20J Gandhara Nurs Alli Health Sci
JGNAHS
:
:
ORIGINAL ARTICLE
https://doi.org/10.37762/jgnahs.150
January - June 2025
KNOWLEDGE, ATTITUDES, AND PRACTICES REGARDING EXCLUSIVE BREASTFEEDING
AMONG MOTHERS OF CHILDBEARING AGE IN MALLAH VILLAGE, HYDERABAD
Yasmeen Sikandar Ali Mugheri 1, Nasreen Rebecca Wilson2, Zafarullah Junejo3, Humaira Sikandar Ali Mugheri4,
Shabana Liaquat Ali Mugheri5, Nazia Hassan Baloch6, Jana Naz Solangi7
How to cite this article
Mugheri YSA, Wilson NR, Junejo Z,
Mugheri HAS, Mugheri SLA, Baloch
NH, et al. Knowledge, Attitudes, and
Practices Regarding Exclusive
Breastfeeding among Mothers of
Childbearing Age in Mallah Village,
Hyderabad. J Gandhara Nurs Alli
Health Sci. 2025;5(1):20-24
Date of Submission:
Date Revised:
Date Acceptance:
2Principal, Isra School of Nursing, Isra
University Hyderabad, Sindh, Pakistan
3Nursing Lecturer, Isra School of
Nursing, Isra University Hyderabad,
Sindh, Pakistan
4BSN Scholar, Isra School of Nursing,
Isra University Hyderabad, Sindh,
Pakistan
5BSN Scholar, Isra School of Nursing,
Isra University Hyderabad, Sindh,
Pakistan
6BSN Staff Nurse, Isra University
Hospital Hyderabad, Sindh, Pakistan
7BSN Scholar, Isra School of Nursing,
Isra University Hyderabad, Sindh,
Pakistan
Correspondence
1Yasmeen Sikandar Ali Mugheri, BSN
Scholar, Isra School of Nursing, Isra
University Hyderabad, Sindh, Pakistan
+92-310-3758383
yasmeenmugheri0@gmail.com
ABSTRACT
OBJECTIVES
To assess the knowledge, attitudes, and practices regarding exclusive
breastfeeding among mothers of childbearing age in Mallah Village,
Hyderabad.
METHODOLOGY
Convenience sampling was used for selecting 75 mothers for this cross-
sectional study, which was carried out between July and September 2024.
Data was collected using structured questionnaires, and IBM SPSS software
version 23 was utilized for analysis. Descriptive statistical techniques were
employed to examine the demographic information and the primary research
variables.
RESULTS
According to the results of the study, most mothers (90.7%) had a good level
of knowledge about exclusive breastfeeding, with healthcare facilities being
the primary source of information (76%). However, there was a knowledge -
practice gap, as many mothers did not exclusively breastfeed for the
recommended six months. Although 93.3% reported practicing exclusive
breastfeeding, only 42.7% initiated breastfeeding immediately after delivery.
Positive attitudes were noted, with 72% of participants finding exclusive
breastfeeding easier than formula feeding. However, 70.7% perceived
exclusive breastfeeding as more demanding.
CONCLUSION
Study concluded that mothers in Mallah Village have adequate knowledge
and positive attitude towards exclusive breastfeeding. However, gaps between
knowledge and practice still exist because of challenges including delayed
initiation of and perceived barriers to exclusive breastfeeding. The analysis
emphasizes the necessity of focused educational initiatives and community-
based interventions to bridge this gap and advance breastfeeding practices in
this region.
KEYWORDS: Exclusive Breastfeeding, Knowledge, Attitudes, Practices,
Maternal Health, Child Health
INTRODUCTION
Exclusive breastfeeding (EBF) is accepted globally as
one of the most effective measures aimed at supporting
the health of infants.1,2 The WHO and UNICEF
introduced the initiative which encourages exclusive
breastfeeding of infants for the first six months,
followed by breastfeeding, in conjunction with
appropriate complementary milk feeding for up to two
years or beyond.3,4 Breast milk acts as a natural food
for the infant because it consists of all the contents
needed for the growth of the child, including nutrients,
antibodies, and growth factors which help in
development and cognition as well as strengthen the
immune system of the child thus preventing easy
falling to diseases such as diarrhea, respiratory
illnesses and other preventable diseases.5 In addition to
the impact on the well-being of the child, breastfeeding
provides numerous unique benefits for the mother such
as decreasing the probability of getting breast and
ovarian cancer, fast recovery, and strengthening the
bond between the mother and her child. Presently,
globally according to WHO only 40% of children
under six months are exclusively breastfed and these
figures vary geographically as well as
socioeconomically.6 This is due to factors such as
minimal health care access, culture beliefs, and lack of
support systems prevalent, especially in rural and low-
income settings making it difficult to close the gap
between the recommended feeding practices and actual
feeding practices in the community.7 This problem is
exacerbated by the growing preference for infant
formula feeding by mothers because of perceived
convenience over breastfeeding, even though it has
05-12-2024
07-01-2025
08-01-2025
21 J Gandhara Nurs Alli Health Sci
JGNAHS
January - June 2025
been scientifically established that formula feeding
does not offer the same protection as breast milk.8,9 In
many rural communities, factors such as lack of
education, inadequate prenatal care, and limited access
to lactation support can negatively influence the
knowledge, attitudes, and practices regarding exclusive
breastfeeding.10 In particular, the role of healthcare
workers, such as midwives and pediatricians, in
providing accurate and culturally sensitive
breastfeeding education is critical.11 Research has
shown that the quality of information that is given to
mothers to do with breastfeeding greatly determines
whether mothers will be able to start and maintain
exclusive breastfeeding.12 There is a lack of
information regarding these barriers unique to mothers
in situations such as living in rural communities like
Mallah Village, and Hyderabad, where people might
follow cultural practices as well as medical advice.
This cross-sectional study focuses on Maternal and
Child Health, especially breastfeeding practices in a
selected rural area called Mallah Village in Hyderabad.
Various literacy levels, health care access, and socio -
economic realities of the community may also impact
breastfeeding in some way. Though there is evidence
of numerous barriers to breastfeeding from research
investigations that have been conducted in urban
environments, little is known about barriers to
breastfeeding in rural settings such as Mallah Village.
Culture-bound beliefs and Practices, social
demographics, and healthcare accessibility should
therefore remain key factors that influence knowledge
and practices about breastfeeding in this region. The
Knowledge, attitude, and practices of Mallah Village
toward exclusive breastfeeding are important and
relevant in designing educational needs assessment.
Research studies demonstrate that maternal education,
community support, and healthcare can affect
breastfeeding outcomes, but the factors operating in
rural areas remain relatively poorly understood due to
the existing literature. This study aims to fill this gap
by establishing the factors that may affect
breastfeeding behaviors in Mallah Village and using
the findings to design future interventions. The
findings are expected to help strengthen the support for
breastfeeding mothers and overall maternal and child
health.
METHODOLOGY
A cross-sectional research study was carried out in
2024 between July and September in Mallah Village,
Hyderabad, to assess knowledge, attitudes, and
practices regarding exclusive breastfeeding among
mothers. The target population consisted of 90
mothers, with a final sample size of 75 determined
using Raosoft software with a 5% margin of error and a
95% confidence level. Non-probability convenience
sampling was used to select participants who were
mothers residing in Mallah Village and willing to
participate. Mothers who refused to participate or fell
outside the childbearing age range were excluded from
the study. Data were collected using a structured
questionnaire, adapted from.13 The questionnaire
contained 17 questions, with 11 questions assessing
knowledge and attitudes about exclusive breastfeeding
(including Yes/No, multiple choice questions) and 6
questions focused on breastfeeding practices (including
Yes/No and multiple choice questions). Permission was
granted by the Head of the Community of Mallah
Village, and prior to data collection, all participants
gave their informed consent. Data analysis was
performed using IBM SPSS version 23 and descriptive
statistics (means, standard deviations, frequencies, and
percentages) were used to summarize the data.
RESULTS
Table 1: Demographic Analysis (n=75)
Characteristics Frequency age (%)
Age (Years)
18-23 22 29.3%
24-30 36 48%
Above 30 17 22.7%
Level Of Education
No Formal Education 45 60%
Primary Education 12 16%
Secondary Education 16 21.3%
Higher Education 02 2.7%
Occupation
Housewife 72 96%
Business 0 0%
Employed 03 4%
Participants were mostly between the ages of 24 and 30
years (48%), and 60% had no formal education, 21.3%
had completed secondary school and 96% were
housewives.
Knowledge, Attitude, and Practices Regarding Exclusive Breastfeeding
JGNAHS
January - June 2025
been scientifically established that formula feeding
does not offer the same protection as breast milk.8,9 In
many rural communities, factors such as lack of
education, inadequate prenatal care, and limited access
to lactation support can negatively influence the
knowledge, attitudes, and practices regarding exclusive
breastfeeding.10 In particular, the role of healthcare
workers, such as midwives and pediatricians, in
providing accurate and culturally sensitive
breastfeeding education is critical.11 Research has
shown that the quality of information that is given to
mothers to do with breastfeeding greatly determines
whether mothers will be able to start and maintain
exclusive breastfeeding.12 There is a lack of
information regarding these barriers unique to mothers
in situations such as living in rural communities like
Mallah Village, and Hyderabad, where people might
follow cultural practices as well as medical advice.
This cross-sectional study focuses on Maternal and
Child Health, especially breastfeeding practices in a
selected rural area called Mallah Village in Hyderabad.
Various literacy levels, health care access, and socio -
economic realities of the community may also impact
breastfeeding in some way. Though there is evidence
of numerous barriers to breastfeeding from research
investigations that have been conducted in urban
environments, little is known about barriers to
breastfeeding in rural settings such as Mallah Village.
Culture-bound beliefs and Practices, social
demographics, and healthcare accessibility should
therefore remain key factors that influence knowledge
and practices about breastfeeding in this region. The
Knowledge, attitude, and practices of Mallah Village
toward exclusive breastfeeding are important and
relevant in designing educational needs assessment.
Research studies demonstrate that maternal education,
community support, and healthcare can affect
breastfeeding outcomes, but the factors operating in
rural areas remain relatively poorly understood due to
the existing literature. This study aims to fill this gap
by establishing the factors that may affect
breastfeeding behaviors in Mallah Village and using
the findings to design future interventions. The
findings are expected to help strengthen the support for
breastfeeding mothers and overall maternal and child
health.
METHODOLOGY
A cross-sectional research study was carried out in
2024 between July and September in Mallah Village,
Hyderabad, to assess knowledge, attitudes, and
practices regarding exclusive breastfeeding among
mothers. The target population consisted of 90
mothers, with a final sample size of 75 determined
using Raosoft software with a 5% margin of error and a
95% confidence level. Non-probability convenience
sampling was used to select participants who were
mothers residing in Mallah Village and willing to
participate. Mothers who refused to participate or fell
outside the childbearing age range were excluded from
the study. Data were collected using a structured
questionnaire, adapted from.13 The questionnaire
contained 17 questions, with 11 questions assessing
knowledge and attitudes about exclusive breastfeeding
(including Yes/No, multiple choice questions) and 6
questions focused on breastfeeding practices (including
Yes/No and multiple choice questions). Permission was
granted by the Head of the Community of Mallah
Village, and prior to data collection, all participants
gave their informed consent. Data analysis was
performed using IBM SPSS version 23 and descriptive
statistics (means, standard deviations, frequencies, and
percentages) were used to summarize the data.
RESULTS
Table 1: Demographic Analysis (n=75)
Characteristics Frequency age (%)
Age (Years)
18-23 22 29.3%
24-30 36 48%
Above 30 17 22.7%
Level Of Education
No Formal Education 45 60%
Primary Education 12 16%
Secondary Education 16 21.3%
Higher Education 02 2.7%
Occupation
Housewife 72 96%
Business 0 0%
Employed 03 4%
Participants were mostly between the ages of 24 and 30
years (48%), and 60% had no formal education, 21.3%
had completed secondary school and 96% were
housewives.
Knowledge, Attitude, and Practices Regarding Exclusive Breastfeeding
JGNAHS
22J Gandhara Nurs Alli Health SciJanuary - June 2025
Table 2: Mother’s Knowledge and Attitude on Exclusive
Breastfeeding (n=75)
Statement Frequency (%) Mean St.
Devi.
Have you heard of exclusive
breastfeeding?
Yes: 90.7%,
No: 9.3%
1.09 .292
Where do you get your
knowledge about exclusive
breastfeeding?
Hospital: 76%,
Friends: 13.3%,
Other: 10.7%
1.58 1.079
Does exclusive breastfeeding
involve feeding your child
just breast milk between the
ages of 0 and 6 months?
Yes: 73.3%,
No: 26.7%
1.26 .445
Have you ever attended an
exclusive breastfeeding
training session?
Yes: 30.7%,
No: 69.3% 1.69 .464
When is the best time to start
breastfeeding a baby
exclusively?
Immediately
after birth:
40%, After
some time: 60%
1.60 .493
How do you handle the first
colostrum or milk?
Feed
immediately:
89.3%, Discard:
10.7%
1.10 .310
Is six months of age the ideal
time to begin supplemental
feeding?
Yes: 46.7%,
No: 53.3% 1.53 .502
Is the formula for infants
less demanding than
exclusive breastfeeding?
Yes: 70.7%,
No: 29.3% 1.29 .458
During exclusive
breastfeeding, should babies
be given fluids other than
breast milk, such as water,
honey, etc.?
Yes: 52%, No:
48% 1.48 .502
Is it easier to exclusively
breastfeed a child than to use
formula?
Yes: 72%, No:
28% 1.28 .452
Is exclusive breastfeeding
preferred over formula
feeding in your community?
Yes: 41.3%,
No: 58.7%
1.58 .495
Most participants (90.7%) were aware of exclusive
breastfeeding, with hospitals being the primary source
of information (76%). Approximately 73.3% of
mothers correctly defined exclusive breastfeeding as
providing only breast milk for the first six months,
while 30.7% had received formal training. A majority
(70.7%) found exclusive breastfeeding to be more
demanding than formula feeding, and 89.3% believed
that colostrum should be fed to the baby immediately
after birth. There was a divide in the responses
regarding the appropriate timing for complementary
feeding (46.7% affirmed) and community support for
exclusive breastfeeding (41.3%).
Table 3: Mother’s Practices on Exclusive Breastfeeding (n=75)
Statement Frequency (%) Mean St.D
evi.
Do you exclusively
breastfeed your child?
Yes:93.3%,
No:6.7%
1.06 .251
After delivery, when did
you begin feeding your
child?
Immediately: 42.7%,
After some time:
57.3%
1.57 .497
Does your infant receive
pre-lactation feedings?
Yes: 52%,
No: 48%
1.48 .502
Does your infant receive
colostrum?
Yes: 60%,
No: 40%
1.40 .493
How frequently do you
breastfeed your baby?
On-demand: 73.3%,
Specific interval:
18.7%, Random: 8%
1.34 .625
Did you or your child
suffer from any illnesses
when you were
exclusively breastfeeding?
Yes:37.3%,
No:62.7%
1.62 .486
A high proportion of mothers (93.3%) reported
exclusively breastfeeding their babies. However, only
42.7% started breastfeeding immediately after delivery.
Pre-lactation feeding was practiced by 52% of mothers,
and 60% fed colostrum to their infants. Most mothers
(73.3%) breastfed on demand, while 62.7% reported no
illness during the exclusive breastfeeding period.
However, 37.3% indicated that they or their baby
experienced illness during this time.
DISCUSSION
This descriptive study’s findings showed that most
mothers had a strong knowledge of exclusive
breastfeeding, with 90.7% of participants reporting
knowledge of the practice. This aligns with earlier
research findings that have shown high levels of
awareness of exclusive breastfeeding, especially in
areas where maternal and child health programs have
been effective.14,15 However, gaps in the knowledge
and practices of EBF remain. One of the main findings
of this study was that while 73.3% of the mothers
correctly identified exclusive breastfeeding as feeding
only breast milk for the first six months, only 30.7%
had received formal training on EBF. This suggests
that although information on EBF is widely available,
formal education and training on EBF may be limited.
These results are consistent with previous research
emphasized the need of targeted training and
counseling to improve breastfeeding practices.16,17 The
Knowledge, Attitude, and Practices Regarding Exclusive Breastfeeding
22J Gandhara Nurs Alli Health SciJanuary - June 2025
Table 2: Mother’s Knowledge and Attitude on Exclusive
Breastfeeding (n=75)
Statement Frequency (%) Mean St.
Devi.
Have you heard of exclusive
breastfeeding?
Yes: 90.7%,
No: 9.3%
1.09 .292
Where do you get your
knowledge about exclusive
breastfeeding?
Hospital: 76%,
Friends: 13.3%,
Other: 10.7%
1.58 1.079
Does exclusive breastfeeding
involve feeding your child
just breast milk between the
ages of 0 and 6 months?
Yes: 73.3%,
No: 26.7%
1.26 .445
Have you ever attended an
exclusive breastfeeding
training session?
Yes: 30.7%,
No: 69.3% 1.69 .464
When is the best time to start
breastfeeding a baby
exclusively?
Immediately
after birth:
40%, After
some time: 60%
1.60 .493
How do you handle the first
colostrum or milk?
Feed
immediately:
89.3%, Discard:
10.7%
1.10 .310
Is six months of age the ideal
time to begin supplemental
feeding?
Yes: 46.7%,
No: 53.3% 1.53 .502
Is the formula for infants
less demanding than
exclusive breastfeeding?
Yes: 70.7%,
No: 29.3% 1.29 .458
During exclusive
breastfeeding, should babies
be given fluids other than
breast milk, such as water,
honey, etc.?
Yes: 52%, No:
48% 1.48 .502
Is it easier to exclusively
breastfeed a child than to use
formula?
Yes: 72%, No:
28% 1.28 .452
Is exclusive breastfeeding
preferred over formula
feeding in your community?
Yes: 41.3%,
No: 58.7%
1.58 .495
Most participants (90.7%) were aware of exclusive
breastfeeding, with hospitals being the primary source
of information (76%). Approximately 73.3% of
mothers correctly defined exclusive breastfeeding as
providing only breast milk for the first six months,
while 30.7% had received formal training. A majority
(70.7%) found exclusive breastfeeding to be more
demanding than formula feeding, and 89.3% believed
that colostrum should be fed to the baby immediately
after birth. There was a divide in the responses
regarding the appropriate timing for complementary
feeding (46.7% affirmed) and community support for
exclusive breastfeeding (41.3%).
Table 3: Mother’s Practices on Exclusive Breastfeeding (n=75)
Statement Frequency (%) Mean St.D
evi.
Do you exclusively
breastfeed your child?
Yes:93.3%,
No:6.7%
1.06 .251
After delivery, when did
you begin feeding your
child?
Immediately: 42.7%,
After some time:
57.3%
1.57 .497
Does your infant receive
pre-lactation feedings?
Yes: 52%,
No: 48%
1.48 .502
Does your infant receive
colostrum?
Yes: 60%,
No: 40%
1.40 .493
How frequently do you
breastfeed your baby?
On-demand: 73.3%,
Specific interval:
18.7%, Random: 8%
1.34 .625
Did you or your child
suffer from any illnesses
when you were
exclusively breastfeeding?
Yes:37.3%,
No:62.7%
1.62 .486
A high proportion of mothers (93.3%) reported
exclusively breastfeeding their babies. However, only
42.7% started breastfeeding immediately after delivery.
Pre-lactation feeding was practiced by 52% of mothers,
and 60% fed colostrum to their infants. Most mothers
(73.3%) breastfed on demand, while 62.7% reported no
illness during the exclusive breastfeeding period.
However, 37.3% indicated that they or their baby
experienced illness during this time.
DISCUSSION
This descriptive study’s findings showed that most
mothers had a strong knowledge of exclusive
breastfeeding, with 90.7% of participants reporting
knowledge of the practice. This aligns with earlier
research findings that have shown high levels of
awareness of exclusive breastfeeding, especially in
areas where maternal and child health programs have
been effective.14,15 However, gaps in the knowledge
and practices of EBF remain. One of the main findings
of this study was that while 73.3% of the mothers
correctly identified exclusive breastfeeding as feeding
only breast milk for the first six months, only 30.7%
had received formal training on EBF. This suggests
that although information on EBF is widely available,
formal education and training on EBF may be limited.
These results are consistent with previous research
emphasized the need of targeted training and
counseling to improve breastfeeding practices.16,17 The
Knowledge, Attitude, and Practices Regarding Exclusive Breastfeeding
JGNAHS
23 J Gandhara Nurs Alli Health Sci January - June 2025
low percentage of mothers receiving training points to
a need for further investment in breastfeeding
education programs that can equip mothers with the
knowledge and confidence to exclusively breastfeed.
The study also revealed that while a significant
majority of mothers (60%) recognized the importance
of feeding colostrum to the infant immediately after
birth, opinions were divided when it came to
complementary feeding and the timing for introducing
it. More importantly, only 46.7% of the mothers knew
the right time to start complementary feeding showing
the need for more sensitization on when to wean from
exclusive breastfeeding to complementary feeding. The
result of this study corroborates prior studies that
recommended the timely introduction of
complementary foods as an essential component of
infant feeding.18,19 When examining the mothers’
practices, the study found that 93.3% of mothers
reported breastfeeding their child exclusively.
However, 57.3% did not start breastfeeding
immediately after delivery, which deviates from the
recommended practice of initiating breastfeeding
within the first hour of birth. This delay in
breastfeeding initiation could have significant
implications for infant health, as early initiation is
crucial for establishing breastfeeding and benefiting
from colostrum.20,21,22 Additionally, while most
mothers breastfed on demand, 37.3% of mothers and
their infants experienced illness during the period of
exclusive breastfeeding, which might reflect challenges
that influence breastfeeding behaviors and practices.
The findings also highlighted that many mothers
(70.7%) perceived exclusive breastfeeding as more
demanding than feeding infants formula. This
perception could influence the decision to adopt
exclusive breastfeeding practices, as mothers may feel
that formula feeding is a less burdensome alternative.
These results align with those from other research,
where the perceived difficulty of exclusive
breastfeeding, especially in the face of societal pressure
and lack of support, has been cited as a major barrier to
successful breastfeeding.15,22,23
LIMITATIONS
The limitations of the study include a small sample size
of 75 mothers, which may not accurately reflect the
population as a whole. Moreover, the study used self-
reported data, which may introduce bias because
individuals may have over-reported knowledge or
actions that were positive. The results of the study may
not be generalized to other areas because it was only
carried out in a single community.
CONCLUSIONS
This study concluded that mothers in Mallah Village,
Hyderabad, demonstrated strong knowledge and
positive attitudes towards exclusive breastfeeding
(EBF). However, significant gap between knowledge
and practice remains, especially in the areas of
complementary feeding and formal training. These
findings highlight that specific initiatives are required
to enhance EBF education and training, particularly
regarding complementary feeding, and to strengthen
community support systems. Future research should
focus on evaluating the effectiveness of these
interventions in improving breastfeeding practices in
rural areas.
CONFLICT OF INTEREST: None
FUNDING SOURCES: None
REFERENCES
1. Mishuk MH. Exploring mother's perception regarding exclusive
breastfeeding (EBF): Brac University; 2024.
2. Apara EF, Olawade DB, Olatunji GD, Kokori E, Aderinto N,
David-Olawade AC. Factors Influencing Nursing Mothers'
Exclusive Breastfeeding Practices and Their Effects on Infants
Aged Zero to Six Months in Nigeria: A Review of Current
Evidence. WCN 2024.
3. Alayón S, Varela V, Mukuria‐Ashe A, Alvey J, Milner E,
Pedersen S, et al. Exclusive breastfeeding: Measurement to
match the global recommendation. Matern Child Nutr.
2022;18(4):e13409.
4. Jama A, Gebreyesus H, Wubayehu T, Gebregyorgis T,
Teweldemedhin M, Berhe T, et al. Exclusive breastfeeding for
the first six months of life and its associated factors among
children age 6-24 months in Burao district, Somaliland. Int.
Breastfeed. J. 2020;15:1-8.
5. Cole J, Bhatt A, Chapple AG, Buzhardt S, Sutton EF. Attitudes
and barriers to breastfeeding among women at high-risk for not
breastfeeding: a prospective observational study. BMC
Pregnancy and Childbirth. 2024;24(1):81.
6. Navarro-Rosenblatt D, Benmarhnia T, Bedregal P, Lopez-
Arana S, Rodriguez-Osiac L, Garmendia M-L. Socio-economic
inequalities in the effect of public policies and the COVID-19
pandemic on exclusive breastfeeding in Chile. Pub Health.
2023;214:61-8.
7. Giang HTN, Duy DTT, Vuong NL, Ngoc NTT, Pham TT, Duc
NTM, et al. Prevalence of exclusive breastfeeding for the first
six months of an infant’s life and associated factors in a low–
middle income country. Int. Breastfeed. J 2023;18(1):47.
8. Alemu HA, Tesfa H, Anagaw TF, Derseh HA, Babbel NF.
Formula feeding practice and associated factors among mothers
who visited health facilities for their infants aged below 6
months in Bahir Dar City, Northwest Ethiopia, 2020. Int. J.
Gen. Med. 2023:5515-26.
9. Conway R, Ritchie I, Esser S, Steptoe A, Smith AD, Llewellyn
C. Perceived influence of commercial milk formula labelling on
mothers’ feeding choices in Great Britain: a qualitative study.
Arch Dis Child 2023;108(12):1008-13.
Knowledge, Attitude, and Practices Regarding Exclusive Breastfeeding
23 J Gandhara Nurs Alli Health Sci January - June 2025
low percentage of mothers receiving training points to
a need for further investment in breastfeeding
education programs that can equip mothers with the
knowledge and confidence to exclusively breastfeed.
The study also revealed that while a significant
majority of mothers (60%) recognized the importance
of feeding colostrum to the infant immediately after
birth, opinions were divided when it came to
complementary feeding and the timing for introducing
it. More importantly, only 46.7% of the mothers knew
the right time to start complementary feeding showing
the need for more sensitization on when to wean from
exclusive breastfeeding to complementary feeding. The
result of this study corroborates prior studies that
recommended the timely introduction of
complementary foods as an essential component of
infant feeding.18,19 When examining the mothers’
practices, the study found that 93.3% of mothers
reported breastfeeding their child exclusively.
However, 57.3% did not start breastfeeding
immediately after delivery, which deviates from the
recommended practice of initiating breastfeeding
within the first hour of birth. This delay in
breastfeeding initiation could have significant
implications for infant health, as early initiation is
crucial for establishing breastfeeding and benefiting
from colostrum.20,21,22 Additionally, while most
mothers breastfed on demand, 37.3% of mothers and
their infants experienced illness during the period of
exclusive breastfeeding, which might reflect challenges
that influence breastfeeding behaviors and practices.
The findings also highlighted that many mothers
(70.7%) perceived exclusive breastfeeding as more
demanding than feeding infants formula. This
perception could influence the decision to adopt
exclusive breastfeeding practices, as mothers may feel
that formula feeding is a less burdensome alternative.
These results align with those from other research,
where the perceived difficulty of exclusive
breastfeeding, especially in the face of societal pressure
and lack of support, has been cited as a major barrier to
successful breastfeeding.15,22,23
LIMITATIONS
The limitations of the study include a small sample size
of 75 mothers, which may not accurately reflect the
population as a whole. Moreover, the study used self-
reported data, which may introduce bias because
individuals may have over-reported knowledge or
actions that were positive. The results of the study may
not be generalized to other areas because it was only
carried out in a single community.
CONCLUSIONS
This study concluded that mothers in Mallah Village,
Hyderabad, demonstrated strong knowledge and
positive attitudes towards exclusive breastfeeding
(EBF). However, significant gap between knowledge
and practice remains, especially in the areas of
complementary feeding and formal training. These
findings highlight that specific initiatives are required
to enhance EBF education and training, particularly
regarding complementary feeding, and to strengthen
community support systems. Future research should
focus on evaluating the effectiveness of these
interventions in improving breastfeeding practices in
rural areas.
CONFLICT OF INTEREST: None
FUNDING SOURCES: None
REFERENCES
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Knowledge, Attitude, and Practices Regarding Exclusive Breastfeeding
JGNAHS
24J Gandhara Nurs Alli Health SciJanuary - June 2025
10. Gebeyehu NA, Tegegne KD, Shewangashaw NE, Biset G,
Abebaw N, Tilahun L. Knowledge, attitude, practice and
determinants of exclusive breastfeeding among women in
Ethiopia: Systematic review and meta-analysis. Public Health
Pract 2023;5:100373.
11. Al Rifai H, Shatila H, Nasreddine L, Yazbeck N, Kabakian-
Khasholian T, Itani L, et al. Knowledge, attitudes, and practices
of pediatricians in relation to breastfeeding support: A national
survey in Lebanon. Plos one. 2023;18(4):e0281865.
12. Ingabire J, Ntakiyinanira D. Assessment of Knowledge,
Attitude and Practices of Exclusive Breastfeeding Among
Postpartum Mothers Attending Kibogora Level two Teaching
Hospital: KP Kibogora Polytechnic; 2023.
13. Sabo A, Abba J, Sunusi Usman U, Musa Saulawa I, Alzoubi
MM, Al-Mugheed K, et al. Knowledge, attitude, and practice of
exclusive breastfeeding among mothers of childbearing age.
Front. Public Health:. 2023;11:1277813.
14. Peran P, Satriani S, Joto NA, Wiryanto W. The Effect of
Exclusive Breastfeeding Education on Changes in Knowledge
and Attitudes of Toddler Mothers. J. Health Resh.
2024;3(1):14-22.
15. Paramashanti BA, Dibley MJ, Huda TM, Alam A.
Breastfeeding perceptions and exclusive breastfeeding
practices: A qualitative comparative study in rural and urban
Central Java, Indonesia. Appetite. 2022;170:105907.
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mothers: a systematic review and meta-analysis. Int.
Breastfeed. J. 2020;15:1-14.
17. AlQurashi A, Wani T, Alateeq N, Heena H, editors. Effect of
counseling service on breastfeeding practice among saudi
mothers. Healthcare; 2023: MDPI.
18. Keen M, Gresse A. Knowledge, attitudes and practices of
mothers regarding breastfeeding and complementary feeding. J
of Cons Sci. 2024.
19. Washabaugh JR, Moore SE, Doel AM, Drammeh S, Ong KK,
Dunger DB, et al. Patterns and determinants of breastfeeding
and complementary feeding practices over the first year of life
in a rural Gambian population. Gates Open Res. 2023;7:103.
20. Paudel DR, Gupta DK, Giri A. Knowledge, attitude and
practice of mothers in breast feeding: A hospital based study.
Janaki Med Coll J Med Sci. 2022;10:14-23.
21. Pannair PP, Shrivastava D, Kalambe MA. Knowledge, Attitude
and Practices of Exclusive Breastfeeding amongst Mothers of
Rural Population in Central India: A Cross Sectional Analytical
Study. Ann. med. health sci. res. 2021;11(S3).
22. Agampodi TC, Dharmasoma NK, Koralagedara IS,
Dissanayaka T, Warnasekara J, Agampodi SB, et al. Barriers
for early initiation and exclusive breastfeeding up to six months
in predominantly rural Sri Lanka: a need to strengthen policy
implementation. Int. Breastfeed. J. 2021;16:1-12.
23. Tran V, Reese Masterson A, Frieson T, Douglass F, Pérez‐
Escamilla R, O'Connor Duffany K. Barriers and facilitators to
exclusive breastfeeding among Black mothers: A qualitative
study utilizing a modified Barrier Analysis approach. Matern
Child Nutr. 2023;19(1):e13428.
CONTRIBUTORS
1. Yasmeen Sikandar Ali Mugheri - Concept & Design
2. Nasreen Rebecca Wilson - Critical Revision; Final Approval
3. Zafarullah Junejo - Critical Revision; Supervision
4. Humaira Sikandar Ali Mugheri - Drafting Manuscript
5. Shabana Liaquat Ali Mugheri - Data Acquisition
6. Nazia Hassan Baloch - Data Analysis/Interpretation
7. Jana Naz Solangi - Data Acquisition; Data
Analysis/Interpretation
LICENSE: JGMDS publishes its articles under a Creative Commons Attribution Non-Commercial Share-Alike license (CC-BY-NC-SA 4.0).
COPYRIGHTS: Authors retain the rights without any restrictions to freely download, print, share and disseminate the article for any lawful purpose.
It includes scholarlynetworks such as Research Gate, Google Scholar, LinkedIn, Academia.edu, Twitter, and other academic or professional networking sites.
Knowledge, Attitude, and Practices Regarding Exclusive Breastfeeding
24J Gandhara Nurs Alli Health SciJanuary - June 2025
10. Gebeyehu NA, Tegegne KD, Shewangashaw NE, Biset G,
Abebaw N, Tilahun L. Knowledge, attitude, practice and
determinants of exclusive breastfeeding among women in
Ethiopia: Systematic review and meta-analysis. Public Health
Pract 2023;5:100373.
11. Al Rifai H, Shatila H, Nasreddine L, Yazbeck N, Kabakian-
Khasholian T, Itani L, et al. Knowledge, attitudes, and practices
of pediatricians in relation to breastfeeding support: A national
survey in Lebanon. Plos one. 2023;18(4):e0281865.
12. Ingabire J, Ntakiyinanira D. Assessment of Knowledge,
Attitude and Practices of Exclusive Breastfeeding Among
Postpartum Mothers Attending Kibogora Level two Teaching
Hospital: KP Kibogora Polytechnic; 2023.
13. Sabo A, Abba J, Sunusi Usman U, Musa Saulawa I, Alzoubi
MM, Al-Mugheed K, et al. Knowledge, attitude, and practice of
exclusive breastfeeding among mothers of childbearing age.
Front. Public Health:. 2023;11:1277813.
14. Peran P, Satriani S, Joto NA, Wiryanto W. The Effect of
Exclusive Breastfeeding Education on Changes in Knowledge
and Attitudes of Toddler Mothers. J. Health Resh.
2024;3(1):14-22.
15. Paramashanti BA, Dibley MJ, Huda TM, Alam A.
Breastfeeding perceptions and exclusive breastfeeding
practices: A qualitative comparative study in rural and urban
Central Java, Indonesia. Appetite. 2022;170:105907.
16. Buckland C, Hector D, Kolt GS, Fahey P, Arora A.
Interventions to promote exclusive breastfeeding among young
mothers: a systematic review and meta-analysis. Int.
Breastfeed. J. 2020;15:1-14.
17. AlQurashi A, Wani T, Alateeq N, Heena H, editors. Effect of
counseling service on breastfeeding practice among saudi
mothers. Healthcare; 2023: MDPI.
18. Keen M, Gresse A. Knowledge, attitudes and practices of
mothers regarding breastfeeding and complementary feeding. J
of Cons Sci. 2024.
19. Washabaugh JR, Moore SE, Doel AM, Drammeh S, Ong KK,
Dunger DB, et al. Patterns and determinants of breastfeeding
and complementary feeding practices over the first year of life
in a rural Gambian population. Gates Open Res. 2023;7:103.
20. Paudel DR, Gupta DK, Giri A. Knowledge, attitude and
practice of mothers in breast feeding: A hospital based study.
Janaki Med Coll J Med Sci. 2022;10:14-23.
21. Pannair PP, Shrivastava D, Kalambe MA. Knowledge, Attitude
and Practices of Exclusive Breastfeeding amongst Mothers of
Rural Population in Central India: A Cross Sectional Analytical
Study. Ann. med. health sci. res. 2021;11(S3).
22. Agampodi TC, Dharmasoma NK, Koralagedara IS,
Dissanayaka T, Warnasekara J, Agampodi SB, et al. Barriers
for early initiation and exclusive breastfeeding up to six months
in predominantly rural Sri Lanka: a need to strengthen policy
implementation. Int. Breastfeed. J. 2021;16:1-12.
23. Tran V, Reese Masterson A, Frieson T, Douglass F, Pérez‐
Escamilla R, O'Connor Duffany K. Barriers and facilitators to
exclusive breastfeeding among Black mothers: A qualitative
study utilizing a modified Barrier Analysis approach. Matern
Child Nutr. 2023;19(1):e13428.
CONTRIBUTORS
1. Yasmeen Sikandar Ali Mugheri - Concept & Design
2. Nasreen Rebecca Wilson - Critical Revision; Final Approval
3. Zafarullah Junejo - Critical Revision; Supervision
4. Humaira Sikandar Ali Mugheri - Drafting Manuscript
5. Shabana Liaquat Ali Mugheri - Data Acquisition
6. Nazia Hassan Baloch - Data Analysis/Interpretation
7. Jana Naz Solangi - Data Acquisition; Data
Analysis/Interpretation
LICENSE: JGMDS publishes its articles under a Creative Commons Attribution Non-Commercial Share-Alike license (CC-BY-NC-SA 4.0).
COPYRIGHTS: Authors retain the rights without any restrictions to freely download, print, share and disseminate the article for any lawful purpose.
It includes scholarlynetworks such as Research Gate, Google Scholar, LinkedIn, Academia.edu, Twitter, and other academic or professional networking sites.
Knowledge, Attitude, and Practices Regarding Exclusive Breastfeeding