Predictors of exclusive breastfeeding intention among pregnant working-class women in Wakiso District, central Uganda: a cross-sectional study

Breastfeeding is globally recognized as one of the most effective ways to ensure the health and survival of infants. However, there is limited literature on exclusive breastfeeding (EBF) intention among working-class women across Uganda. This study aimed to examine the predictors of EBF intention among pregnant working-class women in Wakiso District, Central Uganda. A facility-based cross-sectional survey was conducted among 427 randomly selected pregnant working-class women (defined as pregnant women engaged in either formal or informal employment to earn an income) attending antenatal care at Kasangati Health Centre IV in Wakiso District, Central Uganda between September 2024 and May 2025. EBF intention was defined as the working-class women’s intention to give only breast milk without any additional foods or liquids, including water during the first six months after birth. Breastfeeding intention as measured using the Infant Feeding Intentions (IFI) scale, a 5-item scale with a total score range of 0 to 16, where each item has a five-point response scale: 0 (very much disagree), 1 (somewhat disagree), 2 (neutral), 3 (somewhat agree), 4 (very much agree). Descriptive statistics were used to summarize participants’ characteristics and breastfeeding intention. Modified Poisson regression was used to identify independent predictors of breastfeeding intention, with p < 0.05 considered statistically significant. The mean age of study participants was 28.5 [SD ± 4.3] years. Overall, 30.1% of respondents intended to exclusively breastfeed for six months. Multigravidity (AOR = 2.01, 95% CI: 1.06–3.79) and maternity leave ≥ 4 months (AOR = 2.39, 95% CI: 1.05–5.43) were associated with a higher likelihood of intending to breastfeed exclusively. Conversely, earning a salary of UGX 500,000–1,000,000 (USD 140–280) per month (AOR = 0.54, 95% CI: 0.29, 0.99) and being aged 25–30 years (AOR = 0.47, 95% CI: 0.22, 0.99) were associated with a lower likelihood of exclusive breastfeeding intention. The low intention to exclusively breastfeed among pregnant working-class women highlights the need for structural and workplace reforms that better support maternal health. Strengthening maternity leave policies and creating breastfeeding-friendly work environments could enhance women’s ability and motivation to practice exclusive breastfeeding. These findings underscore the importance of integrating workplace and policy-level strategies into maternal and child health programs to promote optimal infant nutrition in low-resource settings.