Determinants of exclusive breastfeeding among mothers of infants: A cross-sectional study

Objectives: Exclusive breastfeeding (EBF) represents a critical public health practice that promotes the health and survival of both mothers and their children. Despite its well-documented benefits, multiple challenges continue to impede the widespread adoption of EBF across diverse regions. The objective of this study was to analyse the determinants of EBF practice among mothers attending maternal-child health centres (MCHCs) in Brazzaville. Material and Methods: We conducted a cross-sectional analytical study among mother-infant dyads (infants aged between 6 and 12 months) who were randomly selected from those attending MCHCs in Brazzaville, from 05 October 2021 to 04 March 2022. Multivariable analysis was performed using a logistic regression model including sociodemographic, reproductive, and breastfeeding-related variables. The odds ratio with a 95% confidence interval was estimated. Those variables with p ≤ 0.05 were considered statistically significant. Results: A total of 571 mothers were enrolled in the study, with a mean (standard deviation) age of 28 (6.5) years. EBF was reported by 57.4% of participants, and 17.8% initiated breastfeeding within the 1 st h after birth. The factors positively associated with EBF were vaginal delivery (odds ratio [OR] = 1.86 [1.05; 3.34]; p = 0.035), EBF counselling (OR = 1.96 [1.18; 3.23]; p = 0.009), prior EBF experience (OR = 2. 62 [1.47–4.73]; p = 0.001) and no teat usage (OR = 2.21 [1.42–3.43]; p < 0.001). Conversely, higher maternal education was negatively associated with EBF (OR = 0.43, p = 0.021). Conclusion: The rate of EBF observed in Brazzaville’s MCHCs exceeds the targets set by the World Health Organization and the United Nations Children’s Fund. However, this study identifies the multilevel determinants of EBF. The findings highlight the need to implement targeted interventions, combining awareness campaigns and tailored support, to consolidate these advances and make them a sustainable lever for maternal and child health.