Comprehensive Assessment of Exclusive Breastfeeding: Insights into Knowledge, Attitude, and Practice among Lactating Mothers at Hoima Regional Referral Hospital, Hoima District: A High-Impact Analysis

Agaba Deusdedit

Faculty of Clinical Medicine and Dentistry Kampala International University Western Campus Uganda.


This research aimed to rigorously evaluate the knowledge, attitude, and practice concerning exclusive breastfeeding among lactating mothers attending Hoima Regional Referral Hospital (HRRH). Employing a quantitative descriptive research design, the study meticulously selected mothers seeking medical attention for their infants at HRRH, adhering to rigorous selection criteria. A sample size of 208 subjects participated, comprising lactating mothers with infants aged between 0-6 months, utilizing a self-administered structured questionnaire to gather comprehensive data on exclusive breastfeeding behaviors. The data collected underwent meticulous analysis utilizing Statistical Analysis Software (STATA) version 10. Results revealed that a majority of the participants were aged between 25-29 years (30.8%) and had attained secondary education (38.5%), with an employment status predominantly as employed individuals or peasants (38.5%). The study cohort primarily resided in urban areas. Among the 208 lactating mothers, a significant proportion (61.5%) initiated breastfeeding within the first hour after birth, with the mode of delivery significantly influencing this initiation, favoring normal deliveries. However, the practice of exclusive breastfeeding exhibited a decline over subsequent months. Assessment of knowledge demonstrated that over 80% of mothers possessed substantial knowledge regarding exclusive breastfeeding, with a small percentage (5%) exhibiting poor knowledge. In terms of attitude, 74.4% expressed comfort and acknowledged exclusive breastfeeding as superior to artificial feeding, yet 40.9% reported feelings of shyness while breastfeeding. Interestingly, a positive correlation between higher education levels and a favorable attitude toward exclusive breastfeeding was observed. Overall, the study revealed a generally commendable level of knowledge, attitude, and practice concerning exclusive breastfeeding among lactating mothers attending Hoima Regional Referral Hospital. However, a notable finding was the significant decline in exclusive breastfeeding prevalence observed from the first month following initiation.

Keywords: Exclusive breastfeeding, Breast milk, Infants, Lactating mothers.


Exclusive Breastfeeding (EBF) means an infant receives breast milk from his or her mother or expressed breast milk for the first six months of life and no other solids/semisolids are given except vitamins, mineral supplements, or medicine [1, 2]. When infants are exclusively breastfed for the first six months of life, their immune system is stimulated thus protecting them from diseases like diarrhea and acute respiratory infections, which are considered to be two of the major causes of infant mortality in the developing world [3, 4]. Exclusive breastfeeding offers short-term and long-term health benefits both to the mother and infant for example, the breast milk produced from 37 weeks of gestation to about seven days after delivery is called colostrum which is yellowish and sticky and is very significant for immune defenses, provides proteins, vitamins and minerals to the baby during the initial days of life [5-7]. Breastfeeding promotes the health of mothers by reducing in risk of postpartum hemorrhage, and ovarian and breast cancers. Close to 20000 breast cancer deaths can be prevented by exclusive breastfeeding [8, 9]. Breastfeeding, therefore, is an important public health strategy for reducing infant and child morbidity and mortality as well as reducing maternal morbidity and mortality [10-12]. Globally, breastfeeding rates have declined over the past four decades. The percentages of infants younger than 6 months old who were exclusively breastfed in 2000–2007 were 38% worldwide, 23% in West/Central Africa, 39% in Eastern/Southern Africa, 44% in South Asia, 26% in Middle East/North Africa, and 43% in East Asia/ in addition’s in United State only 79.2% of women initiated breastfeeding, 49.4% were still breastfeeding at six months, and 26.7% continued breastfeeding to twelve months [13]. In East Africa, over the years, the prevalence of exclusive breastfeeding has dramatically increased, a report released on 1st August 2017 indicated Uganda, Kenya, and Burundi with percentages of EBF above 60 percent with Tanzania and Rwanda the only East African countries with percentages of 52 and 56, respectively [14]. The above figures don’t however correspond to the expected 90 percent by the World Health Organization. In Uganda, a report released by the Global Breastfeeding Scorecard showed 66 percent of children less than six months were exclusively breastfeeding, 32 percent were mixed feeding, and 2 percent were not breastfed at all [14]. Given these declining trends, new initiatives like the Global Breastfeeding Scorecard, International Code of Marketing Breast Milk Substitutes, and Baby Friendly Hospital Initiative (BFHI) are put in place globally to encourage exclusive breastfeeding [15].

In Uganda, only six in ten Ugandan children below the age of six months are exclusively breastfed with only half the proportion of the children in South Western district breastfed (34%). It is no wonder then that the under-five and infant mortality rates stand at 128 and 79 per 1,000 live births respectively, which is very high by developing world standards. (Economic Policy Research Center, 2012). The number of stunted children in southwestern Uganda has reached epidemic proportions, according to findings of a health research project, a situation that can be attributed to early infant feeding practices [14]. WHO and UNICEF through the Ministry of Health launched the Baby-Friendly Hospital Initiative (BFHI) in 1991 to encourage breastfeeding in Uganda [15]. To achieve the EBF target of 80% by the year 2015, the government of Uganda further introduced other initiatives and policies like the labor law on maternity leave; mobilization of male partners to support breastfeeding mothers, and at the community level, peer counselors provided support for breastfeeding mothers. Despite these policies and programs, the EBF targets still seem to be far from being achieved especially in rural areas. This study therefore intends to assess knowledge, attitude, and practice of exclusive breastfeeding among lactating mothers attending Hoima Regional Referral Hospital, Hoima District given the low exclusive breastfeeding practice in Western Uganda and the limited empirical data on EBF in Uganda especially in rural areas.


The current research provides valuable data that could be used by policymakers, and university health institutions to plan strategies aiming at improving the rates of exclusive breastfeeding. The prevalence of exclusive breastfeeding, mother’s knowledge, and attitude in the present sample is lower in comparison to other published studies and therefore should be considered for health promotion and disease prevention among children. Mothers have shown a relatively alarming negative attitude towards exclusive breastfeeding and this should be targeted and modified. This could be achieved through promoting intervention programs that lead to changing the built environment affecting behavioral modification of mothers’ lifestyles and increased hospital deliveries.


 Health facilities present a great opportunity for focused education programs targeting pregnant and lactating mothers hence should be utilized by healthcare providers in educating mothers. Mothers are thought to be a significant proportion of the persons and thus their habits towards breastfeeding should not be undervalued. Therefore, the mobilization of governmental efforts and drawing the attention of international agencies and local communities is needed to increase the prevalence of exclusive breastfeeding through proper educational practices, and public health campaigns.


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CITE AS: Agaba Deusdedit (2023).Comprehensive Assessment of Exclusive Breastfeeding: Insights into Knowledge, Attitude, and Practice among Lactating Mothers at Hoima Regional Referral Hospital, Hoima District: A High-Impact Analysis. IDOSR JOURNAL OF BIOCHEMISTRY, BIOTECHNOLOGY AND ALLIED FIELDS 8(3): 12-22.