The Relationship Between Postpartum Mother’s Knowledge About Breast Care and Breastfeeding at Technical Implementation Unit Linggang Bigung Health Center

Introduction: In supporting the fulfilment of breast milk for babies it should be as expected, then the quality of breastfeeding is one of the things that must be considered by mothers so that milk production is better. Methods: This study uses a descriptive analytic research design. With a total sample of 44 repondents with data collection instruments using questionnaires with statistical tests using respondent frequency tables. Results and Discussion: The results of the study were obtained from 44 respondents with a chi-square test for postpartum women with P-value = 0.006 < α (α = 0.05), namely there is a significant relationship between knowledge of breast care and the smoothness of breastfeeding. Conclusion: In this study stated that there was a significant relationship between knowledge of breast care and breastfeeding in the area Technical Implementation Unit Linggang Bigung Public Health Center in 2022. To health workers, especially midwives at Technical Implementation Unit Linggang Bigung Health Center is expected to further improve its health promotion regarding breast care to postpartum mothers in increasing the smoothness of breastfeeding to health services and the quality of health services and the quality at the research site.


Introduction
In the puerperium there can be infection and inflammation of the breast, infection occurs through wounds on the nipples, but may also be through blood circulation (Kurniawati &;Sari, 2015).Signs are chills accompanied by an increase in temperature, sufferers feel lethargic and have no appetite.The cause of infection is usually staphylococcus aureus, enlarged breasts, breast pain somewhere red skin, swelling and pain in touch.Therefore, it is necessary to prevent one of them with breast care (Mirdayanti Abbas &;Asi, 2017) (Mirdayanti Abbas & Asi, 2017) Various complications experienced during breastfeeding include nipple pain, nipple blisters, swollen breasts and mastitis or prophylactic breast abscess the mother must take care of the breast correctly and regularly will make it easier for babies to breast milk (Wahyuningsih &;Wahyuningsih, 2020).This breast treatment also stimulates milk production and reduces the risk of injury during breastfeeding (Retnaningtyas et al., 2022) Proper feeding is essential in achieving optimal growth and development and preventing malnutrition in infants and children under five (Kumala et al., 2022).(Kumala et al., 2022) The World Health Organization (WHO) and the United Nations International Children's Emergency Fund (UNICEF) recommend that children should only be breastfed for at least six months and breastfeeding continued until the child is 2 years old (Mardjun et al., 2019).According to WHO data (2020), exclusive breastfeeding coverage worldwide was only around 44% during the 2015-2020 period (Ratnasari et al., 2021).(Ratnasari et al., 2021) Meanwhile, in Indonesia, based on data obtained from the 2020 Indonesian Health Profile, the coverage of infants receiving exclusive breastfeeding in 2020 was 66.06%.This figure has exceeded the 2020 strategic plan target of 40%.East Kalimantan Province has an exclusive breastfeeding coverage of 76.1% (Afini &;Faiqah, 2020) Breast milk is the most important baby food, especially in the first months of life (Herawati &;Desriyeni, 2017).Breast milk is a very ideal source of nutrition with a balanced composition and in accordance with the needs of baby's growth, because breast milk is baby food that is at the best level ( Lindawati, 2019) In supporting the fulfillment of breast milk for babies should be as expected, the quality of breastfeeding is one of the things that must be considered by mothers so that milk production is better (Ginting & Damanik, 2022).In order to ensure optimal fulfillment of breast milk for babies, one of the most decisive factors in breastfeeding is breast care since pregnancy and after childbirth (Hutabarat et al., 2022)

Method
This research was conducted using descriptive analytical methods.The research design used a cross sectional approach.The population used in this study was postpartum mothers who came to visit the Linggang Bigung Community Health Center in 2022.The population in this study was 44 respondents.The total sample was 44 respondents.The sampling technique in this study is purposive sampling.Purposive Sampling.
The study was conducted in March-May 2022 in the Linggang Bigung Community Health Center Area.

Research Results
Table In this study, the independent variable is the technique of postpartum mother's knowledge about breast care and the dependent variable is the smoothness of breast milk expenditure.The research instrument used is the Questionnaire.How to collect data through questionnaires, interviews, and treatment.

The statistical test used is Chi-square.
In table 4.1, it is known that the proportion of respondents aged 21-35 years was 19 respondents (43.1%), most of whom had a high school education (SMA) as many as 18 respondents (40.9%).Most of the respondents were 36 respondents (81.9%), and most of them had Multipara status as many as 29 respondents (65.9%).In tables 2 and 3 show that the success of good knowledge of postpartum mothers about breast care was declared successful in breast care as many as 30 respondents (68.2%), in current breastfeeding as many as 35 respondents (79.6%), while it was stated that maternal knowledge about breast care was 14 respondents (31.8%) and non-current breastfeeding expenditure was 9 respondents (20.4%).The p-value <0.05  is to receive various information so that it affects one's behavior.Lack of knowledge of mothers, especially regarding the benefits of breast care for mothers and babies.Mothers consider that breast care for postpartum mothers is useful in facilitating breast milk for their babies.
Various complications experienced during breastfeeding include nipple pain, nipple blisters, swollen breasts and mastitis or prophylactic breast abscess the mother must take care of the breast correctly and regularly will make it easier for babies to breast milk.
Difficulties that arise during the breastfeeding process can be prevented through good antenatal care, namely by paying special attention to breast preparation and nipples in anticipation positively breastfeeding the baby.
According to researchers, high maternal education does not always have enough knowledge about breast care.In the provision of breast care in the puerperium, high maternal education provides a role in easier receipt of information.

c. Work
Most housewives are 36 respondents (81.9%) based on research (Sriatin, 2017).It reports that non-working mothers are 80.5% more likely to do well in breast care than working mothers.
Non-working mothers are considered to have a lot of free time in breast care for smooth breastfeeding, but working mothers can still do breast care when they have free time or rest at home.
In this study, according to researchers, most mothers have more free time because working mothers are still on maternity leave so they can still do breast care during the puerperium for 42 days,

2.
Postpartum mother Knowledge about Breast Care Based on table 4.2.showed that most respondents had good knowledge about breast care as many as 30 people (68.2%).Breast care is a way of caring for breasts that is done during pregnancy or puerperium for milk production, in addition to breast hygiene and shape nipples that go inside or flat.Such nipples are actually not an obstacle for mothers to breastfeed well knowing from the beginning, mothers have time to work on making nipples easier during breastfeeding.In addition, it is also very important to pay attention to personal hygiene Lactation or breastfeeding has two meanings, namely milk production and milk production.Milk production does not take place until the postnatal period when estrogen levels decrease.A decrease in estrogen levels allows for an increase in prolactin levels and milk production.Continuous milk production is caused by breastfeeding the baby to the mother.The fulfillment of breast milk for babies is as expected, the quality of breastfeeding is one of the factors that must be considered by mothers so that milk production can be good.However, for some mothers in breastfeeding the quality of breastfeeding is less concerned about the duration, frequency, technique, way, position, and readiness of mothers when breastfeeding.This may be influenced by inadequate knowledge.Cultural factors, misperceptions about breasts and breastfeeding or a lack of understanding of the mother's role and function while breastfeeding.As a result, breast milk is sometimes wasted or not used.

Smooth Milk Production
In supporting the fulfillment of breast milk for babies should be as expected, the quality of breastfeeding is one of the things that must be considered by mothers so that milk production is better.In order to ensure optimal fulfillment of breast milk for babies, one of the most decisive factors in breastfeeding is breast care since pregnancy and after childbirth.
Difficulties that arise during the breastfeeding process can be prevented through good antenatal care, namely by paying special attention to breast preparation and nipple milk in positive anticipation of breastfeeding in infants.Breast care is one important part that must be considered as preparation for breastfeeding later, this is because the breast is an essential organ producing breast milk in babies, the main problem and principle is that mothers need help and knowledge and support to care for breasts during pregnancy to prepare breast milk during childbirth so as to increase confidence that mothers can breastfeed their babies well and know the function of the benefits of care breasts at the time of pregnancy.Breast care should be done during pregnancy, namely at 18 weeks gestation to 40 weeks gestation (II and III trimesters) and not after delivery

4.
The relationship of knowledge about breast care with the smooth discharge of breast milk Based on table 4.4.showed that of the 44 respondents, there were respondents with good breast care knowledge and experienced smooth breastfeeding totaling 30 people (68.2%), while respondents with less breast care knowledge and experiencing non-current A SI production amounted to 4 people (9.2%).Based on the results of statistical tests using Chi-Square, p-value = 0.0 06 is obtained which means that the p-value is smaller than the α value (0.05), then H0 is rejected and Ha is accepted so that it is concluded that there is a significant relationship between knowledge about breast care and the smooth release of breast milk in postpartum mothers in the working area of the Technical Implementation Unit of Linggang Bigung Community Health Center.An Odds Ratio of 3.74 was also obtained, which means that postpartum mothers who have knowledge about good breast care have a 3.74 times chance of milk expenditure being smooth.
In this study, there were 14 respondents who had good breast knowledge with substandard breast milk.One condition that causes breast milk is not smooth is a mother who has a sunset nipple so that she feels unable to give milk to her baby, the mother does not understand how to do breast care well and mothers who give birth by cesarean section, because the act of anesthesia at the time of surgery causes the mother to be Alfride Louise, M. H. Supriadi, Rahmawati/KESANS The Relationship Between Postpartum Mother's Knowledge About Breast Care and Breastfeeding at Technical Implementation Unit Linggang Bigung Health Center unresponsive to breastfeeding thus inhibits the formation of milk production and expenditure.
One factor to get enough milk production is that mothers routinely do breast care.In breast care there are du events that can be done simultaneously.This method is breast sequencing and watering.Sequencing or mesas is done to provide stimulation to the breast milk jar to produce milk.Sequencing can be done in the morning and evening, preferably before bathing and continued with watering done simultaneously when bathing.In full-term babies, the frequency of breastfeeding should be done 10 times per day for the first 2 weeks after delivery.While breastfeeding at least 8 times per day in the early period after giving birth.Because the more often the baby breastfeeds, the more milk production and expenditure will be.
In this study, researchers that post-partum mothers who already have good breast knowledge and do breast care regularly and regularly will get enough milk production.In addition, postpartum mothers are encouraged to eat nutritious foods so that nutritional needs can be met properly, not dehydrated so that the milk supply can run smoothly and the postpartum mother must maintain her psychological condition and get plenty of rest so that the condition is well maintained.

Conclusion
The characteristics of the majority of respondents aged 20-35 years were 19 people (43.1%), 18 people with high school education (40.9%), 36 housewives (81.9%) and multipara parity as many as 29 people (65.9%).It was obtained that the majority of respondents had good knowledge about breast care as many as 30 people (68.2%).The majority of respondents obtained breast milk expenditure in the current category as many as 35 people (79.6%).There is a significant relationship between knowledge of breast care and the smooth expenditure of breast milk in postpartum mothers in the working area of the Technical Implementation Unit of Linggang Bigung Community Health Center (pvalue = 0.006).An Odds Ratio of 3.74 was also obtained, which means that postpartum mothers who have knowledge about good breast care have a 3.74 times chance of milk expenditure being smooth.
Based on the data mentioned above, it can be concluded that with breast care knowledge, breast milk expenditure becomes smoother, this is because post-partum mothers who already have good breast knowledge and do breast care regularly and regularly get enough milk production.
Alfride Louise, M. H. Supriadi, Rahmawati/KESANS The Relationship Between Postpartum Mother's Knowledge About Breast Care and Breastfeeding at Technical Implementation Unit Linggang Bigung Health Center

1
Frequency Distribution of Respondent Characteristics in Postpartum Mothers in the Work Area of the Technical Implementation Unit of the Linggang Bigung Public Health Centre

Table 2
Frequency Distribution of Respondents Based on Knowledge of Postpartum Mothers About Breast Care in the Work Area Technical Implementation Unit Linggang Bigung community health center

Table 3
Frequency Distribution of Respondents Based on Smooth Milk Production in Working Areas Technical Implementation Unit Linggang Bigung community health center Smooth Breast milk dispensing Frequency Percentage (%)

Relationship Between Postpartum Mother's Knowledge About Breast Care and Breastfeeding at Technical Implementation Unit Linggang Bigung Health Center
which means that there is Postpartum Mother's Knowledge about Breast Care for Smooth Breastfeeding results of this study, it was found that the average age of respondents aged 21-35 years was 19 respondents (43.1%), the age of <20 years was 10 respondents (22.8%).Age can be used as a benchmark to see the level of biological and psychological maturity of an individual.Based on research (Septiani et al., 2017) mothers who are older or over the age of 35 years' experience stable maternal knowledge for breast care for smooth breastfeeding while mothers who are too Young people mostly lack knowledge in breast care to exclusively breastfeed.In this study, maternal age can be one of the factors in receiving information provided by Health Education about breast care in breastfeeding.b.Education based on the results of research of Postpartum mothers, most of them had the last education in Senior High School as many as 18 respondents (40.9%), according to Notoatmodjo, 2018, in general, someone has a high education, then The easier it Alfride Louise, M. H. Supriadi, Rahmawati/KESANS The