| Summary: | Background. The WHO recommends that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development, and health. Nonadherence to exclusive breastfeeding (EBF) depends largely on the individual, sociocultural context, and institutional factors. The aim of this study is to estimate coverage and factors associated with adherence to EBF among mothers in the urban Hail region, Saudi Arabia. Methods. A cross-sectional study was carried out during February–June 2019 among 450 mothers of children aged 6–24 months attending immunization and well-baby clinics in 6 primary healthcare centers in Hail city. A pretested structured questionnaire was used to interview the consented participants. Results. The majority of mothers (72.9%) were aware of EBF; 24% reported initiation of breastfeeding within one hour after delivery; however, 71.1% did during the first 24 hours. The majority (76.8%) fed colostrum to their newborn; nevertheless, 50.1% had given a prelacteal feeding. Mothers who reported EBF practice were 50.7% (CI 45.9–55.4). The adjusted logistic regression analysis revealed that mother’s awareness about EBF (aOR 3.03; 95% CI 1.78–5.18), antenatal care received at the governmental facility (aOR 2.63; 95% CI 1.28–5.41), breastfeeding a previous child (aOR 2.42; 95% CI 1.46–4.03), counseling received after delivery (aOR 2.47; 95% CI 1.34–4.53), and colostrum feeding given (aOR 4.24; 95% CI 2.31–7.77) were positively associated with EBF practice. On the other hand, mother’s education (OR 0.39; 95% CI 0.15–0.99), higher family income (aOR 0.04; 95% CI 0.00–0.31), and practice prelacteal feeding (aOR 0.61; 95% CI 0.38–0.97) were negatively associated with EBF practice. Conclusion. EBF rate in urban Hail is still far below WHO recommendations. Efforts to strengthen mothers’ counseling/support during antenatal care and immediately after delivery are needed to promote EBF practice, especially in the private sector.
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