Factors associated with successful exclusive breastfeeding among mothers in the formal sector. A mixed method study of Kampala Capital City

Factors associated with successful exclusive breastfeeding among mothers in the formal sector. A mixed method study of Kampala Capital City | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Factors associated with successful exclusive breastfeeding among mothers in the formal sector. A mixed method study of Kampala Capital City Jimmy Edema, Charles Patrick Namisi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7131016/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Globally, evidence show that exclusive breastfeeding (EBF) for the first six months of an infant’s life has several health benefits for the mother–infant pair, family, communities, nation, and the whole world. However, many employed women discontinue EBF before six months, while others succeed. However, limited research on the factors that enable some employed mothers succeed in EBF exists in Uganda. This study aims to identify and explain the factors that enable EBF success among employed mothers in the formal sector. Method The study employed mixed-methods, utilizing questionnaires and key-informant interviews to collect data. Multivariable logistic regression analysis of quantitative data established associated factors with EBF. The qualitative data analysis involved a systematic coding process (using ATLAS Ti v.5.21.2; themes were then used to further describe and understand how and why some employed mothers succeeded in EBF and others failed. Results Participants mean age was 27 years (± SD = 3.87). EBF prevalence was 31.7%. Significant factors were: Financial support (AOR: 6.62. 95% CI.2.27–19.31. P = 0.001***), domestic support (AOR: 5.23. 95% CI.1.88–14.52. P = 0.002**), psychological support (AOR: 5.45. 95% CI.1.47–20.20. P = 0.011*), and workmate support (AOR: 2.95. 95% CI. 1.54–5.67. P = 0.001***). Pre-lacteal feeding reduced likelihood of EBF success by 84% (AOR: 0.16. 95% CI. 0.06–0.45. P = 0.001***). Emerged themes from the qualitative component were: context, social support system, breastfeeding-friendly hospitals and workplace, and maternal EBF mind-set. The analysis of the quantitative and qualitative data yielded four theory relevant concepts: social cognition, individual cognition, EBF behavior, and institutional factors. These concepts align well with Social Cognitive theory. Conclusion EBF prevalence was at 31.7%. Close family support in forms of: financial, domestic, psychological, and workmate support predicted EBF success. Strong social support systems (at family, workplace, and healthcare), positive EBF mindset, and breastfeeding-friendly policies strengthened EBF success. Pre-lacteal feeds harmed EBF success. Thus, concurrent interventions directed at providing: basic-financial package for breastfeeding mothers, domestic, and psychological support coupled with strong social support systems, positive EBF mind-set, and implementation of breastfeeding-friendly policies would increase EBF in the formal sector. Successful exclusive breastfeeding employed mothers formal sector Breastfeeding-friendly workplaces social support systems maternal mind-set Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7131016","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":485792755,"identity":"62a54410-3753-4855-8182-c4f3d9c179bd","order_by":0,"name":"Jimmy Edema","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAz0lEQVRIiWNgGAWjYBACxmYQyfZPjh9EJxQQr+WAsWQDSIsB0XaxHUjccADEIEYLczt3msSHsjuMm8+vTvzwwIBBnl/sACGH8W6TnHHuGbPZjbebJYAOM5w5O4GwFmneNmY2sxtnN4C0JBjcJkbL3zZmHuMZZzf/IF4LY9thCQP+3m1E27LZsudcmoHEDd5tFgkGEoT9Yth/duONH2U29f39Zzff/FFhI88vTUhLAwOLBJglAVYpgV85CMgDo+YDmMV/gLDqUTAKRsEoGJkAACe0RfpfKC3AAAAAAElFTkSuQmCC","orcid":"","institution":"Uganda Martyrs University","correspondingAuthor":true,"prefix":"","firstName":"Jimmy","middleName":"","lastName":"Edema","suffix":""},{"id":485792756,"identity":"18f7970e-cc72-4c49-85fe-0489c96abc07","order_by":1,"name":"Charles Patrick Namisi","email":"","orcid":"","institution":"Uganda Martyrs University","correspondingAuthor":false,"prefix":"","firstName":"Charles","middleName":"Patrick","lastName":"Namisi","suffix":""}],"badges":[],"createdAt":"2025-07-15 13:23:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7131016/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7131016/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86926474,"identity":"b0ecd32a-8b8a-4505-9ae4-b0b837ac39e2","added_by":"auto","created_at":"2025-07-17 08:39:28","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":523468,"visible":true,"origin":"","legend":"","description":"","filename":"JimmyEManuscript.ReversedVersion..pdf","url":"https://assets-eu.researchsquare.com/files/rs-7131016/v1_covered_f090a0bb-ecb0-4f5b-a1fc-0130a114bc67.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Factors associated with successful exclusive breastfeeding among mothers in the formal sector. A mixed method study of Kampala Capital City","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Successful exclusive breastfeeding, employed mothers, formal sector, Breastfeeding-friendly workplaces, social support systems, maternal mind-set","lastPublishedDoi":"10.21203/rs.3.rs-7131016/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7131016/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eGlobally, evidence show that exclusive breastfeeding (EBF) for the first six months of an infant\u0026rsquo;s life has several health benefits for the mother\u0026ndash;infant pair, family, communities, nation, and the whole world. However, many employed women discontinue EBF before six months, while others succeed. However, limited research on the factors that enable some employed mothers succeed in EBF exists in Uganda. This study aims to identify and explain the factors that enable EBF success among employed mothers in the formal sector.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e\u003cp\u003eThe study employed mixed-methods, utilizing questionnaires and key-informant interviews to collect data. Multivariable logistic regression analysis of quantitative data established associated factors with EBF. The qualitative data analysis involved a systematic coding process (using ATLAS Ti v.5.21.2; themes were then used to further describe and understand how and why some employed mothers succeeded in EBF and others failed.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eParticipants mean age was 27 years (\u0026plusmn;\u0026thinsp;SD\u0026thinsp;=\u0026thinsp;3.87). EBF prevalence was 31.7%. Significant factors were: Financial support (AOR: 6.62. 95% CI.2.27\u0026ndash;19.31. P\u0026thinsp;=\u0026thinsp;0.001***), domestic support (AOR: 5.23. 95% CI.1.88\u0026ndash;14.52. P\u0026thinsp;=\u0026thinsp;0.002**), psychological support (AOR: 5.45. 95% CI.1.47\u0026ndash;20.20. P\u0026thinsp;=\u0026thinsp;0.011*), and workmate support (AOR: 2.95. 95% CI. 1.54\u0026ndash;5.67. P\u0026thinsp;=\u0026thinsp;0.001***). Pre-lacteal feeding reduced likelihood of EBF success by 84% (AOR: 0.16. 95% CI. 0.06\u0026ndash;0.45. P\u0026thinsp;=\u0026thinsp;0.001***). Emerged themes from the qualitative component were: context, social support system, breastfeeding-friendly hospitals and workplace, and maternal EBF mind-set. The analysis of the quantitative and qualitative data yielded four theory relevant concepts: social cognition, individual cognition, EBF behavior, and institutional factors. These concepts align well with Social Cognitive theory.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eEBF prevalence was at 31.7%. Close family support in forms of: financial, domestic, psychological, and workmate support predicted EBF success. Strong social support systems (at family, workplace, and healthcare), positive EBF mindset, and breastfeeding-friendly policies strengthened EBF success. Pre-lacteal feeds harmed EBF success. Thus, concurrent interventions directed at providing: basic-financial package for breastfeeding mothers, domestic, and psychological support coupled with strong social support systems, positive EBF mind-set, and implementation of breastfeeding-friendly policies would increase EBF in the formal sector.\u003c/p\u003e","manuscriptTitle":"Factors associated with successful exclusive breastfeeding among mothers in the formal sector. 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