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Maternal factors associated with exclusive breastfeeding failure: a community-based cross-sectional study in the north of Iran

Wien Med Wochenschr. 2026 Feb 9. doi: 10.1007/s10354-025-01127-2. Online ahead of print.

ABSTRACT

BACKGROUND: To improve exclusive breastfeeding, we must resolve challenges for mothers and babies. This study aims to determine the maternal factors contributing to failure of exclusive breastfeeding.

METHODS: This cross-sectional study was conducted in all infants who had attended the healthcare centers for their first 6‑month vaccinations from 2019 to 2021 in Babol, Iran. Maternal factors were collected using a checklist, including demographic, social, and midwifery information. Failure of exclusive breastfeeding was defined as using anything other than breast milk, such as pacifiers, bottles, sugar water, or complementary feeding for infants during the first 6 months of life. Binary logistic analysis examined the influence of predictor variables on exclusive breastfeeding. The significance level was set at P < 0.05.

RESULT: Out of the 1400 infants, at the end of the study, 413 (29.5%) were exclusively breastfed. Multivariate regression showed education level (odds ratio [OR]: 1.42, P = 0.003) and urban residence (OR: 1.89, P < 0.001) to be associated with increased discontinuation, while term pregnancy (OR: 0.47, P = 0.008) served as a preventive factor. Breastfeeding education (OR: 6.7, P = 0.067) and breast problems (OR: 6.4, P = 0.082) had a sixfold effect on the decrease and increase of discontinuation of exclusive breastfeeding, respectively, although this relationship was not statistically significant.

CONCLUSION: This study showed that preterm delivery, higher education, and living in an urban area can increase the probability of failure of exclusive breastfeeding. These findings provide valuable insights for healthcare professionals and policymakers promoting and supporting exclusive breastfeeding.

PMID:41661450 | DOI:10.1007/s10354-025-01127-2

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