Implementation of spiritual education and the speos method using the BEST for moms e-book in mothers with ineffective breastfeeding: A nursing case study
https://doi.org/10.52235/lp.v7i2.760
Keywords:
ineffective breastfeeding, breastfeeding education, speos method, e-book, self-efficacyAbstract
Background: Ineffective breastfeeding remains a common postpartum nursing problem and may be manifested by insufficient milk production, poor infant latch, low breastfeeding frequency, infant dissatisfaction after feeding, and maternal anxiety. Mothers with ineffective breastfeeding require an intervention that addresses not only physiological milk production but also maternal knowledge, confidence, emotional readiness, and spiritual meaning. Spiritual breastfeeding education combined with the Stimulation of Endorphin, Oxytocin, and Suggestive massage method and digital learning media may offer a holistic approach to support breastfeeding success.
Objective: This study aimed to describe the application of spiritual breastfeeding education and the SPEOS method using the BEST for Moms e-book among mothers with ineffective breastfeeding.
Methods: This study used a descriptive case study design with a nursing care approach. The study was conducted in Tanjung Baru Village, Baturaja Timur, and involved two Muslim breastfeeding mothers with infants aged 0–1 month who experienced ineffective breastfeeding and were able to access the e-book. The intervention was delivered in eight visits over four weeks and included spiritual breastfeeding education, endorphin massage stimulation, oxytocin massage, suggestive techniques, and guided use of the BEST for Moms e-book. Data were collected using an ineffective breastfeeding assessment format, a spiritual breastfeeding education questionnaire, an intervention checklist, the Breastfeeding Self-Efficacy Scale–Short Form, and standard operating procedures for the intervention. Data were analyzed descriptively by comparing breastfeeding indicators before and after the intervention.
Results: Both mothers showed improvement after the intervention. Breastfeeding self-efficacy increased from 51 to 59 in the first case and from 55 to 67 in the second case. Breastfeeding frequency and infant urination frequency increased from fewer than eight times per day to more than eight times within 24 hours in both cases. Maternal anxiety decreased, maternal confidence improved, infant latch and breastfeeding position became more appropriate, and infants appeared calmer after breastfeeding. Ineffective breastfeeding was resolved on day seven in the first case and on day six in the second case.
Conclusion: Spiritual breastfeeding education and the SPEOS method using the BEST for Moms e-book may improve breastfeeding effectiveness, maternal self-efficacy, and infant feeding adequacy among mothers with ineffective breastfeeding.
Downloads
References
Agustia, N., & Camelia, R. (2025). Effect of Lactation Massage and Oxytocin Massage on Milk Production in Postpartum Women: A Quasi-experimental Study. Lentera Perawat, 6(2), 355–361. https://doi.org/10.52235/lp.v6i2.475
Al Fidah, M. F., & Efa, S. S. (2023). Skin-to-skin contact and early initiation of breast feeding in Bangladesh: A cross-sectional study using MICS6, Bangladesh (2019) data. BMJ Paediatrics Open, 7(1), e002163.
Angraeni, D. F. A., Manalu, L. O., & Purwati, P. (2025). Edukasi media leaflet terhadap pengetahuan ibu balita dengan ISPA di Puskesmas Curugkembar Kabupaten Sukabumi. Bakti Nusantara Pengabdian Masyarakat Indonesia, 2(2), 32-38. https://doi.org/10.63202/bnpmi.v2i2.78
Aulia, S. (2025). Knowledge of exclusive breastfeeding among primigravida mothers: A descriptive study. Indonesian Journal of Health Services, 2(3), 96-104. https://doi.org/10.63202/ijhs.v2i3.109
Ba, M. F., Bassoum, O., Camara, M. D., & Faye, A. (2023). Predictors of cessation of exclusive breastfeeding according to the Cox regression model: Survey of mothers of children aged 6–12 months, Thiès, Senegal. Pan African Medical Journal, 46(12), 1–10.
Blixt, I., Axelsson, O., & Funkquist, E.-L. (2024). Partners’ experiences of breastfeeding: A qualitative evaluation of a breastfeeding support intervention in Sweden. International Breastfeeding Journal, 19(1), 6.
Boa, G. F., & Agustine, U. (2022). Counselling of mothers to improve interest in exclusive breastfeeding. KnE Life Sciences, 7(2), 636–646.
Bürger, B., Schindler, K., Tripolt, T., Griesbacher, A., Stüger, H. P., Wagner, K.-H., et al. (2022). Factors associated with (exclusive) breastfeeding duration—Results of the SUKIE-Study. Nutrients, 14(9), 1704.
Deswani, D., Mulyanti, Y., Djuwitaningsih, S., Syafdewiyani, S., & Siti, E. (2025). Enhancing the role of health cadres in stunting prevention in the Munjul region through elderly support for breastfeeding: A participatory action research. Journal of Community Nursing and Primary Care, 2(2), 43-48. https://doi.org/10.63202/jcnpc.v2i2.81
Economou, M., Kolokotroni, O., Paphiti-Demetriou, I., Kouta, C., Lambrinou, E., Hadjigeorgiou, E., et al. (2021). The association of breastfeeding self-efficacy with breastfeeding duration and exclusivity: Longitudinal assessment of the predictive validity of the Greek version of the BSES-SF tool. BMC Pregnancy and Childbirth, 21(1), 421.
Elalfy, S. A., Elsayed, W. A., Abdelrhman, A. G., & Eldahshan, N. A. (2022). Factors affecting exclusive breast feeding of infants in Port Fouad City. Suez Canal University Medical Journal, 25(1), 57–67.
Fitriani Agustina, Handry Darussalam, & Indah Julia. (2024). Application of Breast Care to Prevent Breast Milk Dams in Postpartum Mothers. Lentera Perawat, 5(2), 209–217. https://doi.org/10.52235/lp.v5i2.344
Gebeyehu, N. A., Tegegne, K. D., Shewangashaw, N. E., Biset, G., Abebaw, N., & Tilahun, L. (2023). Knowledge, attitude, practice and determinants of exclusive breastfeeding among women in Ethiopia: Systematic review and meta-analysis. Public Health in Practice, 5, 100373.
Hackman, N. M., Sznajder, K. K., & Kjerulff, K. H. (2022). Paternal education and its impact on breastfeeding initiation and duration: An understudied and often overlooked factor in US breastfeeding practices. Breastfeeding Medicine, 17(5), 429–436.
Haryanti, Ita, & Yuriah, S. (2025). Socio-Economic Analysis of Parents on the Practice of Providing Early Complementary Feeding to Infants Aged 6-12 Months in Tanjung Baru Village : A Cross-sectional Study. Lentera Perawat, 6(2), 395–403. https://doi.org/10.52235/lp.v6i2.497
Jebena, D. D., & Tenagashaw, M. W. (2022). Breastfeeding practice and factors associated with exclusive breastfeeding among mothers in Horro District, Ethiopia: A community-based cross-sectional study. PLoS ONE, 17(4), e0267269.
Kimuli, D., Nakaggwa, F., Namuwenge, N., Nsubuga, R. N., Isabirye, P., Kasule, K., et al. (2023). Sociodemographic and health-related factors associated with exclusive breastfeeding in 77 districts of Uganda. International Breastfeeding Journal, 18(1), 66.
Koksal, I., Acikgoz, A., & Cakirli, M. (2022). The effect of a father’s support on breastfeeding: A systematic review. Breastfeeding Medicine, 17(9), 711–722.
Mohammed, S., Yakubu, I., Fuseini, A.-G., Abdulai, A.-M., & Yakubu, Y. H. (2023). Systematic review and meta-analysis of the prevalence and determinants of exclusive breastfeeding in the first six months of life in Ghana. BMC Public Health, 23(1), 920.
Niazy, N. A., & Fathy, A. A. (2022). Prevalence and determinants affecting breast feeding among mothers attending Meet Mazah outpatient clinic. The Egyptian Journal of Hospital Medicine, 89(2), 7043–7049.
Otim, M. E., Omagino, E. K., Almarzouqi, A., Rahman, S. A., & Asante, A. D. (2022). Exclusive breast-feeding in the first six months: Findings from a cross-sectional survey in Mulago hospital. African Health Sciences, 22(2), 535–544.
Pakilaran, G., Rasni, H., Nur, K. R. M., & Wijaya, D. (2022). Family support on exclusive breastfeeding in babies aged 0–6 months in Indonesia: Literature review. Nursing and Health Sciences Journal (NHSJ), 2(2), 104–107.
Rahman, A., Nomani, D., & Taneepanichskul, S. (2020). Trends and determinants of EBF among adolescent children born to adolescent mothers in rural Bangladesh. International Journal of Environmental Research and Public Health, 17(24), 9315.
Rohini, A. M., Elavally, S., & Saradakutty, G. (2022). Effectiveness of breastfeeding education compared to standard hospital information on exclusive breastfeeding among mothers: A systematic review. Journal of Education and Health Promotion, 11, 125.
Rosa EF, Rohana IGAPD, Ulfa MH. Effectiveness of exclusive breastfeeding holistic education. Rawal Medical Journal. 2022;47(4):1026-1026.
Rosa EF. Android-Based Breastfeeding Counseling for the Success of Exclusive Breastfeeding during the Covid-19 Pandemic [Konseling Menyusui Berbasis Android terhadap Keberhasilan Asi Eksklusif di Masa Pandemi Covid-19]. Jurnal Keperawatan Silampari. 2022;5(2):659-668. doi:10.31539/jks.v5i2.3145
Rosa, E. F. (2023). Edukasi holistik menyusui, sukseskan asi eksklusif. Deepublish
Rosa, E. F., Aisyah, A., Dina Oktavia, & Rustiati, N. (2025). Combination of Breast Care and Acupressure Interventions to Increase Milk Production and Breast Care in Breastfeeding Mothers. Lentera Perawat, 6(1), 82–91. https://doi.org/10.52235/lp.v6i1.410
Rosa, E. F., Pome, G, Fildzah, & Nelly Rustiati. (2023). Edukasi Massage Oksitosin Pada Ibu Menyusui Dengan Masalah Menyusui Tidak Efektif. Cendekia Medika: Jurnal Stikes Al-Ma`arif Baturaja, 8(2), 189–197. https://doi.org/10.52235/cendekiamedika.v8i2.238
Rosa, E. F., Wahyuni, Sari., & & Ulfa, M. H. (2024). Best for Moms : Sukses menyusui tanpa drama. Deepublish
Sari, F. Y. P., & Astuti, D. A. (2021). The image of age and occupation toward exclusive breastfeeding success in the working area of Turi Primary Health Center, Sleman District, Yogyakarta. Pakistan Journal of Medical and Health Sciences, 15(2), 587–590.
Sayed, S. H., & Bugis, B. A. (2023). Predicting perceived exclusive breastfeeding behavior among higher education female students in Saudi Arabia. African Journal of Reproductive Health, 27(5), 58–71.
Shiraishi, M., Matsuzaki, M., Kurihara, S., Iwamoto, M., & Shimada, M. (2020). Post-breastfeeding stress response and breastfeeding self-efficacy as modifiable predictors of exclusive breastfeeding at 3 months postpartum: A prospective cohort study. BMC Pregnancy and Childbirth, 20, 1–10.
Shofiya, D., Sumarmi, S., & Ahmed, F. (2020). Nutritional status, family income and early breastfeeding initiation as determinants to successful exclusive breastfeeding. Journal of Public Health Research, 9(2), 1814.
Soleha, M., Zelharsandy, V. T., Sepiwiryanti, W. ., & Indah Lestari. (2024). Effectiveness of Katuk Leaf (Sauropus Androgynus) Consumption on the Smoothness of Milk Production in Primpara Breastfeeding Mothers. Lentera Perawat, 5(2), 304–308. https://doi.org/10.52235/lp.v5i2.337
Tsegaw, S. A., Dawed, Y. A., & Amsalu, E. T. (2021). Individual level and community level factors affecting exclusive breast feeding among infants under-six months in Ethiopia using multilevel analysis. Italian Journal of Pediatrics, 47(1), 106.
Vilar-Compte, M., Pérez-Escamilla, R., & Ruano, A. (2022). Interventions and policy approaches to promote equity in breastfeeding. International Journal for Equity in Health, 21(1), 63.
Wihyawari, H., Gurning, M., & Mannopposem, I. A. (2025). Relationship of mother’s knowledge about exclusive breastfeeding: A literature review. Indonesian Journal of Health Services, 2(1), 11-20. https://doi.org/10.63202/ijhs.v2i1.60
Wu, Q., Tang, N., & Wacharasin, C. (2022). Factors influencing exclusive breastfeeding for 6 months postpartum: A systematic review. International Journal of Nursing Knowledge, 33(4), 290–303.
Yourkavitch, J., & Hall, S. P. (2022). Women’s status, breastfeeding support, and breastfeeding practices in the United States. PLoS ONE, 17(9), e0275021.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Eni Folendra Rosa, Meilina Estiani, Suparno Suparno, Rita Kamalia, Rosdiana Rosdiana
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
