BACKGROUND:
Breastfeeding is a sustainable, zero-waste resource that markedly decreases carbon emissions. In contrast, formula feeding entails considerable environmental repercussions in terms of manufacturing, packing, transportation, and preparation activities.

OBJECTIVES:
This study aimed to investigate midwives' participation in breastfeeding advocacy to deliver eco-friendly health services

METHODS:
This study employed a mixed-methods approach with an explanatory sequential design. The quantitative phase employed a descriptive study methodology, encompassing 278 midwives across several healthcare settings in Indonesia. This phase evaluated midwives' understanding, perspectives, and behaviours regarding breastfeeding promotion and ecological sustainability. The qualitative phase included a phenomenological study involving in-depth interviews with 25 participants and three focus group discussions to identify obstacles to integrating environmental factors into breastfeeding practice.

RESULTS:
The findings indicated a notable deficiency in midwives' engagement with breastfeeding advocacy from an environmental sustainability standpoint, as evidenced by the fact that only 28% of respondents regularly addressed its environmental advantages with prospective parents, while 92% of participants recognised the health benefits of breastfeeding. Qualitative studies revealed midwives' knowledge inadequacies regarding ecologically sustainable health, insufficient institutional support, constrained time for breastfeeding counselling, breaches of the International Code, and deficiencies in environmental awareness about climate change.

CONCLUSIONS:
Although midwives play a crucial role in pregnancy and postnatal care, their ability to advocate for breastfeeding as an environmentally advantageous practice is hindered by information deficiencies, institutional limitations, and the pervasive marketing of infant formula. Robust measures are required to enhance midwives' ability to include an environmental sustainability viewpoint in their breastfeeding advocacy. This method will improve health outcomes and significantly support the health service's dedication to reducing its carbon footprint.

KEY MESSAGE:
Midwives' advocacy for breastfeeding as an eco-friendly practice is limited by knowledge gaps, institutional barriers, and formula marketing, highlighting the need for enhanced training and support to promote sustainable health services and reduce carbon emissions. Poster session 4 (Group B)