Factors associated with exclusive breastfeeding practice among children aged 6- 23 month in Lao PDR

Background: Exclusive breastfeeding (EBF) is crucial for providing infants with essential nutrients and antibodies during the first six months of life. It significantly contributes to child growth, cognitive development, and the reduction of illness. Despite its well-documented benefits and intensive efforts to promote EBF, in the Lao People's Democratic Republic (Lao PDR), prevalence of EBF are reported to be suboptimal. This study aims to identify the factors associated with EBF among mothers of children aged 6 to 23 months in Lao PDR. Methods: A cross-sectional study was conducted across three provinces, involving a total of 960 mothers of children aged 6 to 23 months. Participants were recruited using multi-stage sampling techniques. Data were gathered through face-to-face structured interviews. To identify the factors associated with EBF, both binary and multiple logistic regression analyses were employed. The adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) were calculated to assess the strength and direction of the relationships, along with their statistical significance. Results: The majority of mothers (85.5%) reported having previously breastfed a child; among them, 86% provided colostrum and 72.6% initiated breastfeeding within the first hour after birth. However, only 44.7% of mothers continued to breastfeed, and 61.1% practiced exclusive breastfeeding (EBF) during the first six months. More than half (59.8%) introduced foods other than breast milk when their child reached six months of age or older. Statistical analysis revealed several factors associated with an increased likelihood of practicing EBF: mothers over 30 years old (AOR: 1.9; 95% CI: 1.1–2.6), mothers as housewives, farmers, or sellers (AOR: 1.7; 95% CI: 1.1–2.6), mothers with more than one child under five years of age in the family (AOR: 1.4; 95% CI: 1.1-2.0), mothers with infants aged 12 months or older (AOR: 1.6; 95% CI: 1.1–2.2), those attending postnatal care (PNC) (AOR: 1.8; 95% CI: 1.4–2.4), those with higher knowledge of EBF (AOR: 1.7; 95% CI: 1.3–2.3). And mothers who delivered via cesarean section decreased likelihood of practicing EBF (AOR: 0.7; 95% CI: 0.5–0.9). Conclusion: The study revealed a relatively high prevalence of exclusive EBF under 6 months. Significant socio-demographic factors, knowledge of EBF, and obstetric considerations were identified as key determinants associated with EBF practices. Given the multifaced nature of these factors, continued advocacy for EBF is essential to enhance maternal and child health outcomes. Advocacy efforts should particularly target young and first-time mothers, working mothers and those who have undergone caesarean sections emphasizing the importance of re-establishing EBF immediately following delivery.