The Influence of Health Education Using Brainstorming Method About Exclusive Breastfeeding on Breastfeeding Mother's Knowledge in PMB D Bogor District in 2023

Health education is expected to increase the knowledge of breastfeeding mothers in exclusive breastfeeding. West Java Health Profile in 2017 the coverage of exclusive breastfeeding in Bogor Regency was 22.84%. Mother's knowledge can influence exclusive breastfeeding. To determine the effect of health education using the brainstorming method about exclusive breastfeeding on the knowledge of breastfeeding mothers at PMB D Bogor Regency in 2023. This study used a one group pre-test post-test pre-experimental research design. Analytical research method with cross sectional design. Total population of 35 people with a sample of 32 people. The sampling technique used was purposive sampling, and bivariate data analysis used the assisted t-test. The results of the univariate analysis showed that the respondents were aged 20-35 years (84.4%), high school (78.1%), housewife (90.6%), the knowledge of breastfeeding mothers before being given health education using the brainstorming method was mostly lacking (43.8%), the knowledge of breastfeeding mothers after being given health education using the brainstorming method was mostly good (65.6%). The results of the bivariate analysis showed that there was an effect of health education using the brainstorming method about exclusive breastfeeding on increasing the knowledge of breastfeeding mothers with a p-value of 0.000 <0.05. There is an effect of health education using the brainstorming method about exclusive breastfeeding on increasing the knowledge of breastfeeding mothers .


INTRODUCTION
According to the World Health Organization (WHO, 2011) Exclusive breastfeeding means that from birth to 6 months of age, babies are given only breast milk without any other food or drink except medicines and vitamins.Exclusive breastfeeding given in the first 6 months can improve the baby's immune system (Humune, Nugroho and Tampubolon, 2020).
Results data Research Health Base (Riskesdas) Profile Health Indonesia 2018 shows that the proportion of breastfeeding patterns for babies aged 0-6 months in Indonesia is 37.3%, this figure is still below the target of the Indonesian Ministry of Health through the Republic of Indonesia Minister of Health Decree No. 450/Menkes/SK/IV/Year 2004 concerning exclusive breastfeeding of 80%.West Java Province is one of the provinces where breast milk is still below the national target .The latest data obtained according to the Indonesian Health Profile in 2018 shows that 57.97% of babies are breastfed in West Java, this indicates a lack of exclusive breastfeeding for babies in the West Java area (Pratiwi, 2020).Research results according to the Indonesian Health Profile (2017), the percentage of exclusive breastfeeding for babies aged 0-6 months is 35.73%.Based on the 2016 West Java Health Profile, the percentage of exclusive breastfeeding for babies aged 0-6 months in West Java was 46.4% and the coverage of exclusive breastfeeding in Bogor Regency in 2016 was 52.6%.Meanwhile, in 2017, based on the 2017 West Java Health Profile, the coverage of exclusive breastfeeding in Java West is 53.0% and coverage of exclusive breastfeeding in Bogor Regency is 22.84%.There has been a decrease in exclusive breastfeeding coverage in Bogor Regency (Purvitasari, 2019).
The results of research conducted by Nasution et al (2016), factors that influence mothers in deciding and implementing breastfeeding patterns, especially the mother's physical and psychological lack of readiness, lack of information and knowledge about the benefits of breast milk, and lactation management as well as matters related to breastfeeding.Therefore, Breastfeeding is one of the most important factors in reducing IMR, which is supported by The Lancet Breastfeeding Series in 2016 which states that breastfeeding can reduce IMR in Indonesia.
Based on the results of research by Sarik, Pratiwi & Maharani (2021) entitled the influence of health education using booklets about exclusive breastfeeding on the knowledge of breastfeeding mothers, it was found that providing health education using booklets about exclusive breastfeeding had an effect on the knowledge of breastfeeding mothers (Sarik, Pratiwi and Ajeng, 2019).
Based on the results of a preliminary study conducted by researchers at PMB D, Bogor Regency in November 2022, there were 35 breastfeeding mothers, the results of interviews conducted by researchers with several breastfeeding mothers at PMB D, there were mothers who did not exclusively breastfeed their children because the mothers were busy.working, there is a perception that a baby without additional food will become hungry and the mother's knowledge about breast milk is lacking (Hamidou et al., 2024).Mother's knowledge about the advantages of breast milk will support the success of exclusive breastfeeding (Mardhika et al., 2022).
Based on the background above, the author is interested in further research on "The Influence of Health Education using the Brainstorming Method about Exclusive Breastfeeding on the Knowledge of Breastfeeding Mothers in PMB D Bogor Regency in 2023".

RESEARCH METHODS
This research uses an experimental type of research with a pre-experimental approach.In this design there are no control variables and the research design uses one group pre-posttest.Analytical research method with a cross sectional design.The data collection method used was a survey using a questionnaire.This research was carried out on March 22 and April 5 2023, at PMB D, on Jl E. Sumawijaya, Parakan, Kec.Ciomas, Bogor Regency.This research was carried out on March 22 and April 5 2023.Based on table 1. above, it shows that there were 3 respondents aged < 20 years (9.4%), 27 people aged 20-30 years (84.4%), and 2 respondents aged > 35 years (6, 2%).Based on table 2. above, it shows that the majority of respondents had a junior high school education of 5 people (15.7%), a high school degree of 25 people (78.1%), a bachelor's degree of 2 people (6.2%).Based on table 3. above, it shows that the majority of respondents were 29 domestic workers (90.6%), 1 private employee (3.1%), 2 civil servants (6.3%).Based on the results of the analysis in the table above, it shows that the knowledge of breastfeeding mothers about exclusive breastfeeding before being given health education using the brainstorming method was mostly in the category of insufficient knowledge, 14 people (43.8%), sufficient knowledge, 12 people (37.5%), and a small portion of good knowledge 6 people (18.7%).Based on the results of the analysis in the table above, it shows that the knowledge of breastfeeding mothers about exclusive breastfeeding after being given health education using the brainstorming method is mostly with good knowledge as many as 21 people (65.6%), with sufficient knowledge as many as 8 people (25%), and a small percentage There were 3 respondents with less knowledge (9.4%).Based on the results of the analysis in the table above, it shows that respondents experienced an increase in knowledge, this can be seen from the average increase in knowledge before being given health education (9.38) and after being given health education (12.56).

b. Bivariate analysis
Based on the table of statistical test results using the t-test, it was found that the p-value was 0.000 < 0.05, meaning it was significant, so H0 was rejected and Ha was accepted using a confidence level of 95%, which means there was an influence of health education using the brainstorming method about exclusive breastfeeding on the knowledge of breastfeeding mothers.at PMB D Bogor Regency in 2023.

Discussion
Based on the research results, it shows that before being given health education using the brainstorming method to breastfeeding mothers, the average respondent's knowledge was poor and after being given health education using the brainstorming method, the average respondent's knowledge increased to good.Based on the results of statistical tests using the ttest, it was found that the p-value was 0.000 < 0.05, meaning that there was an influence of health education using the brainstorming method on increasing breastfeeding mothers' knowledge about exclusive breastfeeding.
This research is in line with research conducted by Lintang (2016), which found a p-value of 0.000 < 0.05, which means that there is an influence of the brainstorming method on mothers' knowledge and attitudes about exclusive breastfeeding.
The results above indicate an increase in knowledge after the intervention was carried out, and the media used during the intervention was leaflet media with the brainstorming method.In this research, through leaflets about exclusive breastfeeding and brainstorming methods, breastfeeding mothers were able to understand and find out about the importance of exclusive breastfeeding for the baby's future.
Counseling using leaflets is a process of providing various information to breastfeeding mothers, especially about exclusive breastfeeding for babies aged 0-6 months to optimize their growth and development (Widyawati, 2020).In general, leaflets are a form of media used to convey message information through folded sheets, containing information in the form of sentences or images.This is proven by research conducted by Lela (2019) which examined increasing mothers' knowledge and attitudes about exclusive breastfeeding at the Karya Mulya Pontianak Community Health Center through leaflet media.The research results showed that there was an increase in mothers' knowledge and attitudes about exclusive breastfeeding after being given intervention through leaflet media.
Ambarwati (2016) explained that one of the benefits of learning with brainstorming health education is that it creates more motivation in respondents, so that with this motivation the information given to respondents will be more easily accepted and understood.This is proven by research conducted by Bunasari (2016) which examined the effect of brainstorming on increasing maternal behavior in providing exclusive breastfeeding.The results of the study showed that there was an increase in maternal behavior in providing exclusive breastfeeding after being given the brainstorming intervention (ER, 2010).
Mothers' good knowledge about exclusive breastfeeding will influence their timing of exclusive breastfeeding.Knowledge can be influenced by the number of sources of information obtained, such as a respondent's knowledge is influenced by the level of education a person has, the higher the level of education, the more information the respondent receives, the environment where they live and work factors can also influence the information obtained (Sholichah, 2016).
According to researchers, mothers who do not provide exclusive breastfeeding are caused by a lack of maternal knowledge.Health education using brainstorming methods about exclusive breastfeeding can change mothers' actions for the better.This is because mothers' knowledge has increased after being given health education using the brainstorming method, so that breastfeeding mothers with good knowledge can influence exclusive breastfeeding for their children from 0 to 6 months of age.
The Influence of Health Education Using Brainstorming Method About Exclusive Breastfeeding on Breastfeeding Mother's Knowledge in PMB D Bogor District in 2023 Zulfa Nur Azizah, Ekki Noviana, Fauzul Munah

Table 1 .
Distribution of Respondents Based on Age

Table 2 .
Distribution of Respondents Based on Education

Table 3 .
Distribution of Respondents Based on Occupation

Table 4 .
Distribution of Respondents Based on Knowledge of Breastfeeding Mothers Before Giving Health Education Using the Brainstorming Method The Influence of Health Education Using Brainstorming Method About Exclusive Breastfeeding on Breastfeeding Mother's Knowledge in PMB D Bogor District in 2023 Zulfa Nur Azizah, Ekki Noviana, Fauzul Munah

Table 5 .
Distribution of Respondents Based on Knowledge of Breastfeeding Mothers After Being Given Health Education Using the Brainstorming Method

Table 6 .
The Effect of Health Education Using the Brainstorming Method on Increasing Breastfeeding Mothers' Knowledge about Exclusive Breastfeeding The Influence of Health Education Using Brainstorming Method About Exclusive Breastfeeding on Breastfeeding Mother's Knowledge in PMB D Bogor District in 2023 Zulfa Nur Azizah, Ekki Noviana, Fauzul Munah