KNOWLEDGE, ATTITUDES, AND PRACTICES OF EXCLUSIVE BREASTFEEDING AMONG MOTHERS IN RURAL SINDH, PAKISTAN

Abstract

Background: Exclusive breastfeeding for the first six months of life is a proven strategy to improve infant survival, growth, and development. Despite global and national recommendations, exclusive breastfeeding remains suboptimal in many rural communities of Pakistan due to cultural beliefs, misinformation, and limited maternal support. Objective: To assess the knowledge, attitudes, and practices of exclusive breastfeeding among mothers in rural Sindh, Pakistan. Methods: A community-based cross-sectional study was conducted among mothers in Village Paryo Tunio, Kandiaro, Sindh, Pakistan, from August to November 2025, among 96 mothers using convenience sampling. Data were collected using a structured, pre-validated questionnaire covering socio-demographics and EBF-related knowledge, attitudes, and practices. Data were analysed using SPSS v23 with descriptive statistics. Results: Overall knowledge was moderate in 52% of mothers, good in 26%, and poor in 22%. Most mothers (67.7%) had heard of EBF, and 70.8% correctly defined it. While 80.2% recognized the importance of initiating breastfeeding immediately after birth, only 58.3% actually practiced immediate initiation. Colostrum was fed by 63.5%, and 69.8% provided pre-lacteal feeds. Exclusive breastfeeding for six months was reported by 58.3%, with overall practices moderate in 52%, good in 21%, and poor in 27%. Attitudes were generally positive, with 83.3% perceiving breastfeeding as easier than formula feeding. Conclusion: Mothers demonstrated moderate knowledge and generally positive attitudes toward EBF, but practices were inconsistent, reflecting cultural norms, limited formal education, and inadequate counseling. The gap between knowledge and practice highlights the need for community-based education, structured postnatal support, and engagement of family decision-makers to improve EBF adherence and maternal-child health outcomes.