Prevalence of exclusive breastfeeding and associated factors among adolescent mothers in Mukono District, Uganda: a mixed-methods cross-sectional study

Exclusive breastfeeding (EBF) is the recommended feeding choice for infants from birth to 6 months. However, the prevalence of EBF among adolescent mothers in many parts of Uganda including Mukono District was not known. We assessed the prevalence of EBF and associated factors among adolescent mothers in Mukono District. A cross-sectional study using mixed methods of data collection was conducted among 454 adolescent mothers of children aged 6–23 months from April 25th -May 31st, 2025. Eleven key informant interviews (KIIs) were also conducted regarding perceptions of stakeholders on the barriers and facilitators of EBF. Multivariable modified Poisson regression analysis generated adjusted prevalence ratios (aPRs). Thematic analysis was used for the qualitative data whose findings were triangulated with the quantitative results. The average age of adolescent mothers was 18(± 1) years, with 81.7% aged 18–19 years. The prevalence of EBF among adolescent mothers was 59.2%. The predictors of EBF cessation among adolescent mothers included limited knowledge about EBF (aPR = 0.70[0.53–0.91]), maternal depression (aPR = 0.64[0.49–0.84]), lack of support from skilled health workers in properly latching the new-born during the first breastfeeding sessions (aPR = 0.37[0.20–0.67]), and absence of maternity leave for working adolescent mothers (aPR = 0.34[0.14–0.83]). Barriers to EBF included health workers’ omission to teach adolescent mothers proper newborn breastfeeding attachment, maternal depression and psychological stress. Facilitators of EBF included maternity leave and maternal knowledge about the practice. Low prevalence of EBF among adolescent mothers remains a significant public health problem in Mukono District. Limited EBF knowledge, maternal depression, lack of breastfeeding support at birth, and not getting maternity leave were the predictors of EBF cessation. Provision of mental health services, breastfeeding support, and contraceptives at health facility and community levels, alongside adolescent education on pregnancy risks, enforcement of workers’ rights, peer support groups, and community sensitization, could improve EBF practice among adolescent mothers.