Determinants of Maternal Adherence to Complementary Feeding Guidelines in Padang City, Indonesia: An Application of the Integrated
Change Model

Determinants of Maternal Adherence to Complementary Feeding Guidelines in Padang City, Indonesia: An Application of the Integrated
Change Model

Complementary feeding; infants;
malnutrition; maternal adherence;
young children

Background: Maternal adherence to complementary feeding guidelines is crucial
in preventing childhood malnutrition, yet adherence remains low. Although
previous studies have identified several influencing factors, evidence from
Indonesia is limited and lacks a theory-based explanation of how cognitive and
behavioral determinants influence maternal feeding practices.
Purpose: This study applied the Integrated Change Model (I-Change Model) to
examine determinants of maternal adherence to complementary feeding guidelines.
Methods: A cross-sectional design was used, involving 579 mothers of children
aged 6−23 months selected through cluster-stratified random sampling. Maternal
adherence to complementary feeding guidelines was assessed using the Infant and
Young Child Feeding (IYCF) indicators, while a self-developed questionnaire, along
with several modified questionnaires, was used to evaluate the associated factors.
Multiple logistic regression analysis was applied to identify the determinants of
maternal adherence to these guidelines.
Results: Only 40.1% of mothers adhered to complementary feeding guidelines.
Maternal adherence to complementary feeding guidelines was significantly
associated with higher education (AOR = 1.984; 95% CI: 1.053–3.739), positive
attitudes (AOR = 5.752; 95% CI: 1.283–25.794), high self-efficacy in providing
complementary feeding (AOR = 2.695; 95% CI: 1.426–5.091), and non-provision of
formula milk (AOR = 0.549; 95% CI: 0.384−0.784).
Conclusion: Maternal education, attitudes, self-efficacy, and non-provision of
formula milk were identified as key determinants of adherence. These findings
highlight the need for interventions focusing on enhancing maternal education,
promoting positive attitudes, and improving self-efficacy. Future research should
examine social support and sociocultural or economic factors through longitudinal
studies to better understand their impact on adherence behaviors.

Hermalinda Herman1

, Ying-Ju Chang

https://doi.org/10.14710/nmjn.v15i3.73812

30 December 2025

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