Trends and Determinants of Exclusive Breastfeeding in Turkey: A Trend Analysis and Determinants Analysis of Four Demographic and Health Surveys, 2003–2018

Background;This study aimed to examine temporal trends in exclusive breastfeeding (EBF) rates among infants aged 0-5 months in Turkey and to identify determinants of EBF using a comprehensive national-level approach.Methods;The research was based on a pooled secondary analysis of data from the 2003, 2008, 2013, and 2018 Turkish Demographic and Health Surveys.Results:Analyses revealed that EBF rates in Turkey showed an increasing trend over time, but when 2018 was taken as a reference, the likelihood of EBF in 2003 was significantly lower (adjusted odds ratio [aOR] = 0.37, 95% CI 0.22-0.64). The likelihood of EBF was higher among second-born infants than among firstborns (aOR = 1.85, 95% CI 1.17-2.92) and among mothers who gave birth for the first time between the ages of 25 and 34 years compared with those aged 18-24 years (aOR = 1.97, 95% CI 1.19-3.26). In contrast, the likelihood of EBF was lower in infants perceived as very large or larger than average compared with those perceived as average or smaller than average (aOR = 0.51, 95% CI 0.29-0.90) and among those living in the southern region compared with the West (aOR = 0.47, 95% CI 0.27-0.84). No significant association was found with socioeconomic status or mode of delivery.Conclusions:Although EBF rates in Turkey have increased, gains remain inconsistent and below World Health Organization targets. Findings demonstrate that breastfeeding success is shaped by maternal experience, maternal age, and regional inequalities. Strategies targeted specifically for primiparous mothers, younger age groups, and high-risk regions are essential.