Determinants of Exclusive Breastfeeding Among Mothers in Buleleng Regency, Bali: A Cross-Sectional Study

Abstract

Background: Exclusive breastfeeding plays a crucial role in supporting infant growth, health, and development during the first six months of life. Despite ongoing breastfeeding promotion efforts, the proportion of infants receiving exclusive breastfeeding remains inadequate in several parts of Indonesia. Identifying factors that influence breastfeeding behavior is essential for developing targeted maternal and child health programs. This study explored determinants associated with exclusive breastfeeding among mothers residing in Buleleng Regency, Bali.

Method: A community-based analytical study with a cross-sectional approach was undertaken between June and July 2025. The study involved 144 mothers who had children aged 6–24 months. Eligible participants were selected from public health service areas through purposive recruitment. Information was gathered through face-to-face structured interviews, and factors related to exclusive breastfeeding were examined using multivariable logistic regression.

Result: Of all respondents, 43.1% reported practicing exclusive breastfeeding during the first six months after birth. After controlling for potential confounding factors, mothers from lower-income households were less likely to exclusively breastfeed than those from higher-income households (AOR=0.20; 95%CI: 0.07–0.60; p=0.005). Receipt of breastfeeding information during the postpartum period was strongly associated with increased odds of exclusive breastfeeding (AOR=23.82; 95%CI: 3.10–182.94; p=0.001). In addition, mode of birth remained significantly related to breastfeeding practice, with mothers who delivered by cesarean section showing higher odds of exclusive breastfeeding than those who delivered vaginally (AOR=4.50; 95%CI: 1.39–15.12; p=0.012).

Conclusion: Exclusive breastfeeding prevalence in Buleleng Regency has not yet reached optimal levels. Household economic status, childbirth-related factors, and postpartum breastfeeding support were identified as important determinants of breastfeeding continuation. Expanding breastfeeding assistance after delivery may contribute to improving exclusive breastfeeding outcomes in community settings.