Prevalence and Predictors of Exclusive Breast Feeding among Mothers Attending the Immunization Clinic of a Tertiary Teaching Hospital in Northern Uganda

Background: Exclusive breastfeeding (EBF) is a critical public health strategy for reducing child morbidity and mortality and improving maternal health. Despite its recognized benefits, the global and national prevalence of EBF remains below recommended levels. In Uganda, EBF rates decrease significantly as infants age, contributing to preventable health complications. This study aimed to investigate the prevalence and predictors of EBF among mothers attending the immunization clinic at Gulu Regional Referral Hospital (GRRH). Methods: A hospital-based, cross-sectional descriptive study was conducted between July and October 2024, among 424 mothers with infants aged 6–12 months at GRRH. Data were collected using a semi-structured questionnaire and analyzed using STATA version 17. We obtained an ethical approval and clearance from Gulu University Research and Ethics Committee. We used convenience sampling method to obtain mothers having children of 6 months to one year of age attending postnatal and immunization during the time of the study at Gulu RRH. Ethical approval and Informed consent was obtained from all respondents and participation was free and voluntary. We obtained a quiet and private room for carrying out data collection. Descriptive statistics were employed to summarize EBF prevalence, while bivariate and multivariate analyses identified significant predictors of EBF. Results: The prevalence of EBF was 35.9% (95% CI: 31.48–40.64). Factors positively associated with EBF included maternal education (primary: aOR = 3.0, 95% CI: 1.01–9.20), family support (aOR = 2.2, 95% CI: 1.13–4.31), community support (aOR = 3.2, 95% CI: 1.68–6.23), attendance at healthcare programs (aOR = 10.5, 95% CI: 4.45–24.75), and perceived importance of EBF (aOR = 22.1, 95% CI: 4.05–120.20). Grand multiparity and poor maternal health negatively influenced EBF. Conclusion: The prevalence of EBF at GRRH is suboptimal, with significant predictors including maternal education, social support, healthcare program attendance, and maternal perception of EBF's importance. Interventions targeting education, social support systems, and healthcare engagement are crucial for promoting EBF practices. Recommendations: Strengthening health education, engaging family and community support networks, and improving maternal access to healthcare services can enhance EBF prevalence and contribute to better maternal and child health outcomes in the region.