MOTHER'S KNOWLEDGE ABOUT LACTATION AMENORRHEA METHOD (LAM) OF BREASTFEEDING

ABSTRACT


INTRODUCTION
A healthy, happy and prosperous family is everyone's dream.The quality family (healthy, happy and prosperous) could obtained by the Family Planning program.The Family Planning Program is the use of contraceptives.The variant method of contraceptives are Pills, Injections, Implants, Condoms, Male and Female Sterilization, Lactation Amenorrhea Method (LAM) and IUDs (Mufdlilah, Johan and Sri Ratna Ningsih, 2021).The best choices of contraception method will improves the health and well-being of individuals, families and communities.(Rodriguez MI, L and M., 2014).
Lactation Amenorrhea Method (LAM) method is contraceptive method with giving exclusive breastfeeding to temporarily help prevent pregnancy, exclusive breastfeeding mean that only given breast milk without additional food or other drinks (Setya Arum and Sujiatini., 2011).LAM provides 98% protection against pregnancy if: 1) The woman's menstrual period has not returned since giving birth, 2) The baby is completely breastfed, and 3) The baby aged less than six months (Wijden and C, 2015;World Health Organization, 2018).The correct of LAM contraception will provides the effectiveness and affordable of contraceptive for breastfeeding women.LAM also can preventing unplanned pregnancies during breastfeeding (Alege et al., 2016 Another study found that most of the active family planning participants used injection contraceptives, and the common problem was breastfeeding should be carried out based on the needs of the baby and it carried out regularly in whole day, both in morning or evening, this make the biggest problem for mothers, especially the mothers who work and they were difficult to follow the breastfeeding pattern (Hartanto, 2010).
Another study found that most of the active family planning participants used injection contraceptives, and the common problem was breastfeeding should be carried out based on the needs of the baby and it carried out regularly in whole day, both in morning or evening, this make the biggest problem for mothers, especially the mothers who work and they were difficult to follow the breastfeeding pattern (Hartanto, 2010).
The LAM contraception will make the optimal quality and quantity of mother's milk, because breast milk is very important for the growth and passive immunity for baby, it also the best nutrition intake for optimal growth and development for baby (Prasetyo, Bambang and Jannah., 2012).The advantages of Lactation Amenorrhea Method for mothers can reduce the risk of postpartum hemorrhage, reduced the risk of anemia, improving the psychological relationship between mother and baby, reduces the risk of ovarian cancer and breast cancer and improve maternal health and well-being.For children, it will improves the quality of growth and development, increases the baby's resistance of various diseases, protection for babies from allergies, increase intelligence.For families, it will save household expenses for the purchase of formula milk, the maternal cost and infant health care, contraception devices/drugs cost (Muryanto, 2012) One of the factors influenced the using of LAM contraception is knowledge.Knowledge is the result of knowing and this happens after the people sense certain objects.Knowledge is very important domain in shaping one's actions (overt behavior).Behavior based on knowledge will be better than behavior that is not based on knowledge (Notoatmodjo, 2012).
In Indonesia, the achievement of LAM is still low, this measured by the level of achievement of exclusive breastfeeding is still low.According to the national socio-economic survey in 2010, only 33.6% of infants who aged 0-6 months were received exclusive breastfeeding, the low rate of exclusive breastfeeding was due to the lack of knowledge about the benefits of breastfeeding and the incessant promotion of formula milk made the mothers didn't gave breastfeeding (Muryanto, 2012).
The role of midwives for contraception and implementation of family planning programs is one of personal duties and government duties because family planning program is one of government programs.The implementation of government program should be do in high quality, so the midwives should have the right perspective.The success of contraceptive and family planning services are influenced by knowledge, belief, understanding, and perspective of midwife about the relationship between women and health, as well as the midwife's understanding of the midwifery perspective on contraception and family planning, types of methods and hormonal and non-hormonal contraception mechanisms, side effects and complications of contraception, decision making, promoting and preventive the efforts related to family planning and contraception, comparison of contraceptive methods, contraceptive counseling, post-abortion contraceptive services, emergency contraception, Evidence Based in contraceptive services, and the provision of contraceptive services.(Dina Dewi Anggraini, Wanodya Hapsari et al., 2021).Some evidence showed that the low breastfeeding rates (Rahman, Nomani and Taneepanichskul, 2020) will increasing of discontinuing exclusive breastfeeding before the baby reaches 6 months (Jara-Palacios et al., 2015) Education level, mode of delivery baby, antenatal care and postpartum breastfeeding counseling are some factors influencing breastfeeding practice (Benova et al., 2020).Based on the phenomena above, the researchers are interested to conducting a study entitled "Mother's Knowledge about Lactation Amenorrhea Method (LAM) of Breastfeeding at Menturo Village, Sumobito District, Jombang Regency.

METHOD
This research used descriptive research.The population in this study obtained 75 sample of breastfeeding mothers at Menturo Village, Sumobito District, Jombang Regency.Sampling method in this study used total sampling.The data collected by using 10 standard questions relating with the knowledge about Lactation Amenorrhea Method (LAM) of Breastfeeding.The data analysis used Univariate analysis.Based on table 1 found that the respondents aged between 26-35 years (73.3%), and more than half of them were educated in primary level or above (50.7%).Most of respondents do not work (72%), and more than half of them in primigravida level of parity (68%).All of respondents exposed to information about LAM (100%) and the information mostly came from electronic media (92%).

PEMBAHASAN
Lactation Amenorrhea Method is a natural contraception method, and it method quite reliable and low cost expensive.Exclusive breastfeeding provides excellent protection against pregnancy with 6 months after delivery, amenorrhea and exclusive breastfeeding used lactation mechanism by blocked ovulation because lactation will increasing the level of prolactin (Gofurovna, 2022).
The effectiveness of LAM depends on the user, the risk of pregnancy could happen when a mother cannot fully or almost completely breastfeed for her baby.Some data showed that about 2 women per 100 women getting pregnancies who used LAM in the first 6 months after giving birth.This means that 98 out of 100 women who used LAM as their contraception will not get pregnant.The correct of LAM showed that few than 1 pregnancy per 100 women in the first 6 months after delivery.The returning of fertility depend on how long the mother giving breastfeed for their baby.However, LAM does not protect against sexually transmitted infections (World Health Organization; Johns Hopkins, 2018).(Cahyaning Setyo Hutomo, Ninik Azizah et al., 2022) The effectiveness of LAM depends on the user, the risk of pregnancy could happen when a mother cannot fully or almost completely breastfeed for her baby.Some data showed that about 2 women per 100 women getting pregnancies who used LAM in the first 6 months after giving birth.This means that 98 out of 100 women who used LAM as their contraception will not get pregnant.The correct of LAM showed that few than 1 pregnancy per 100 women in the first 6 months after delivery.The returning of fertility depend on how long the mother giving breastfeed for their baby.However, LAM does not protect against sexually transmitted infections (World Health Organization; Johns Hopkins, 2018).(Cahyaning Setyo Hutomo, Ninik Azizah et al., 2022) The age characteristics of the respondents showed that most of them aged between 26-35 years old, and this result also related with the study by Gofurovna (2022), the study mentioned that most of women aged 20 to 35 years who used the lactation amenorrhea method (87.5%) (Gofurovna, 2022).
Most of respondents in this study were housewives (72.0%) 54 people.This result was related with Nagar study (2022), he mentioned that 78.3% of respondents were housewives who used contraception (Nagar, Hany and Mohammed, 2022).
The information obtained by respondents about LAM mostly from electronic media (92%) 69 people.Information sources obtained between housewives and mothers who work are varieties, it could come from their environment with various natures and characteristics, therefore various kinds of information are obtained.All respondents in this study got the information about Lactation Amenorrhea Method (100% or 75 women).
Most of mothers were assumed to have sufficient knowledge about proper and right breastfeeding as a safe contraception, low cost expensive, and efficient natural contraceptive.In addition, it is necessary to increase knowledge about LAM to prevent incorrect implementation (Mufdlilah, Johan and Ningsih, 2021) The results of this study showed that most of the breastfeeding mothers had sufficient knowledge about the Lactation Amenorrhea Method, this was influenced by the low level of education among breastfeeding mothers so it affected the knowledge of breastfeeding mothers.The one of solving this problems is giving counseling or education related with Lactation Amenorrhea Method so the breastfeeding mothers will understand that Lactation Amenorrhea Method give benefits for the mother and her baby.

CONCLUSION
The results of this study indicated that most of respondents have sufficient knowledge.Therefore, the role of health workers is needed to intensify information about variant of contraceptive method, especially about lactation amenorrhea method. ).

Table 2 .
The Distribution of Mother's Knowledge Level about Lactation Amenorrhea Method