Prevalence, barriers and determinants of exclusive breastfeeding among Palestinian mothers: a multicenter study

The World Health Organization recommends exclusive breastfeeding (EBF) for the first six months of an infant's life to ensure optimal growth and health. Despite its well-established benefits, many mothers discontinue EBF early due to various barriers. This study aimed to assess the prevalence of EBF among Palestinian mothers, identify EBF barriers, and determine factors associated with maintaining EBF during the first six months.

A multicenter cross-sectional study was conducted in four Ministry of Health primary care clinics across the West Bank, Palestine. Mothers who visited the selected clinics to vaccinate their infants aged 6-12 months between April 15, 2023, and May 15, 2023, were interviewed face-to-face using a structured questionnaire. Logistic regression was used to identify factors associated with EBF. A p-value ≤ 0.05 is considered statistically significant.

Of the 495 participating mothers, 38.2% reported exclusively breastfeeding for six months. The most common self-reported barrier was the perception of insufficient breast milk. Mothers with prior EBF experience were more than twice as likely to maintain EBF compared to those without such experience (AOR = 2.081; 95% CI: 1.094, 2.405). Working mothers had nearly 39% lower odds of maintaining EBF compared to non-working mothers (AOR = 0.610, 95% CI: 0.386-0.965), and pacifier use was associated with a 59.8% reduction in the odds of maintaining EBF (AOR = 0.402, 95% CI: 0.275-0.588).

This study indicates a relatively low prevalence of EBF among Palestinian mothers. Employment and pacifier use were negatively associated with EBF practices, while prior experience significantly supports the continuation of EBF for up to six months. It is essential to emphasize the importance of breastfeeding education and support, especially for new mothers.