Insights into breastfeeding practices: A mixed-method study conducted in the tribal areas of Koraput, India

Background Breastfeeding is a cornerstone of infant health, ensuring optimal growth, immunity, and development. Despite strong evidence of its benefits, breastfeeding practices are influenced by cultural, social, and economic factors, especially in tribal communities where traditional beliefs and practices play a major role. Understanding these dynamics is crucial for designing effective public health interventions. Objectives This study aimed to assess the knowledge, attitudes, and practices (KAP) of tribal women regarding breastfeeding and to explore the facilitators and barriers influencing breastfeeding practices in the tribal areas of Koraput district, Odisha. Methods An explanatory sequential mixed-methods design was adopted over three months (May 2023–April 2024). Quantitative data were collected from tribal women using a structured questionnaire to assess knowledge, attitudes, and practices. The findings were analyzed for associations with socio-demographic factors such as age, literacy status, and socio-economic status. Qualitative data were gathered through in-depth interviews and focus group discussions to explore underlying perceptions, cultural influences, and barriers. Thematic analysis was performed, generating code clouds and themes to complement quantitative findings. Results While awareness of the benefits of breastfeeding was present among most women, gaps were noted in exclusive breastfeeding practices, particularly in relation to early initiation and duration. Literacy status and socio-economic background were significantly associated with both knowledge and practice. Qualitative insights revealed cultural beliefs, family influences, lack of support, and myths around colostrum feeding as major barriers, whereas maternal motivation, peer support, and guidance from health workers acted as facilitators. Conclusions Breastfeeding practices in tribal communities are shaped by a complex interplay of knowledge, beliefs, and social structures. Addressing misconceptions, strengthening community-based counseling, and employing culturally sensitive strategies such as the NURTURE model can enhance exclusive breastfeeding practices and improve maternal-child health outcomes in these underserved populations.