BARRIERS OF FAILURE OF EXCLUSIVE BREASTFEEDING AMONG MOTHERS IN CITY MUZAFFARABAD, AJK: A COMPARATIVE CROSS-SECTIONAL QUANTITATIVE STUDY

Abstract

Background: Exclusive breastfeeding (EBF) during the first six months of life is recognized as one of the most effective public health interventions for reducing infant morbidity and mortality. Despite global recommendations, EBF prevalence remains critically low in Pakistan, particularly in Azad Jammu & Kashmir (AJK).

Objectives: To analyze the knowledge of exclusive breastfeeding among mothers and To identify the barriers of failure of exclusive breastfeeding among mothers.

Methodology: A comparative cross-sectional study was conducted among 200 mothers with infants aged 0–6 months in Muzaffarabad, AJK. One hundred mothers practicing EBF were assigned to the control group and 100 non-EBF mothers to the target group. A standardized structured questionnaire (adapted from King Khalid University, Saudi Arabia) was used for data collection. Data were analyzed using SPSS version 26 with descriptive statistics and independent sample t-tests.

Results: Significant barriers identified included: medical conditions (70% in target vs. 8% in control group; p<0.001), low confidence in milk supply (46% vs. 81%; p<0.001), maternal employment (22% vs. 11%; p=0.036), physical challenges such as sunken nipples (29% vs. 10%; p=0.001), prolonged hospital stay >3 days (25% vs. 8%; p=0.002), and early introduction of complementary foods (17% vs. 7%; p=0.043). Paradoxically, higher education and income levels were more prevalent in the non-EBF group.

Conclusion: EBF failure in Muzaffarabad is driven by an interplay of medical, psychosocial, and structural barriers. Strengthening lactation counseling, psychosocial reassurance, and breastfeeding-friendly workplace policies are critical to improving EBF practices and infant health outcomes