An Analysis On Knowledge, Perception And Sociocultural Factors Affecting Motherâ€™s Behavior In Giving Breastfeed-supplement Meal

The administration of breastfeed-supplement meal to less than 6-month age baby occurs because mother considers that breastfeed-supplement meal is better than breastfeed. The objective of research is to analyze knowledge, perception and sociocultural factors affecting motherâ€™s behavior in giving breastfeed-supplement meal in less than 6-month age baby.  The research design used was correlational analytical one with crosssectional approach. The population of research included all mothers of 7-12 month age baby, consisting of 40 mothers. The sample consisted of 37 respondents, taken using simple random sampling technique. Data was collected using questionnaire and tested using linear regression, as well as presented in the form of frequency distribution frequency.  From the result of regression test, it could be found R value = 0.717, indicating that there is a fairly strong relationship between independent and dependent variables, while coefficient of determinacy or R square value was 0.514 or 51.4%, meaning that independent variable contributed to dependent variable by 51.4%.  Mothersâ€™ good knowledge on breastfeed-supplement meal can affect their behavior in giving breastfeed-supplement meal because through such knowledge, mothers can recognize and understand how to give breastfeed-supplement meal appropriately to babies. Similarly, perception and socio-cultural factors developing in family or community environment can affect mothersâ€™ behavior


INTRODUCTION
Exclusive breastfeeding is the provision of breast milk without food and other additives in infants aged 0 to 6 months. Even water is not given at this exclusive breastfeeding stage. The World Health Organization states that exclusive breastfeeding during the first six months of life is best. The fact that there are still many mothers who provide weaning foodof milk in infants when aged less than six months, Early supplementary feeding in infants occurs because the mother is less aware of the proper breastfeeding feeding, in addition to the mother's employment status being the reason the mother provides weaning foodtoo early for lack of time for her child, besides adanyan assumes that the baby will continue crying after breastfeeding means the baby is still hungry, so it should be given additional food, as well as a growing culture in the environment around the mother that has been done for generations such as infant banana in infants when the age of 4 months (Diah, 2011).
The fact that there are still many mothers who provide weaning foodin infants when aged less than 6 months, where this occurs because the mother considers that the MPASI is better than breast milk, the mother is also less understanding about how to provide the right MP-ASI and also because mothers follow the advice of the family when the age of 4 months the child must be given banana pulp. Provision of MP-ASI less than six months can cause a negative impact on the health of infants such as infants become easily affected diarebahkan can increase infant mortality. In 2010 in Indonesia, infants who received breast milk and liquid food (predominant) by 4.5%; breastfed and early-stage breastfed infants (81.54%); while for the coverage of nutritional status of infants 0-6 months in 2010 was 4.2% including malnutrition; 7.2% were included in malnutrition; 82.3% included good nutrition and 6.2% including more nutrition. In 2010 in East Java there were 136 malnutrition-prone sub-districts or 20.54% of the 662 sub-districts in East Java Province. The number of BGM infants in East Java in 2010 was 42,826 or 2.07% of all babies weighed. The coverage of nutritional status in East Java in 2010 was 4.8%, including malnutrition; 12.3% were included in malnutrition, 75.3% including good nutrition and 7.6% including more nutrition. Early MP-ASI in East Java is still high at 69.28%. The low feeding of appropriate age-appropriate feeding for babies is one of the triggers.
Inadequate knowledge causes the family or the mother to be unable to choose the best food that should be given to the baby (Fadilah, 2004). The purpose of this research is to analyze the knowledge, perception and socio-cultural factors that influence mother's behavior in providing weaning foodfor infants less than six months

MATERIAL AND METHOD Material 1. Basic Behavioral Concepts
Behavior is an individual response to a stimulus or an action that can be observed and has a specific frequency, duration and purpose either realized or not (Wawan, 2011).
According to Skinner (1938) cited by Notoatmodjo (2011) behavior is the result of the relationship between a stimulus (stimulus) and response (response). He distinguishes the two responses: 2. Respondent response or reflexive response It is the response required by certain stimuli.
Such excitements are calledeliciting stimuli because they produce relatively fixed responses. Respondent responses also include emotional behaviors that arise because of an uncomfortable organism in question.

a. Operant responseeorinstrumental response
The operant response is a response that arises and develops followed by a certain stimulation. Such stimulation reinforces the response that the organism has made. In everyday life, the operant's response or instrumental response constitutes the lion's share of human behavior and the possibility to modify it is immense or unlimited.

The basic concept of weaning food
Breastfeeding food is food given to children aged 6-24 months. The role of supplementary food is not at all to replace breast milk but to complement breast milk. Thus, weaning foodshouldbe given to the child, at least until the age of 24 months (Yesrina, 2000in Suparyanto, 2010. Breastfeeding Foods are foods or beverages containing nutrients given to infants/children to meet their nutritional needs (Utami, 2006).
Additional food starts to be given to infants after six months of age, and breast milk should be given to infants at least until the age of 24 months. Food additives for this baby should be a complement and can meet the needs of the baby. So baby supplements are useful to cover the nutritional deficiencies contained in breast milk (Revelation, 2012).

Method
The design of this research is correlational analytic by using cross-sectional approach that is researcher emphasize time measurement data or research subject is assessed only one time only. Whereonly the factors that influence the mother's behavior in giving the MP-ASI is the factor of knowledge, perception and social culture. The sample of this research is all mothers who have babies aged 7-12 months in Kedungsolo Village, Porong Sub-district, Sidoarjo Regency as many as 37 mothers. The instrument used in this study is a questionnaire which contains about knowledge about MP-ASI as much as 16 questions, mother's perception about MP-ASI as many as 12 problems and socio-culture that developed in the community as much as 1 question and questionnaire about behavior of giving of ASI in baby less than 6 months as many as 10 questions.
Evaluation activities in this study were conducted in the following manner: 1) Knowledge Assessment To answer the correct given score 1 and wrong answer given score 0. result of the weightedanswer, then summed and compared with the highest score then multiplied 100% according to Setiadi (2007)  Results of questionnaire data processing then calculated by using the formula as follows: Information : T = Score obtained X = score of respondents changed to score T Then the results of questionnaires calculated in interpreted For classification of perception is categorized as follows: (1) Positive if score T> T Mean (2) Negative If score T <T Mean.

1) Socio-Cultural Measurement
Assessment of socio-cultural aspects that may affect breastfeeding supplementary feeding is done by examining whether there is a tradition of giving breast milk to infants aged less than six months such as banana or other pulp. Results of questionnaire data processing then calculated by using the formula as follows: Information : T = Score obtained X = score of respondents changed to score T Then the results of questionnaires calculated in interpreting for classification of behavior are categorized as follows: (1) Positive if score T> T Mean (2) Negative If score T <T Mean.

3)
Hypothesis testing To know the influence of knowledge, perception and socio-cultural factors affecting mother's behavior in giving of breast milk to infant less than six months old by using linear regression test with assumption if ρ <α and α = 0,05 then H¬0 is rejected then factor knowledge, perception and social culture influence mother's behavior in giving of breast milk to baby less than six months and vice versa. Total 37 100 Table 1 shows that most respondents aged 20-35 years were 27 respondents (73%).  Table 2 shows that most of the respondent's age is 9-10 months old as 23 respondents (62.2%). Total 37 100 Table 3 shows that almost half of the respondents gave the first breastfeeding at the age of 5 months as many as 17 respondents (45.9%). Total 37 100 Table 4 shows that almost half of the respondents did not work or as housewives as much as 17 respondents (45.9%). Tabel5 Table 5  University (D3, S1, S2) 7 18,9

Characteristics of Respondents by Education
Total 37 100 Table 5 shows that most mothers have a secondary education background (SLTA, MAN) of 18 mothers (48.6%).   Total 37 100 Table 7 shows that almost half of respondents have income above Rp. 2,200,000 as many as 18 respondents (48.6%). Total 37 100 Table 8 shows that almost half of the respondents obtained information from health workers as many as 15 respondents (40.5%). Total 37 100 Table 9 shows that almost half of the respondents have sufficient knowledge about breastfeeding food as much as 18 respondents (48.6%).  No 20 54,1

Mother's Perception of Breastfeeding Foods
Total 37 100 Table 11 shows that most respondents had negative family or family backgrounds supporting early breastfeeding as much as 20 respondents (54.1%). Total 37 100 Table 12 shows that most of the respondents had negative behaviors about breastfeeding food as much as 23 respondents (62.2%).

Mother's Knowledge About Breastfeeding Foods
Respondents in this study indicated that they had sufficient knowledge about complementary feeding. The emergence of consciousness of respondents in this study because the respondents are still lacking in understanding the information about breastfeeding complementary food even though the respondents have obtained information about it so that some of the respondents still have enough knowledge about breastfeeding food. Based on the age of respondents belonging to the age of adulthood where at this age the thinking process of a person already can be said mature where should respondents have a good understanding of complementary foods of milk, but because respondents lack understanding of information received so well that they do not have good knowledge about food breastfeeding companions so that they still have a lot of negative behavior in the provision of MP-ASI early.

Mother's perception of weaning food
Respondents in this study indicated that many mothers considered breast milk supplementary foods may be given to infants under 6 months of age, this is because they followed a growing tradition around the respondents because the people around them gave mashed bananas to children at four years of age does not have any impact on the baby. So even though mother Apra has good knowledge about breastfeeding food but they still try to provide weaning foodas they follow the tradition that has been running and they assume that weaning foodfood will not give bad effect if given to children under six months. Based on the number of respondent's children it can be seen that the respondents still do not have enough experience in providing weaning foodof milk in their toddlers, so they still assume that breastfeeding supplements can be given to children according to direction or guidance from parents, so they assume that weaning foodBreast milk may be given under 6 months of age.And from the respondent's source of information they should be able to show or have positive perception about weaning foodso that they have assumed that the companion breastfeeding supplementary should be given when the child is more than 6 months but apart from the health worker the respondent also get information from health workers will but some of the respondents get information from magazines and from friends or relatives where the information received may influence the perceptions of the respondents about breastfeeding complementary foods, whether they consider whether they are good or not to give to their children.Also, this happens because sometimes the information obtained still can not be verified and many still have not had a good understanding.

Social culture of the mother towards the provision of MP-ASI
The results of this study indicate that most of the respondents follow the traditions or habits that have developed in their environment either family environment or community environment in general, where the culture states that there will be no negative effects if they are given complementary feeding, because if only given ASI children will still feeling hungry, therefore mothers feel confident with the habits that families do about the provision of MP-ASI so they provide early breastfeeding on their babies.

The behavior of Mother against the provision of MP-ASI
The results of this study indicate that most respondents have negative behaviors about breastfeeding food in which respondents provide weaning foodat age less than 6 months because respondents assume that at that age there will be no adverse side effects if the child is given MP ASI early, In addition, because the environment around the respondents also support the provision of early breastfeeding MP makes respondents feel confident that children aged 4 months need to be trained or introduced to solid foods other than breast milk.Based on the age of the respondents in this study indicates that the experience they have about the provision of MP-ASI early is not only derived from their personal experience but also from experiences owned by people around respondents such as respondent siblings, parents or other family members, where the experience obtained by the respondents indicated that early delivery of ASI MP would not have a detrimental effect or effect on their child, so the respondents followed the behavior. Based on the result of cross-tabulation between knowledge and behavior of respondents obtained data from 18 respondents who have enough knowledge there are ten respondents (55,6%) who have negative behavior in giving MP-ASI. While the cross-tabulation between perception and the behavior of MP-ASI obtained data from 20 respondents who have negative perceptions there are 17 respondents (85%) who has negative behavior in giving MP-ASI early on their child. And on cross tabulation between culture and weaning food providing obtained data from 20 respondents mostly have negative behavior also.
The result of linear regression test shows that the value of R = 0.717 indicates that the relationship of independent variable and dependent variable is strong enough, while the coefficient of determination or R Square shows the value of 0,514 or 51,4%, meaning independent variable (knowledge, perception, and social culture) has an influence of 51.4% of the dependent variable (mother's behavior in giving MP-ASI), while 48.6% is influenced by other factors such as economic conditions or mother's motivation in giving MP-ASI Sig value. <0.05, the regression model shows its linearity, where it can be stated that the regression model can show the independent variable in influencing the dependent variable occurs directly so that the knowledge, perception and behavioral variables directly influence the mother's behavior in giving the MP-ASI. Based on the ANOVA table, we get the value of Sig = 0,000 which means ρ <significant criterion (0,05), thus the regression equation model based on the research data is significant meaning the assumption which can be expressed from the result of this regression test indicate that the variables of knowledge, directly influence the mother's behavior in giving the MP-ASI and the result of this linear regression test showed that there is a linear relationship or linierity criterion fulfilled.
The results of this study indicate that the mother's knowledge about good weaning food can influence mother's behavior in giving the breast milk because with that knowledge mother can understand and understand how to give the weaning food appropriately in their abak. Similarly, the perception and socio-culture that develops in the family or community can affect the behavior of the mother, where with a negative perception about the provision of weaning food such as mother assume that if the child is 4 or 5 months may be given weaning food because if only given breast milk they will still feel hungry. While the socio-cultural factors also show the same thing, where if people already have a very strong belief and belief that when the baby is givenweaning food since the age of 4 months then the baby will be faster strong and not easy to cry and easily hungry.

CONCLUSION
Mother's knowledge about breastfeeding food in KedungsoloPorong Village of Sidoarjo Regency has enough knowledge. While the perception of a mother about the complementary food of ASI obtained data mostly have a negative perception. Sociocultural influences on the provision of weaning foodof milk obtained data that most of the respondents gave the breast milk to their babies. Maternal behavior in providing weaning food of milk in obtained data mostly have negative behavior. Based on the analysis of the three factors, namely knowledge, perception and socio-culture shows that there is a relationship between the three factors (knowledge, perceptionand socioculture) on the mother's behavior in giving weaning food.

SUGGESTION
The need to develop the material about weaning food in health education institutions so that students can get more information and add literature library and equipped with a simulation of the provision of good weaning food. It is expected that more respondents to improve information about breastfeeding complementary foods such as active in following the counseling conducted by cadres or health personnel so that more understanding about the importance of complementary foods ASI. Health Service Institution (Posyandu and Puskesmas) should be more active in conducting health promotion activities in the community, especially about weaning foodso that it can provide better health services and can improve community understanding about complementary foods. Subsequent research can conduct other material assessments such as factors that influence the knowledge and perception of mothers in providing food pendampign ASI so that the results of research can be more helpful in the development of science.