The Effectiveness of E-Learning Interventions in Enhancing Parental Knowledge and Attitudes Toward Exclusive Breastfeeding: A Narrative Review for Implementation in the Indonesian Context

Elvaro Islami Muryadi Muryadi (Department of Community, Family and Occupational Medicine, Faculty of Medicine, Khon Kaen University)
Radhakrishnan Muthukumar (Khon Kaen University)
Isaraporn Thepwongsa (Department of Community, Family and Occupational Medicine, Faculty of Medicine, Khon Kaen University)
Pattapong Kessomboon (Department of Community, Family and Occupational Medicine, Faculty of Medicine, Khon Kaen University)

Public Health of Indonesia
Vol. 12 No. 2 (2026): April - June

Background: Exclusive breastfeeding provides substantial health benefits for infants and mothers; however, adherence rates remain suboptimal worldwide. Barriers such as limited access to healthcare services, inadequate prenatal education, and insufficient involvement of fathers continue to undermine breastfeeding practices. Objectives: This narrative review aims to critically synthesize global evidence on e-learning interventions for exclusive breastfeeding education and explore their effectiveness, contextual determinants, and implementation challenges relevant to Indonesia. Methods: A narrative review was conducted using PubMed, Scopus, ScienceDirect, and Google Scholar (2015–2024). Of 187 identified articles, 29 met the inclusion criteria and were thematically analyzed to evaluate e-learning interventions and barriers to exclusive breastfeeding education. Results: The findings demonstrate that e-learning interventions can improve parental knowledge and breastfeeding self-efficacy; however, their impact on sustained exclusive breastfeeding behavior remains variable. Interventions incorporating multimedia content, interactive engagement, and personalized digital support tend to yield stronger outcomes than passive formats. Father-inclusive approaches are consistently associated with improved parental alignment and breastfeeding continuation. Nevertheless, effectiveness is moderated by technological access, digital literacy, healthcare system integration, and sociocultural factors, particularly in low-resource and rural settings. Conclusion: E-learning interventions offer a potentially scalable approach to promoting exclusive breastfeeding; however, their effectiveness is highly context-dependent. In settings such as Indonesia, digital strategies must be culturally adapted, family-inclusive, and integrated within existing healthcare and community support systems to achieve meaningful and equitable impact. Rather than functioning as standalone solutions, e-learning frameworks should complement structural and relational determinants of breastfeeding behavior. Future initiatives should prioritize contextual adaptation, technological equity, and rigorous evaluation to inform sustainable program development and policy decisions.