Why mothers are not exclusively breast feeding their babies till 6 months of age? Knowledge and practices data from two large cities of the Kingdom of Saudi Arabia.

The noble practice of breast feeding is on the decline across the globe. Our objective was to research why women stop feeding their infants before the recommended 6 months of exclusive breast feeding and to assess the mothers' knowledge regarding importance and benefits of breast feeding. A cross-sectional study was conducted in two cities of Riyadh and Dammam using a structured questionnaire to 614 Saudi females in reproductive age group (15-45 years) from February to April 2016. Majority of the respondents were <30 years old, housewives and multiparous. The breast feeding initiation rate was 76% while only 37% continued to exclusively breast feed the infants until 6 months. Mothers of Dammam city showed higher rates of overall breast feeding, higher initiation of breast feeding within 24 hours of delivery and longer duration of breast feeding practices. Mothers older than 30 years (p < 0.014), residents of Dammam city (P < 0.000) and receiving information on breast feeding during antenatal care (P < 0.001) were associated with higher knowledge scores. Residents of Riyadh, working mothers, delayed initiation of breast feeding after 24 hours of giving birth, and those who did not get information on breast feeding during antenatal classes were at higher risk of stopping exclusive breast feeding before 6 months. Regional differences exist with Dammam city having greater awareness and better compliance to breast feeding practices. There is a need to strengthen the education facilities at ANC clinics in Riyadh regarding duration and benefits of breast feeding along with nationwide promotion of breast feeding practices as per guidelines.