Factors affecting breastfeeding practices in Yunnan Province, China: data from cross-sectional national household health services surveys in 2008, 2013, and 2018

Background Breastfeeding is essential for infant health and maternal well being, yet China continues to experience relatively low breastfeeding rates, with significant regional disparities. Yunnan Province, characterized by its unique demographic and geographic profile, may face even greater challenges. This study aims to investigate the prevalence and factors of breastfeeding practices in Yunnan Province using data from the 2008, 2013, and 2018 National Household Health Services Surveys (NHHSS). Methods This cross-sectional study included 742 mother-child pairs in 2008, 909 in 2013, and 620 in 2018. We assessed key breastfeeding indicators, including overall breastfeeding rate, early initiation of breastfeeding, exclusive breastfeeding for 6 months or longer, continued breastfeeding for at least 1 year, and timely introduction of complementary foods. Multivariate logistic regression was used to analyze the associations between breastfeeding practices and maternal, child, and health service-related factors. Results The overall breastfeeding rate in 2018 was 94.35%, with no significant difference across the three survey years ( P > 0.05). Early initiation of breastfeeding increased from 33.83% in 2008 to 41.61% in 2018. Continued breastfeeding rose from 0.22% in 2013 to 7.10% in 2018. Urban mothers were more likely to initiate breastfeeding early but less likely to practice exclusive or continued breastfeeding (OR = 0.684, 95% CI: 0.532–0.879, P < 0.05). Older maternal age was associated with lower rates of continued breastfeeding (OR = 0.453, 95% CI: 0.227–0.904, P < 0.05). Han ethnicity, adequate antenatal care, and postpartum visits were positively associated with continued breastfeeding ( P < 0.05). Mothers without chronic conditions were more likely to practice breastfeeding and introduce complementary foods on time. Conclusion While the overall breastfeeding rate in Yunnan Province is relatively high, the rates of exclusive and continued breastfeeding remain low. The findings highlight the need for targeted interventions and stronger social and health system support to promote sustained breastfeeding practices. Enhanced public education and maternal support services are crucial for improving breastfeeding outcomes in the region.