of fishing families is highly dependent on the season, weather, and catch. When fish are abundant, all family members are often involved in processing and sales activities.
In such conditions, a mother who has just given birth does not always have the opportunity to rest and accompany her baby fully for several months.
Economic demands force some mothers to return to work even while still breastfeeding. When mother and baby are separated for long periods without adequate preparation for expressed breast milk, maintaining exclusive breastfeeding becomes increasingly difficult.
Second, legal protection has not fully reached the needs of informal workers.
Law Number 4 of 2024 concerning Maternal and Child Welfare in the First Thousand Days of Life provides protection for working mothers.
Through Article 4, the law regulates the right to maternity leave for a minimum of the first three months, with the possibility of an additional maximum of three months if there are special conditions proven by a doctor's certificate.
The regulation also provides for opportunities and decent facilities for mothers to breastfeed during working hours.
However, the implementation of rights related to employer obligations faces its own problems for coastal women who work independently or in family businesses.
Fish processors, anchovy dryers, and fish traders at the market do not always have a formal employment relationship with an employer.
As a result, they cannot automatically enjoy maternity leave protection and breastfeeding facilities like workers in the formal sector.
Third, the habit of giving food or drink before breast milk comes in is still found in the community.
In some families, a crying baby is often considered hungry and is immediately given sugar water, honey, formula, or other foods like mashed bananas.
In fact, giving food or drink other than breast milk without medical indication before the baby is six months old can disrupt the success of exclusive breastfeeding.
Research by Angga Sisca Rahadian and Yuly Astuti published in the Jurnal Promkes on 2023 found a correlation between prelacteal feeding and the failure of exclusive breastfeeding.
The results of the study show that mothers who provide prelacteal food or drink have a chance approximately 5.67 times higher of not providing exclusive breastfeeding compared to mothers who do not, based on the adjusted odds ratio in the study.
These findings highlight the importance of education regarding breastfeeding from birth, including the understanding that a baby's crying does not always indicate a lack of breast milk.
Fourth, the work environment of coastal women does not yet support breastfeeding activities.
Piers, fish auction sites, marine product processing centers, and drying racks are generally not designed with the needs of breastfeeding mothers in mind.
The availability of clean and comfortable spaces for breastfeeding or expressing milk remains a challenge. The same applies to access to safe storage for expressed breast milk.
In these conditions, mothers must divide their attention between work, family economic needs, and the responsibility of breastfeeding their babies.
This situation shows that the issue of exclusive breastfeeding is not just a matter of a mother's knowledge or willingness, but is also closely related to social, economic, cultural, and work environment conditions.
Breastfeeding Must Be Supported, Not Burdened on the Mother
Breastfeeding is often considered a personal matter for a mother. In reality, the success of exclusive breastfeeding is heavily influenced by the support of the family, the community, health workers, and government policy.
For fishing families, there are at least four steps that can be taken to strengthen support for breastfeeding mothers.
First, strengthen breastfeeding counseling from pregnancy by involving husbands and family members.
Midwives need to provide education on the benefits of exclusive breastfeeding, the risks of early complementary feeding, and how to express and store breast milk safely.
Education should not only be given to the mother. Husbands, grandmothers, and other family members involved in childcare also need to have the same understanding.
This is important because when mothers work, decisions regarding the food or drink given to the baby are often in the hands of family members caring for the baby at home.
By involving the family from the start, support for exclusive breastfeeding is expected to be stronger.
Second, provide lactation corners in the work environment of coastal women.
Village governments, market managers, and relevant agencies can work together to provide breastfeeding facilities at fish auction sites, fisheries processing centers, and fish markets.
These facilities do not have to be built at a high cost. A clean, enclosed space with adequate ventilation, a comfortable chair, access to clean water, and a place to wash hands can be a first step.
If the facility is used to express and store breast milk, storage equipment that meets safety and hygiene requirements is also needed.
The presence of lactation facilities can help mothers continue their economic activities without having to ignore the need to breastfeed their babies.
Third, provide recognition and social protection to fisherwomen.
Women working in the production and marketing chain of fishery products need to receive recognition for their economic contributions.
This recognition is important to open wider access to employment data, empowerment programs, social protection, and supporting facilities for breastfeeding mothers.
The government can also consider economic assistance policies for mothers from informal worker families during the early stages of infant care, according to the needs and capabilities of available programs.
Without adequate income support, the opportunity to rest after childbirth can be difficult for coastal women to achieve.
Fourth, form breastfeeding support groups in fishing villages.
Support groups can involve village midwives, posyandu cadres, community leaders, and mothers who have experience in exclusive breastfeeding.
Through these groups, breastfeeding mothers can share experiences, get accurate information, and receive support when facing difficulties in the breastfeeding process.
Community-based mentoring can also help reduce the practice of early feeding or drinking, which is still influenced by family habits.
The presence of breastfeeding support groups is important because changes in health behavior are more easily built when supported by the immediate environment.
From the Pier, for the Maritime Generation
Law Number 4 of 2024 concerning Maternal and Child Welfare affirms the mother's right to provide exclusive breastfeeding from birth until the child is six months old. Breastfeeding is then continued until the child is two years old, accompanied by complementary foods.
Fulfilling these rights should not only be a concern in formal work environments or urban health facilities.
Support for breastfeeding mothers must also reach piers, fish markets, marine product processing centers, and stilt houses in fishing villages.
Coastal women play an important role in maintaining the sustainability of the family economy. However, this role should not cause the health needs of mothers and babies to be neglected.
Cooperation between health workers, families, village governments, and stakeholders in the marine and fisheries sector is needed to create an environment that supports exclusive breastfeeding.
Coastal children are part of the next generation who will one day protect and develop the life of the maritime community.
Ensuring they receive exclusive breastfeeding from the beginning of life is one of the important efforts to support their growth, health, and future.
Ultimately, the success of exclusive breastfeeding is not just a mother's responsibility. Support for breastfeeding mothers is a shared responsibility that must be present even in coastal areas.
About the Author
Epifania Margarida F.G is a Master's student in Midwifery Science at the Postgraduate School of Hasanuddin University, Makassar.
Student ID: P102261024
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