Exclusive breastfeeding practices and influencing factors among mothers of six-month-old infants in Chongqing China

According to the “Report on the Nutritional Status and Chronic Diseases of the Chinese Population (2020)”, the exclusive breastfeeding rate among infants under six months of age in China stands at 34.1%. As a major city in south-western China, Chongqing lacks city-wide data on exclusive breastfeeding rates. A mixed study of interpretation sequences was performed. In the quantitative research section, the researchers conducted a questionnaire survey of 510 women who gave birth at a Grade A, Level 3 hospital in Chongqing. All 510 women had voluntarily joined the research WeChat group before giving birth, and the questionnaires were distributed and completed via the WeChat mini-program “Wenjuanxing”; a total of 501 questionnaires were returned. The primary outcome measure was exclusive breastfeeding at six months postpartum (defined as feeding only breast milk, with no other liquids or solid foods added, except for vitamins, minerals, or medication). Logistic regression was used to calculate adjusted odds ratios (OR). For the qualitative study, a phenomenological approach was adopted, involving semi-structured interviews with 14 mothers, with themes extracted using Colaizzi’s seven-step analysis method. The rate of exclusive breastfeeding at six months was 38.92%. Multivariate analysis revealed that monthly household income per capita ( P = 0.048, OR = 0.354, 95%CI: 0.127–0.989), postpartum breast condition ( P = 0.006, OR = 4.152, 95%CI: 1.498–11.510), newborn weight ( P = 0.041, OR = 0.509, 95%CI: 0.266–0.972) are important factors influencing exclusive breastfeeding, exclusive breastfeeding for the preceding 24 h ( P <0.001, OR = 12.796, 95%CI: 6.667–24.560) was significantly positively correlated with exclusive breastfeeding at 6 months; given the temporal overlap between this variable and the outcome measure, it was considered a concurrent behavioral indicator rather than a causal predictor. Qualitative analysis identified four themes: the multifaceted drivers of feeding decisions; the practical challenges of feeding implementation; the imbalance between supply and demand in support systems; and the dual influence of societal attitudes and the environment. A mixed-methods analysis indicates that “exclusive breastfeeding in the past 24 hours” exhibits both consistency and an expansive relationship in both qualitative and quantitative data; “monthly per capita household income” and “newborn birth weight” exhibit both consistency and a complementary relationship in both qualitative and quantitative data; whilst “postnatal breast condition”, although seemingly contradictory on the surface, is in essence complementary. Future efforts should focus on addressing mothers’ dual physiological and psychological needs, moving away from the “widow-style parenting” approach and strengthening family care support; establishing a social breastfeeding support network to resolve the breastfeeding challenges faced by working mothers; upholding scientific feeding principles, respecting mothers’ feeding choices and fundamental human rights; and, through collaborative efforts among medical, family and community sectors, increasing the rate of exclusive breastfeeding to promote the healthy development of both mothers and infants.