Prevalence and factors associated with 6 months exclusive breastfeeding among mothers with formal employment in Rwanda: A cross-sectional survey

Background: Breastfeeding is crucial for infant and young child nutrition as it provides essential nutrients, immune protection, and supports healthy growth and development. However, exclusive breastfeeding for the first six months remains a major challenge, especially among women with formal employment. This study determined the prevalence and factors associated with exclusive breastfeeding for the first 6 months among working mothers in Rwanda. Methods: This was a cross-sectional study that collected data from August 5th to 29th, 2025, using a Google Form. The collected data were analyzed using STATA 17. Descriptive statistics were used to describe participants' characteristics and key data on exclusive breastfeeding. A generalized estimating equation (GEE) model was used to identify factors associated with the first six months of exclusive breastfeeding among the mothers. Statistical significance was assumed at a p-value less than 0.05. Results: A total of 848 working mothers across Rwanda, aged between 18 and 46 years with a mean age of 32 years, were enrolled in the study. Among them, 61.1% were aged 25 to 34 years, 72.6% were married, nearly half (48.6%) had secondary or vocational training as their highest education level achieved, 72.6% had full-time employment, and 9.7% held managerial, supervisory, or directorial positions. According to participants' self-reports, the prevalence of six-month exclusive breastfeeding was 29.8%. Mothers in rural areas were more likely to practice exclusive breastfeeding compared to those in urban areas of Kigali City [aOR: 3.5, 95% CI: 1.3-9.0]. The likelihood was also higher among mothers who did not report a lack of a breastfeeding room at work [aOR: 2.5, 95% CI: 1.4-4.3] and those who received exclusive breastfeeding information from social media [aOR: 2.2, 95% CI: 1.3-3.6]. Conversely, the lowest likelihood was observed among mothers in the Southern province compared to those in other provinces, which are 2.6 to 3.7 times higher than the Southern province [aOR: 2.6-3.7, 95% CI: 1.2-11.1] and those who reported that implementing a designated lactation room in their workplace was very feasible. Conclusion: Overall, less than one-third of working mothers in Rwanda exclusively breastfeed for six months, indicating a need for increased workplace and community support. Rural mothers exhibit higher rates of exclusive breastfeeding compared to those in Kigali, with the lowest rates in the Eastern Province. Access to breastfeeding facilities and information through social media has a positive impact on breastfeeding practices. Enhancing workplace policies and bridging regional disparities can enhance maternal and child health outcomes.