Health Education about Preparation of Exclusive Breastfeeding for Pregnant Women

Mother's Milk is the ideal food for the growth and development of babies. in Indonesia the coverage of exclusive breastfeeding is still far from the national target of 80%, health education activities for pregnant women related to knowledge about exclusive breastfeeding, the benefits of breastfeeding for babies and mothers, nutritional and psychological preparation and practicing proper breastfeeding being solution The right way to prepare yourself from the start so that pregnant women can provide exclusive breastfeeding, his community service is carried out at the Bara-Baraya Community Health Center, Makassar City. The service method is interactive participation accompanied by lectures, questions and answers, discussions, and roleplay. As a result of this service, we get enthusiastic pregnant mothers who actively ask questions, so they are committed to providing exclusive breast milk to their babies, thus this health education is an effective effort to increase knowledge among pregnant women. It is recommended that health workers can carry out health education on an ongoing basis considering that there are still pregnant women who have insufficient knowledge about the importance of preparing for exclusive breastfeeding.


Introduction
Exclusive breastfeeding rates in Indonesia remain suboptimal, primarily due to a widespread lack of public awareness.It is imperative to recognize that breastfeeding, particularly exclusive breastfeeding, holds immense potential for the health and well-being of both infants and mothers.In developing nations, breastfeeding practices have played a pivotal role in saving approximately 1.5 million babies annually, underscoring the crucial importance of this natural and accessible source of nutrition.Breast milk stands as the quintessential nourishment for infants, fostering their growth and development.Initiated from birth, breastfeeding yields a multitude of positive outcomes for both mothers and babies.For mothers, it not only fosters emotional bonding but also aids in reducing postpartum bleeding, expedites postpartum recovery, delays the return of fertility, lowers the risk of breast cancer, and contributes to maternal happiness.exclusive breast milk (ASI), so it is necessary to prepare pregnant women to provide exclusive breastfeeding to their babies (KemenKes RI, 2022).
Indonesia has coverage of exclusive breastfeeding, which is still far from the national target, which is 80%.Efforts to increase exclusive breastfeeding include the age factor for mothers who are <20 years old, breastfeeding for babies tends to be smaller due to social demands, mother's obligations and social pressure that can affect the production of breast milk, the factor of higher education will make it easier for someone to absorb information and implement it in health behavior and work factors in mothers affect the practice of exclusive breastfeeding due to lack of time for breastfeeding (Surya Wilis Gemilang, 2020).
Although many mothers, both in urban and rural areas, do not know the benefits of exclusive breastfeeding.Lack of knowledge is one of the factors for failure in exclusive breastfeeding, socio-cultural influences where the mother's activities or work outside the home causes the mother to be unable to share her time to provide exclusive breastfeeding and breastfeed her baby (Nurjanah, Hamidah, & Sari, 2022).one of the factors directly related to stunting is exclusive breastfeeding.Children who are exclusively breastfed have a lower risk of developing stunting.The thing that determines a mother's attitude in exclusive breastfeeding is knowledge about exclusive breastfeeding itself (Mika, Nurhayati, & Patriasih, 2020) Breast milk is the best food that contains the most complete nutrition and is much needed in the early period of life.The behavior of not giving exclusive breastfeeding to infants will have a long-term impact on the health of the next child.Health behavior according to Lawrence Green is influenced by three factors, namely predisposing factors, enabling factors and reinforcing factors predisposing factors that influence mother's behavior in exclusive breastfeeding (Anisak, Farida, & Rodiyatun, 2022).
In giving exclusive breastfeeding, a mother also needs to practice and prepare well.Exclusive breastfeeding behavior is influenced by external factors and internal factors.Internal factors are a person's characteristics that become the basis or motivation for someone to make it easier for exclusive breastfeeding behavior to occur including the level of knowledge, breastfeeding experience, and demographic factors such as age, occupation, education.While external factors are factors that strengthen the occurrence of breastfeeding behavior.This external factor is very necessary because even if a person knows and can behave healthily, the person may not do it.Therefore, an example or support from family (husband and parents) and health workers is needed, (Rinata & Syahilda Hamdi, 2016) Research result Octaviyani said Based on in-depth interviews, the background of mothers who did not practice exclusive breastfeeding, namely work, the assumption that milk production was lacking, and the baby's health condition (Octaviyani, 2019) Preparation for exclusive breastfeeding is an effort made by mothers and families to support the success of breastfeeding.Pregnant women need support and education about the implementation of breast care to deepen knowledge about breast care that can expedite milk production.

Method
At the Bara Baraya Makassar Health Center, our community service approach encompasses a multifaceted strategy, incorporating counseling, open discussions, and interactive question-and-answer sessions tailored specifically for expectant mothers.We provide comprehensive support to pregnant women, aiming to empower them with knowledge and guidance during this crucial phase of their lives.To ensure clarity and transparency, we have included a detailed agenda outlining the various activities and initiatives we intend to undertake as part of our community service program.Through these efforts, we aspire to enhance the well-being and health of pregnant women while fostering a stronger sense of community engagement and support.Ø Pregnant women possess a solid comprehension of the various benefits associated with exclusive breastfeeding.Expectant mothers display a strong grasp of the essential preparations mothers should make for exclusive breastfeeding.
Ø Pregnant women exhibit an impressive level of proficiency in understanding the correct techniques for breastfeeding.

a. Preparation Phase
Preparation is carried out by conveying to partners what will be done, then the Team makes the Extension Event Unit (SAP), as well as prepares materials and tools to be used, for example Posters and Leaflets.

b. Implementation Stage
We came to the Bara-baraya Makassar Health Center to prepare and arrange the place to be used.Pregnant women gathered at the place directed by the members and students.The activity began with my colleague as the moderator (Ns Jamila Kasim) opening the counseling activity.I am the presenter delivering the counseling material.as a facilitator and assisted by students.

Figure 1. Extension Activities c. Activity Evaluation
Evaluation of the activity by asking each participant to explain and practice the results of the discussion regarding the understanding, benefits, preparation of mothers and practicing how to breastfeed properly, at the end of the activity pregnant women can re-understand regarding the understanding, benefits and preparation of mothers and practice how to breastfeed properly, this It is known that participants can answer questions given by the presenters and can practice breastfeeding techniques correctly.
Breast milk is a dynamic fluid that changes in composition during lactation and varies within and between feeds and between mothers.Its composition also varies between full-term and premature infants.The first fluid made by a nursing mother is called colostrum.Like most nutrients, breast milk contains macro and micronutrient components.Macronutrients are carbohydrates, proteins, and fats while micronutrients are vitamins and minerals.Each component of breast milk has its own benefits for the baby's growth.About 88% of breast milk is water.
Water is useful for dissolving substances in it.Breast milk is a source of water which is metabolically safe.The relatively high water in breast milk will relieve thirst stimulation from the baby.Exclusive breastfeeding for babies given by mothers turns out to have an important role, namely increasing the baby's body resistance.Therefore, it can prevent the baby from getting various diseases that can threaten the health of the baby.In addition, the most important benefit of exclusive breastfeeding is that it can support and help the baby's brain and physical development process.This is because, at the age of 0 to 6 months, a baby is certainly not allowed to consume any nutrition other than breast milk.Therefore, for six months in a row, breast milk given to the baby, of course, has a big impact on the baby's brain and physical growth in the future.While the benefits of breastfeeding for mothers is to eliminate trauma after giving birth.In addition to making the mother's health and mental condition more stable, exclusive breastfeeding can also minimize the risk of breast cancer.because one of the causes of breast cancer in nursing mothers is the lack of exclusive breastfeeding for their own babies.
Caring for the breasts during the breastfeeding period is beneficial for preventing and managing the risk of possible breast problems.Of course, if the breasts are cared for properly, the moment of breastfeeding becomes more enjoyable for both the mother and the baby.Explaining breast care is important for success in breastfeeding and supporting the Exclusive Breastfeeding program.In the process of pregnancy many mothers feel discomfort in the breast such as pain in the breast, sensitivity to the touch, swelling in the breast, and it looks enlarged.Problems that are often faced by breastfeeding mothers after childbirth are sore nipples, swollen breasts, mastitis, or breast abscess, finding a good and correct and comfortable position for breastfeeding, pain in the nipples, blockage of milk ducts, and breast infections.Breast care is often called breast care.done to nourish the breasts and multiply and facilitate milk production The knowledge of pregnant women regarding the preparation for exclusive breastfeeding is very lacking, as evidenced during the counseling process, presenters occasionally ask about what are the benefits of exclusive breastfeeding and how to breastfeed properly and they answer that they do not understand and have never received a clearer explanation regarding the preparation for exclusive breastfeeding, research at the Tanti Depok maternity clinic found that there was an effect after being given health education on the level of knowledge of pregnant women about exclusive breastfeeding (Firdaus, Siringoringo, Hunun Widiastuti, & Butarbutar, 2022).
Preparation during pregnancy about breastfeeding tends to increase the rate of exclusive breastfeeding, these visits are used as a promotion of exclusive breastfeeding in addition to routine obstetric services.Preparation for breastfeeding during pregnancy is an important thing to do, because with better preparation, mothers are better prepared to breastfeed their babies and support the success of exclusive breastfeeding.One of the reasons for the low level of exclusive breastfeeding in Indonesia is due to insufficient preparation during pregnancy.This situation shows the importance of preparing for breastfeeding during pregnancy.
Counseling is also an effort to exchange ideas with partners so that information can be added to each other accompanied by knowledge.Lactation preparation is all the efforts made to help mothers achieve success in breastfeeding their babies.This effort is carried out in 3 stages, namely during pregnancy (antenatal), when the mother is in labor until she leaves the hospital (perinatal), and during the next breastfeeding period until the child is 2 years old (postnatal).In line with that, Khotimah's research also reminded the importance of counseling (Khatimah, Akhfar, & Khaera, 2021).This community service activity adds knowledge and solutions for pregnant women who are preparing for the lactation process and can maximize exclusive breastfeeding.

Conclusion
Based on the results of the evaluation of community service activities, it was found that there was an increase in the knowledge of pregnant women after attending health education.The evaluation results showed that of the 23 pregnant women who took part in the activity, there were 6 pregnant women whose knowledge was lacking or around 26%.It is recommended that health workers carry out education.health regarding the importance of providing exclusive breastfeeding on an ongoing basis considering that there are still pregnant women who have insufficient knowledge regarding the importance of preparing for exclusive breastfeeding.

Acknowledgment
The author would like to express his gratitude to the Bara-Baraya Health Center for providing facilities and infrastructure during the implementation of this activity, pregnant women who are willing to attend and thank STIKES Nani Hasanuddin Makassar who has especially the Diploma three study program in Midwifery and Nursing who has given permission, financial support, and opportunities for the service team so that implementation can run smoothly.

Ø
Expectant mothers actively engage in counseling sessions focused on "Preparation for Exclusive Breastfeeding."Ø Counseling sessions are conducted at the Bara-Baraya Health Center in Makassar.Ø Counseling sessions are strategically scheduled two days in advance of the due date.b) Process Evaluation** Ø Pregnant women demonstrate enthusiastic participation and a keen interest in the counseling materials.Ø Pregnant women exhibit commitment by staying engaged throughout the entire duration of the counseling sessions.c)Results EvaluationØ Expectant mothers exhibit a profound understanding of key concepts, including the precise definition of exclusive breastfeeding.