Maternal Breastfeeding Technique and Early Breastfeeding Problems as Predictors of Exclusive Breastfeeding Duration in the Neonatal Period

Background: Globally, exclusive breastfeeding (EBF) rates remain < 50%, with the highest rate of discontinuation occurring within the first 30 days. Early identification of breastfeeding difficulties is essential for timely intervention and extension of the EBF duration. Research Aim: To determine the association between early assessment of breastfeeding techniques (within 48 hr postpartum), breastfeeding-related breast complications (e.g., mastitis, fissures, engorgement, and pain), and EBF duration during the first month. Method: This prospective observational study included 120 mother–infant dyads who were followed up for 30 days postpartum. The breastfeeding technique was assessed during rooming-in using the United Nations Children’s Fund (UNICEF) Breastfeeding Observation Aid, and breast-related problems were recorded. The EBF duration was tracked through weekly telephone follow-up. Kaplan-Meier survival curves and Cox regression models were used to analyze the associations between breastfeeding technique, breast complications, and EBF duration. Results: At 30 days of age, 43% of the infants were exclusively breastfed. Each additional breastfeeding difficulty was associated with a 17% higher risk of EBF interruption over time (adjusted HR: 1.17; 95% CI [1.08, 1.30]; p < 0.001). Breast-related problems during the first week postpartum, present in 29.2% of dyads, were also linked to early EBF cessation (adjusted HR, 1.77; 95% CI [1.07, 2.92]; p = 0.020). Conclusion: Difficulties in breastfeeding techniques and breast-related problems were significantly associated with a shorter EBF duration in the first month. Structured tools such as the Breastfeeding Observation Aid may support the early identification of at-risk dyads and improve EBF outcomes during the neonatal period.