Three themes are identified in this study that motivates mothers in breastfeeding efforts and efforts to increase milk production and fulfillment of nutrition for their babies. First, An understanding of breastfeeding at this location can have implications for breastfeeding. A mother must have good knowledge of breastfeeding. Losing knowledge about breastfeeding means a major loss of confidence in a mother to be able to provide the best care for her baby and the baby is deprived of vital food sources and optimal care methods.8 This is also in line with research conducted in Buton and Bengkulu which found that there is a relationship between knowledge and exclusive breastfeeding.9,10

In connection with exclusive breastfeeding for six months, the IEB process is one of the determining factors for its success. Breast milk production will be stimulated from an early age so that there is no more excuse for “lack of milk”, or “breast milk does not come out.11 However, the activity that triggers breast milk production has never been known by the informants at the location. The mother also has never received information related to colostrum. The production of breast milk in the first days of labor, known as colostrum, is relatively small, only about 1 tsp or 5ml and a maximum of about 2.8 tsp or 13.72ml.

Insufficient breast milk means that the milk received by the baby is really not enough, because milk production is decreasing or milk production is actually sufficient but the baby is not getting the milk he needs.12 This is characterized by several criteria among others the mother's breast feels tense, a lot of breast milk can come out of the nipple by itself, the color of urine is clear yellow if enough milk after breastfeeding then the baby is asleep or calm for 2–3h, or by a characteristic of baby defecation.13,14 The non-smooth release of breast milk on the first day after delivery can be caused by a lack of stimulation of the hormone oxytocin.15 Mothers often feel worried about the production of their milk on the first day of birth. Stress or discomfort will cause obstacles from the let down reflex, which will reduce milk production.12

The second themes identified were attitudes. Mother show a positive attitude, but several informants admitted that even though they thought breast milk was good for babies, they were not able to fully provide breast milk to their babies because they felt that milk production was not enough. Attitudes are influenced by personal experience, culture, other people who are considered important, mass media, educational or religious institutions or institutions, and emotional factors in individuals.16 The mother's attitude in the research location is at the level of acceptance and responsiveness and self-worth, not reached yet the characterization. In the first days after childbirth, the family thought that breastmilk is not enough, so they recommend giving breastmilk substitutes temporarily.

Another of them identified is the behavior of mothers in increasing breast milk production. An effort to fulfill nutrition by giving local vegetables like jantung pisang or green vegetables. It is believed that since ancient times can increase breast milk. According to reasearch, there are several foods and drinks that are believed to increase milk production, including katuk leaves, banggun-wake leaves, oatmeal, and an American herb, namely Fenugreek. Tobangun leaves significantly increase milk production by triggering the release of the hormone prolactin.17 Research conducted by Zakaria found that Moringa leaf extract increases the quantity of breast milk.18 In fact, there is no special food or drink that can produce breast milk miraculously, although many people believe that certain foods/drinks will increase milk production.19

Breastfeeding at the study site was in the form of partial breastfeeding. This research is in line with research conducted in Semarang which found that the tendency of mothers not to exclusively breastfeed their babies is getting bigger, the socio-cultural environment, education, low knowledge, and lack of support from husbands.20 This can be seen from the large number of breastfeeding mothers who provide additional food or formula milk earlier as a substitute for breast milk. Various reasons put forward by mothers so that the use of breastfeeding exclusively for their babies is low, including the influence of advertising/promotion of breastfeeding substitutes, working mothers, the socio-cultural environment, education, low knowledge, and lack of support from husbands.

Mother's knowledge about breast milk is that breast milk is the provision of breast milk to babies. The mother doesn’t know about IMD and Colostrum yet. The mother thinks there is not enough milk because there is no visible milk flowing out. Mothers are open to receiving information related to breast milk and breastfeeding. Behavior Consuming vegetables is an effort made by breastfeeding mothers to increase their milk production. The mother provides formula milk as an effort to meet the nutritional needs of the baby due to insufficient milk production. Breastfeeding at the study site was in the form of partial breastfeeding. For this reason, proper efforts are needed to increase milk production for breastfeeding mothers in this region in order to achieve breastfeeding success.

The ethical clearance of this research was based on the letter from the Ethical committee of Universitas Muslim Indonesia and Ibnu Sina Hospital, Makassar Indonesia No. 084/A.1/KEPK-UMI/VIII/2020.

The authors declare no conflict of interest.