Factors associated with exclusive breastfeeding among mothers of children under two years of age in Dalit community, Rajbiraj municipality, Saptari, Nepal

The prevalence of exclusive breastfeeding (EBF) is suboptimal in Nepal and very low in Madhesh province. Dalits are commonly recognized for experiencing economic exploitation, a lack of political representation, social marginalization, educational disadvantage, being classified as untouchables, and enduring the denial of basic human dignity and social justice. Objective of this study is to assess the proportion of mothers of children under 2 years of age, practicing exclusive breastfeeding and associated factors in the Dalit community of Rajbiraj Municipality, Saptari, Nepal. The study utilized an analytical, cross-sectional design by using a semi-structured questionnaire to 156 Dalit mothers of children under 2 years of age in Rajbiraj Municipality, Saptari, Nepal. In the bivariate analysis, which focuses on exploring the connection between independent variables and dependent variables, chi-squire statistics were utilized. Subsequently, the independent variables that displayed significance in the bivariate analysis were included in the multivariate logistic regression. The estimated prevalence of exclusive breastfeeding in the population was 43.6%. Mothers occupation (adjusted odds ratio (AOR = 4.459; CI = 1.444 -13.767), smoking habit (AOR = 2.755; CI = 1.120 - 6.774), colostrum milk feeding (AOR = 12.472; CI = 3.253 - 47.823), number of times visit the health center for ANC (AOR = 2.333; CI = 1.040 - 5.233) were positively associated with exclusive breastfeeding, whereas, sex of the child, type of family, knowledge about breastfeeding, counselling on EBF in ANC and/or PNC visit were also associated with exclusive breastfeeding. Among the respondents who did not practice exclusive breastfeeding, the common reasons cited were trouble initiating milk flow (23.7%), insufficient breast milk production (21.7%), breast milk not satisfying the baby (20.9%), domestic work burden (12%), difficulties with infant sucking or latching (6.4%), and the baby being unable to be breastfed owing to sickness (4.8%). Maternal education, occupation, colostrum milk feeding, and antenatal care visits were identified as important influencers of exclusive breastfeeding. Healthcare professionals, policymakers, and community leaders can utilize these insights to formulate effective strategies and design intervention that encourage and support exclusive breastfeeding among Dalit mothers, ultimately improving the health and well-being of the infants of the marginalized community.