Empowering Mothers in Kinshasa, Democratic Republic of the Congo: The Role of Maternal Education, Mental Health, Diet and Support in Enhancing Exclusive Breastfeeding Prevalence

Background: Exclusive breastfeeding (EBF) is crucial for infant health, yet maternal mental health significantly influences breastfeeding practices. This study investigates the relationships among postpartum depression (PPD), maternal dietary diversity, and exclusive breastfeeding in Kinshasa, Democratic Republic of the Congo. Methods: A cross-sectional study was conducted with mothers of infants aged 0–6 months. Data collection used various tools, primarily the 24-hour dietary recall method to assess dietary intake and exclusive breastfeeding (EBF) status. EBF prevalence was evaluated using three metrics: the EBF-24H method (percentage of infants exclusively breastfed in the previous 24 hours), maternal self-declaration of breastfeeding practices, and the EBF-SB method (breastfeeding since birth). The Breastfeeding Self-Efficacy Scale—Short Form (BSES-SF) measured mothers' confidence in their breastfeeding abilities. Maternal education, antenatal care sessions, mental health status, husband support were also collected. Structural equation modeling (SEM) was employed to analyze the interactions among these variables. Results: The proportion of infants in the study sample who were exclusively breastfed was 29.1% (95% CI: 26.0–32.3%). Breastfeeding self-efficacy is positively influenced by nutritional advice during pregnancy, with a coefficient of 2.25 (p = 0.044). The husband’s support in exclusive breastfeeding positively correlates with both breastfeeding self-efficacy (coefficient = 0.26, p = 0.002) and EBF (coefficient = 0.0058, p = 0.058). A significant negative relationship exists between child age and EBF (coefficient = −0.0847, p < 0.001). Conversely, religion positively influences EBF (coefficient = 0.0441, p = 0.029). There is a noteworthy negative effect of mother’s education on EBF (coefficient = −0.1490, p = 0.006). Conclusions: This study highlights the multifaceted challenges faced by mothers in Kinshasa regarding exclusive breastfeeding. By prioritizing maternal mental health, as well as the roles of husband support and nutritional advice during pregnancy, we can create a more supportive framework for breastfeeding practices. Future research should explore longitudinal approaches to understand the long-term effects of PPD and the roles of husband support and nutritional advice during pregnancy on breastfeeding and infant health, as well as the potential benefits of integrated maternal health programs that address both psychological and nutritional needs.