Abstract:

Introduction: Exclusive breastfeeding offers both mothers and infants vital psychological and health benefits. However, its practice has declined globally, including in Sierra Leone, where inappropriate feeding practices contribute to high infant mortality. Malnutrition causes 60% of 10.9 million infant deaths, which are often linked to poor breastfeeding habits. Addressing cultural barriers and misconceptions is key to promoting exclusive breastfeeding. The findings of this study will guide policymakers in designing strategies to improve breastfeeding practices and reduce infant mortality nationwide. Aim: This study aimed to evaluate the knowledge, attitudes, and practices toward exclusive breastfeeding among mothers attending a postnatal clinic at the Kenema Government Referral Hospital. Method: This cross-sectional descriptive study evaluated the knowledge, attitudes, and practices (KAPs) of exclusive breastfeeding among 233 mothers attending the postnatal clinic at Kenema Government Referral Hospital. Data were collected via a structured questionnaire based on the health belief model (HBM). Stratified random sampling was employed, and face-to-face interviews were conducted in local languages. Statistical analysis included chi-square tests and logistic regression to determine associations and predictors of exclusive breastfeeding. Ethical approval was obtained, and participant confidentiality was maintained throughout the study. Result: Among the 233 mothers, 96.1% were aware of exclusive breastfeeding (EBF), with healthcare workers being the primary source (78.5%). Approximately 55.8% knew that EBF should last for six months, but 25.3% discarded colostrum. A positive attitude towards breastfeeding was reported by 59.1% of mothers, with 75.6% practicing EBF on demand. Chi-square tests revealed significant associations between knowledge (p = 0.0004), attitude (p = 0.017), and EBF. Logistic regression revealed that knowledge (OR = 2.12) and attitude (OR = 1.57) were strong predictors of EBF, whereas self-efficacy showed a weaker effect (OR = 1.35). Conclusion: This study revealed that while mothers had high levels of knowledge and positive attitudes toward exclusive breastfeeding, their practices did not meet WHO recommendations. Key gaps include understanding the role of breastfeeding in pregnancy prevention and milk production. Enhanced public awareness, government policy integration, and future research on sociocultural factors are recommended.