Exclusive Breastfeeding and its associated factors among mothers of children aged 6 to 23 months in Biratnagar Metropolitan City, Nepal.

Roka, Kritika; Pangeni, Paras Modi; Rajbanshi, Manish; Thapa, Susmita; Rana, Aashish; Chapagain, Shakuntala · PLoS One · 2026

cross_sectional · Level IV

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Abstract

Exclusive breastfeeding (EBF) is one of the most vital interventions to promote child's growth, survival and maternal health, yet the rate of EBF remains suboptimal in many developing nations, leading to increase in infant and childhood mortality and morbidity. This study aimed to assess the practice of exclusive breastfeeding and its associated factors among mothers of children aged 6-23 months in Biratnagar Metropolitan City, Nepal. A cross-sectional study was conducted among 202 mothers with children aged 6-23 months in Biratnagar, Nepal, employing a Population Proportionate to Size (PPS) technique for sampling. The participants were asked about their feeding practice to infants since birth with a face-to-face interview using a structured questionnaire. Written consent was taken for each participant prior to the interview. Among 202 mothers (Mean ± S.D = 25.65 ± 4.15), nearly one-fourth of the participants reported practicing early breastfeeding. Most of the participants consumed plain water with milk (53.5%), followed by infant formula milk (35.6%) in early infancy. One fourth of the participants (21.8%) had adequate knowledge of EBF. The reported exclusive breastfeeding was 37.6% with the median duration of four months. The major reason for mixed feeding was mother's perceived milk as not sufficient, followed by work. In multivariable analysis, mothers from joint/extended families (AOR = 1.95, 95% CI: 1.23-4.09), illiterate mothers (AOR = 2.90, 95% CI: 1.14-7.41), and mothers without breastfeeding problems (AOR = 8.23, 95% CI: 2.97-22.74) were significantly more likely to practice EBF. Despite the national and local efforts on nutrition, our study revealed the exclusive breastfeeding rate was low, with lower participants having adequate knowledge on EBF. This implies the need for counselling mothers regarding EBF on ANC, PNC visits. As the breastfeeding problem was significantly hindering breastfeeding practice, counselling on interventions to deal with breastfeeding problems would benefit the improvement in practice.

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