Knowledge, attitude and practices of breastfeeding among urban and rural mothers in the field practice area of a tertiary care centre: a cross-sectional analytical study

Background: Breastfeeding is an important infant nutrition and maternal health factor. Although there are clear recommendations by the World Health Organization on the exclusive breastfeeding practice in the first six months, significant differences continue to be observed between the urban and rural population as a result of socio-cultural variations, education and access to health services. Methods: A cross-sectional analysis study was done between February and July 2025 with a total number of mothers (n=278) with children under two years of age to be included in the study according to cluster and simple random sampling method. A structured questionnaire was used to collect data on socio-demographic variables, breastfeeding knowledge, attitudes and practices (WHO IYCF indicators). The data were analysed through descriptive statistics and chi-square tests. Results: The general knowledge and attitude to breastfeeding was satisfactory among urban and rural mothers. The awareness of the prevention of breast cancer and the milk storage was higher among urban mothers compared to rural mothers and longer and more frequent time of breastfeeding was reported by rural mothers. Rural mothers were found to have pre-lacteal feeding more as compared to urban mothers who practiced early breastfeeding initiation. Attitude (p=0.032) and practice (p=0.003) had significant relationships with place of residence whereas knowledge did not. Conclusions: Despite the fact that the knowledge and positive attitudes of both urban and rural mothers were sufficient, there were considerable differences in the patterns of breastfeeding and rural mothers were more acceptable. Intensifying antenatal and postnatal counselling, breastfeeding support at the workplace and family involvement is required to fill the knowledge-practice gap and enhance the outcomes of breastfeeding.