Assessing the Influence of Cultural Beliefs and Practices on Early Breastfeeding Initiation Rates in Rural Sarawak Communities, Malaysia

Introduction: Early initiation of breastfeeding is crucial for infant health and survival. However, breastfeeding initiation rates remain suboptimal in rural Sarawak, Malaysia. This study aimed to assess the influence of cultural beliefs and practices on early breastfeeding initiation rates in these communities. Methods: A mixed-methods study was conducted in two rural districts of Sarawak. Quantitative data were collected through a cross-sectional survey of 385 mothers with infants aged 0-6 months. Qualitative data were collected through in-depth interviews with 20 mothers and 10 healthcare providers. Data were analyzed using descriptive statistics, logistic regression, and thematic analysis. Results: Early breastfeeding initiation rates were 62.1%. Factors associated with early initiationincluded higher maternal education (OR=2.34, 95% CI: 1.12-4.89), positive attitudes towards breastfeeding (OR=3.18, 95% CI: 1.56-6.47), and support from healthcare providers (OR=2.87, 95% CI: 1.38- 5.96). Cultural beliefs and practices, such as colostrum avoidance and delayed breastfeeding due to traditional rituals, were identified as barriers to early initiation. Conclusion: Cultural beliefs and practices significantly influence early breastfeeding initiation rates in rural Sarawak. Interventions to promote early initiation should address these cultural factors and provide targeted support to mothers.