Using logistic regression analysis to measure the determinants of exclusive breastfeeding in Al-Kharj Governorate in Saudi Arabia

Background: Exclusive breastfeeding (EBF) is the safest option for infant feeding. This study is the first in the Al-Kharj region to apply recent UNICEF/WHO indicators. Objective: To identify factors associated with exclusive breastfeeding practices among infants aged 6 to 24 months using retrospective data. Methods : 573 infants were included in the final analysis. The dependent variable was a binary (yes/no) response to "Did you exclusive breastfeeding for the full first six months?" Results: Although 77.1% of participants were aware of breastfeeding benefits, only 38% practiced exclusive breastfeeding. Logistic regression revealed several factors negatively associated with exclusive breastfeeding: Insufficient milk (AOR=0.077; 95% CI: 0.045–0.134; p<0.001), delayed breastfeeding initiation (AOR=0.107; 95% CI: 0.035–0.329; P<0.000), returning to work (AOR=0.147; 95%CI:0.076–0.283; P<0.000), offering fluids before breastfeeding, high income, delayed baby holding, traditions, short interbirth intervals, cesarean, breast problems, breastfeeding< 8 times, premature, new pregnancy. Conversely, positive predictors of exclusive breastfeeding: >3 antenatal care visits (AOR=23.773; 95% CI:17.95–41.077; p<0.001), previous breastfeeding experience (AOR=16.593; 95% CI: 7.028–21.130; p<0.001), colostrum feeding, husband’s support, room-sharing with the infant, antenatal and postpartum breastfeeding education, early skin-to-skin contact, full-term pregnancy, middle income, and early baby holding. Conclusion: The prevalence of exclusive breastfeeding in Al-Kharj is below WHO recommendations. The most common reasons for not practicing it are insufficient milk, delayed breastfeeding initiation, and work or school commitments. We recommend implementing six months of paid maternity leave, educating healthcare workers to address misconceptions, and promoting positive attitudes toward breastfeeding, and a structured exclusive breastfeeding promotion program, it emphasizes early breastfeeding initiation.