Abstract
BACKGROUND: Breastfeeding supports infant health and development. In Saudi Arabia, although most mothers initiate breastfeeding, fewer maintain exclusive breastfeeding for the first 6 months. This study explored the relationship between maternal knowledge, attitudes, counseling, and sociodemographic factors with breastfeeding initiation and exclusive breastfeeding. METHODS: A cross-sectional survey was conducted among 507 Saudi mothers. Self-administered Arabic questionnaire was used to assess breastfeeding practices, knowledge, attitudes, counseling experiences, and sociodemographic characteristics. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression. RESULTS: While n = 457 (90.1%) initiated breastfeeding; however, only n = 183 (40%) practiced exclusive breastfeeding for 6 months. Knowledge significantly predicted initiation (OR = 3.664, CI = [1.98, 6.36], P = .05) but did not predict exclusive breastfeeding. Positive attitudes significantly predicted both outcomes (initiation: OR = 1.147, CI = [1.070, 1.230], P < .01; exclusive breastfeeding: OR = 1.090, CI = [1.045, 1.138], P < .01). Prenatal counseling was associated with higher exclusive breastfeeding rates. Marital status influenced breastfeeding initiation, but no sociodemographic factors were linked to exclusive breastfeeding. CONCLUSION: Enhancing maternal knowledge may increase the initiation of breastfeeding. Meanwhile, improving attitudes and offering prenatal counseling may help increase exclusive breastfeeding rates in Saudi Arabia. Therefore, interventions that target exclusive breastfeeding may improve its rates.