The Relationship Between Family Support And The Attitudes Of Partworld Mothers In Exclusive Breastfeeding At The Hj Clinic.

Mother's Milk (ASI) is the best and most suitable food for babies to ensure the growth of babies into human quality. The substances contained in breast milk contain almost all the nutrients needed by babies with concentrations that suit the needs of the baby. (MOH RI, 2014). Based on preliminary studies conducted by researchers at Clinic Hj. Tapianie Prambon Sidoarjo in January 2020 from 15 respondents showed that the attitude of the mother in giving exclusive breast milk is very good, this is because of the large amount of family support in motivating mothers to want to breastfeed exclusively. The purpose of this study was to determine the Relationship Between Family Support and Attitude of Postpartum Mother in Giving Exclusive Breast Milk at Clinic Hj. Tarpianie Prambon Sidoarjo Year 2020. The design of this study included a cross sectional analytic study with a survey approach. The population in this study were all postpartum mothers in Clinic Hj. Tarpianie Amd. Keb Prambon Sidoarjo Year 2020, the sample in this study was taken with a non-probability sampling technique by means of accidental sampling, amounting to 31 respondents. The independent variable in this study is family support with an ordinal scale and the dependent variable is the attitude in exclusive breastfeeding with an ordinal data scale. This research was conducted from January to July 2020 in the Class of Pregnant Women at Clinic Hj. Tarpianie, Amd. Keb Prambon Sidoarjo used a questionnaire measuring instrument that was tested with a validity and reliability test. In collecting data from respondents the next step taken by researchers is data processing by editing, coding, scoring, tabulating, data entry, and cleaning. Data analysis in this study used the Spearman rank test. From the Spearman rank test results following the normal distribution with a significant level (α = 0.05), it was found that p value < α or 0.001 < 0.05 which means that H0 is rejected and H1 is accepted. The conclusion is that there is a relationship between family support and mother's attitude in exclusive breastfeeding. The form of husband's support can be shown by the husband through daily activities, for example giving information to the mother about the importance of exclusive breastfeeding to the baby or taking the mother to a health service to find information. If a mother benefits from all her husband's support, then a mother has received a positive stimulus to change her attitude to be positive.


INTRODUCTION
Mother's milk (ASI) is the best and most suitable food for babies to ensure the baby's growth into a quality human being.The substances contained in breast milk contain almost all the nutrients needed by babies in concentrations that suit the baby's needs.Breast milk also contains immune factors that provide the baby's body with protection against infection, when the baby's body cannot yet protect itself.Experts have agreed that breast milk can provide everything a baby needs from birth to 6 months, which is called exclusive breast milk (MOH RI, 2004).
Data on exclusive breastfeeding carried out by the 2017 Indonesian Basic Health Survey (SDKI) stated that 32% of babies under six months were exclusively breastfed.Compared with the 2017 IDHS, the number of babies under six months who received exclusive breastfeeding increased by 6.4 % to 38.4%.The target for exclusive breastfeeding for babies 0-6 months is set at 80%, but the achievement rate is still very far from this target, while the provision of formula milk as a complementary food for breast milk reaches 85.8 % .Exclusive breastfeeding coverage in East Java was 30.72 % in 2017, far from the target set at 80% (East Java Provincial Health Service, 2017).
Based on initial studies conducted by researchers at the Hj Clinic.Tapianie Prambon Sidoarjo in January 2020 from 15 respondents, it was found that 9 people strongly supported the percentage (60%) with a very good attitude of 6 people (66.7%), a good attitude of 3 people (33.3%).3 respondents supported (20%) with a very good attitude of 2 people (33.3%), a good attitude of 1 person (66.7%). 2 respondents did not support it with a good attitude of 1 person (50%), a bad attitude of 1 person (50%) and a very bad attitude of none.And 1 respondent was very unsupportive and 1 person (100%) behaved very unkindly.Based on the survey above, it can be concluded that mothers' attitudes towards providing exclusive breastfeeding are very good, this is due to the large amount of family support in motivating mothers to want to breastfeed exclusively.Roesli (2004) states that family support is the external factor that has the greatest influence on the success of exclusive breastfeeding.Having family support, especially the husband, will have an impact on increasing the mother's self-confidence or motivation in breastfeeding.It was stated that encouragement and support from the government, health workers and family support determine the mother's motivation to breastfeed.Friedman (2010) suggests that family support can be provided in several forms, namely: informational support, appreciation support, instrumental support and emotional support.Nursing mothers need support and help, both when starting and continuing breastfeeding.As a first step, they need help during pregnancy and after giving birth.They need support for breastfeeding for up to 2 years, health care and support from their family and environment (Proverawati, 2010).The family, especially the husband, is an important part in the success or failure of breastfeeding, because the husband determines the smoothness of breastfeeding knowledge ( let down reflex ) which is greatly influenced by the mother's emotional state and feelings (Roesli, 2007).
The general aim of this research is to determine the relationship between family support and attitudes Postpartum Mothers in Exclusive Breastfeeding At the Hj Clinic.Tarpianie Prambon Sidoarjo 2020.The specific aim of this research is to identify family support In Providing Exclusive Breast Milk At the Hj Clinic.Tarpianie Prambon Sidoarjo 2020, Identifying Attitudes Postpartum Mothers in Exclusive Breastfeeding At the Hj Clinic.Tarpianie Prambon Sidoarjo 2020, Analyzing the Relationship Between Family Support and Attitude Postpartum Mothers in Exclusive Breastfeeding At the Hj Clinic.Tarpianie Prambon Sidoarjo 2020.

METHODS
cross-sectional quantitative analytical research with a survey approach ( survey research ).The population in this study were all postpartum mothers at the Hj Clinic.Tarpianie Amd.Keb Prambon Sidoarjo In 2020, the sample in this study was taken using a nonprobability sampling technique using accidental sampling , totaling 31 respondents.The independent variable in this study is family support, namely the mother's assessment of the provision of support from the family to the mother regarding exclusive breastfeeding which is categorized as Very not supportive (0-25%), Not supportive (26-50%), Supportive (51-75% ), Very supportive (76-100%) with an ordinal scale and the dependent variable is Attitude towards exclusive breastfeeding, namely the reaction that arises after receiving support from the family regarding exclusive breastfeeding which is categorized in Very bad (0-25%), Not good (26-50%), Good (51-75%), Very good (76-100%) with ordinal data scale.
This research was conducted from January to July 2020 in the Pregnant Women's Class at the Hj Clinic.Tarpianie, Amd.Keb Prambon Sidoarjo using a questionnaire measuring instrument which was tested with validity and reliability tests with the results for the questionnaire supporting all valid questions indicated by the results of the Pearson correlation being all positive and the 2 tailed sign value < 0.05, while in the questionnaire the mother's attitude in giving There is one question regarding exclusive breastfeeding, namely question number 11, the Pearson correlation result is positive with a 2-tailed sign value of 0.237>0.05,so question number 11 is declared invalid.In this research, before data collection was carried out, a cover letter was submitted from the Faculty of Nursing, DIV Midwifery Study Program, IIK Strada, then submitted to the Hj Clinic.Tarpianie Amd.Keb Prambon Sidoarjo to request permission for research.After receiving permission, the researcher then asked the respondent's permission to be used as subjects in conducting research to determine the relationship between family support and attitudes Postpartum Mothers in Exclusive Breastfeeding At the Hj Clinic.Tarpianie Amd.Keb Prambon Sidoarjo Method of collecting data by giving questionnaires to respondents.by carrying out the process of editing, coding, scoring, tabulating, data entry and cleaning .
This research was analyzed using the Spearman rank statistical test which was interpreted as if the p value > level of significance (0.05) then the conclusion was that Ho was accepted and H1 was rejected, meaning that there was no relationship between family support and attitudes .Postpartum Mothers in Exclusive Breastfeeding At the Hj Clinic.Tarpianie Amd.Keb Prambon Sidoarjo and if the p value < level of significance (0.05) then the conclusion is that Ho is rejected and H1 is accepted, meaning there is a relationship between family support and attitude .Postpartum Mothers in Exclusive Breastfeeding At the Hj Clinic.Tarpianie Amd.Keb Prambon Sidoarjo.From the results of the Spearman rank test following a normal distribution with a significance level (α = 0.05), it is found that p value < α or 0.001 < 0.05 , which means that H 0 is rejected and H 1 is accepted.The conclusion is that there is a relationship between family support and the mother's attitude towards exclusive breastfeeding.

Family Support in Exclusive Breastfeeding
Based on the results of data processing in table 2, it was found that of the 31 respondents, the majority (70.9%) of families strongly supported exclusive breastfeeding at the Hj Clinic.Tarpiani Prambon Sidoarjo in 2020, namely 22 respondents.The mother's mental condition greatly influences breast milk production, so it also indirectly influences the fulfillment of breast milk intake for her baby.Therefore, mothers should avoid feeling uncomfortable, anxious and depressed.Comfortable conditions cannot be created if the mother does not receive enough support from parties, including : close family, husband, support group , health workers, the agency where the mother works and the government.According to Chomaria (2011) Support is helping, supporting, supporting something.The family is one of the most important institutions of society.The family represents the primary social group that influences and is influenced by other institutions.Individuals recognize the family as the basic social unit because most individuals have more continuous contact with this social group than with other social groups.The family carries the main responsibility in introducing and socializing the individual.The family transmits the basic cultural background of a family to its members.

Postpartum Mothers' Attitudes in Exclusive Breastfeeding
Based on the research results presented in table 3, data was obtained that the majority of respondents (58.1 % ) had a very good attitude towards exclusive breastfeeding.According to Allport (1954) quoted by Notoatmodjo (2010), attitude is a tendency to act ( tend to behave ), which means that attitude is a component that precedes action or overt behavior.Attitudes do not form by themselves but occur in human interactions.The process of change and formation of new attitudes comes from internal and external factors (Gerungan, 2004).External factors come from outside the individual in the form of stimuli to form and change attitudes, for example from friends, family (husband), the environment and the media (Sunaryo , 2004 ).Factors that influence attitudes include personal experience, the influence of people who are considered important, the influence of culture, mass media, educational institutions and religious institutions and the influence of emotional factors.This condition will contribute to the action of giving exclusive breastfeeding to breastfeeding mothers, meaning that seen from the aspect of attitude, it shows a positive attitude, so that it will have an impact on the mother's desire to give breast milk exclusively.
The Relationship Between Family Support and Postpartum Mothers' Attitudes in Exclusive Breastfeeding at the Hj Clinic.Tarpianie Prambon Sidoarjo 2020.
Based on table 4, it shows that the majority of respondents (51.5%) are very supportive and have a very good attitude, as many as 16 respondents.From the results of the Spearman rank test following a normal distribution with a significance level (α = 0.05 ), it is found that the p value < α or 0.001 < 0.05 , which means that H 0 is rejected and H 1 is accepted.The conclusion is that there is a relationship between family support and the mother's attitude towards exclusive breastfeeding.The conclusion is that there is a relationship between family support and the attitude of postpartum mothers in providing exclusive breastfeeding at the Hj Clinic.Tarpianie Prambon Sidoarjo 2020.Based on the research above, it can strengthen the theory put forward by Sunaryo (2004) that factors forming and changing attitudes can come from friends, family (husband), environment and the media.So the husband's support that a mother receives can be a factor in the mother's attitude towards giving exclusive breast milk to her baby.Family (husband) social support consists of informational support, assessment support, instrumental support and emotional support (Asih et al. , Eds ., 1998: 196).Husbands can show their support through daily activities, for example providing information to mothers about the importance of exclusive breastfeeding for babies or taking mothers to health services to seek information.If a mother benefits from all her husband's support, then the mother has received a positive stimulus to change her attitude to a positive one.
So that the mother receives greater family support in providing exclusive breastfeeding at the Hj Clinic.Tarpianie Prambon Sidoarjo In 2020, mothers' attitudes will be better in giving exclusive breast milk to their babies.Therefore, efforts should be made to provide maximum family (husband) support to the mother while still paying attention to other factors that can influence the mother's attitude towards exclusive breastfeeding.To improve the attitude of postpartum mothers in providing exclusive breastfeeding, the participation of health workers is needed because in general mothers are willing, obedient and follow the advice of health workers, therefore health workers are expected to provide information about the right time to give exclusive breastfeeding.The benefits of exclusive breastfeeding can increase the body's immune system and the risks of not giving exclusive breast milk to babies.The research was conducted using an instrument in the form of a questionnaire filled in by respondents.In this research there were obstacles either from the researchers themselves or other matters related to the research.These obstacles include: the researcher is conducting research for the first time and is still in the learning process, therefore there are still many shortcomings and the results are still far from perfection.Limited data collection in the form of closed questions allows respondents to answer dishonestly or not understand the intended question.

CONCLUSION
The majority (70.9%) of families strongly support postpartum mothers at the Hj Clinic.Tarpianie Prambon Sidoarjo in 2020 in providing exclusive breastfeeding, there were 22 respondents.The majority (58.1%) of postpartum mothers at the Hj Clinic.Tarpianie Prambon Sidoarjo in 2020 had a very good attitude towards exclusive breastfeeding, namely 18 respondents.From the results of the Spearman rank test following a normal distribution with a significant level (α = 0.05 ), it is found that the p value < α or 0.001 < 0.05 , which means that H 0 is rejected and H 1 is accepted.The conclusion is that there is a relationship between family support and the mother's attitude towards exclusive breastfeeding. .The conclusion is that there is a relationship between family support and the attitude of postpartum mothers in providing exclusive breastfeeding at the Hj Clinic.Tarpianie Prambon Sidoarjo 2020

Table 2 .
Family support for exclusive breastfeeding Based on table 2 above, it shows that of the 31 respondents, the majority (70.9%) strongly support exclusive breastfeeding, namely 22 respondents.

Table 3 .
Attitudes towards exclusive breastfeeding