IJGPNInternational Journal of General Practice Nursing2981-94152981-9423Bio-Byword Scientific Publishing Pty. Ltd.10.26689/ijgpn.v4i1.14046ArticleFactors Affecting Exclusive Breastfeeding Practices Between Rural and Urban Areas in Anhui Province, China: A Comparative Studyhttps://artdesignp.com/journal/IJGPN/4/1/10.26689/ijgpn.v4i1.14046WangJunya2026412026-03-12Aim: This study aimed to compare the factors influencing exclusive breastfeeding (EBF) practices between rural and urban areas in Anhui Province, China, with a focus on identifying biophysical, social, and cultural determinants. Background: The World Health Organization and UNICEF both recognize exclusive breastfeeding as the optimal method of infant nutrition. In China, breastfeeding practices vary significantly between urban and rural areas due to factors such as cultural beliefs, healthcare services, socioeconomic status, and employment. This study aims to fill the research gap in Anhui Province, a rapidly urbanizing region. Methods: A quantitative comparative research design was employed, with data collected from 200 lactating mothers (100 from urban and 100 from rural areas) aged 18 years and above. The study used self-administered questionnaires that assessed demographic characteristics, biophysical, social, and cultural factors influencing EBF practices. Poisson regression analysis was conducted to examine the association between urbanicity and breastfeeding practices, adjusting for key variables such as age, employment, and income. Results: The study indicated that mothers in both rural and urban Anhui Province engaged more in exclusive breastfeeding (EBF) when supported by biophysical and social factors. Cultural influences were notably greater for rural mothers. Biophysical and social factors showed no significant differences between the groups. Regression analysis identified maternal age (31–35 years) and female infant sex as significant predictors of EBF. Employment negatively affected social support in both environments, while education and income impacted cultural attitudes towards EBF differently. Conclusion: Regardless of location, mothers who exclusively breastfeed highly value biophysical, social, and cultural factors. In urban areas, factors such as age, employment, and higher income significantly influence breastfeeding, while in rural areas, infant gender, marital status, income, and employment status are more crucial. Furthermore, both urban and rural mothers consider biophysical and social factors, but cultural factors are more prominent in the breastfeeding practices of rural mothers than urban mothers.

Saeed OB, Haile ZT, Chertok IA, 2019, Association between Exclusive Breastfeeding and Infant Health Outcomes in Pakistan. Journal of Pediatric Nursing, 2019(50): e62–e68.

Hossain S, Mihrshahi S, 2022, Exclusive Breastfeeding and Childhood Morbidity: A Narrative Review. International Journal of Environmental Research and Public Health, 19(22): 14804.

Gao H, Wang J, An J, et al., 2022, Effects of Prenatal Professional Breastfeeding Education for the Family. Scientific Reports, 12(1): 11. https://doi.org/10.1038/s41598-022-09586-y

Mei H, Zhang Y, Chang R, et al., 2024, Mediating Role of Birth at a Baby-friendly Hospital in the Association between Parental Socioeconomic Status and Infant Exclusive Breastfeeding at Six Months Old. BMC Public Health, 24(1): 8.

Nie J, Zhang L, Song S, et al., 2021, Exclusive Breastfeeding in Rural Western China: Does Father’s Co-residence Matter? BMC Public Health, 21(1): 1981.

Horwood C, Surie A, Haskins L, et al., 2020, Attitudes and Perceptions about Breastfeeding among Female and Male Informal Workers in India and South Africa. BMC Public Health, 2020(20): 875.

Baker P, Smith JP, Garde A, et al., 2023, The Political Economy of Infant and Young Child Feeding: Confronting Corporate Power, Overcoming Structural Barriers, and Accelerating Progress. The Lancet, 401(10379): 503–524.

Neves PAR, Barros AJD, Gatica-Domínguez G, et al., 2021, Maternal Education and Equity in Breastfeeding: Trends and Patterns in 81 Low- and Middle-income Countries between 2000 and 2019. International Journal for Equity in Health, 20(1): 20.

Chen Y, Zhao Y, Wang W, et al., 2023, Factors Associated with Exclusive Breastfeeding during Postpartum in Lanzhou City, China: A Cross-sectional Study. Frontiers in Public Health, 2023(11): 1089764. https://doi.org/10.3389/fpubh.2023.1089764

Lin KY, Shao W, Tsai YJ, et al., 2023, Physical Therapy Intervention for Breast Symptoms in Lactating Women: A Randomized Controlled Trial. BMC Pregnancy Childbirth, 2023(23): 792.

Asaro T, Gutema BT, Weldehawaryat HN, 2023, Colostrum Avoidance Practice and Associated Factors among Mothers of Infants Less than Six Months in Chencha District: Cross-sectional Study. BMC Nutrition, 2023(9): 18.

Wu Q, Hengudomsub P, Wacharasin C, 2024, Determinants of Exclusive Breastfeeding among Chinese Mothers in the First 6 Months. British Journal of Midwifery, 32(5): 240–247.

Li J, Zhao C, Wang Y, et al., 2021, Factors Associated with Exclusive Breastfeeding Practice among Mothers in Nine Community Health Centres in Nanning City, China: A Cross-sectional Study. International Breastfeeding Journal, 2021(16): 71.

Zhao S, Jiang H, Sun H, et al., 2024, Effects of Responsive Breastfeeding Intervention on Breastfeeding and Infant Growth in China: A Randomised Controlled Trial. Maternal and Child Nutrition, 20(3): e13654.

Vilar-Compte M, Hernández-Cordero S, Ancira-Moreno M, et al., 2021, Breastfeeding at the Workplace: A Systematic Review of Interventions to Improve Workplace Environments to Facilitate Breastfeeding among Working Women. International Journal for Equity in Health, 2021(20): 110.

Samuel A, Osendarp SJM, Feskens EJM, et al., 2022, Gender Differences in Nutritional Status and Determinants among Infants (6–11 m): A Cross-sectional Study in Two Regions in Ethiopia. BMC Public Health, 22(1): 401.

Shankar AH, Agustina R, Setiyawati Y, 2022, Nutritional Anemia in Pregnancy and Lactation, in Nutritional Anemia. Springer, Cham, 91–103. https://doi.org/10.1007/978-3-031-14521-6_7

Islam MJ, Broidy L, Baird K, et al., 2021, Early Exclusive Breastfeeding Cessation and Postpartum Depression: Assessing the Mediating and Moderating Role of Maternal Stress and Social Support. PLoS ONE, 16(5): e0251419.

Zhang B, Duan Z, Zhao Y, et al., 2020, Intermittent Kangaroo Mother Care and the Practice of Breastfeeding Late Preterm Infants: Results from Four Hospitals in Different Provinces of China. International Breastfeeding Journal, 15(1): 64.

Buckland C, Hector D, Kolt GS, et al., 2020, Interventions to Promote Exclusive Breastfeeding among Young Mothers: A Systematic Review and Meta-analysis. International Breastfeeding Journal, 2020(15): 102.

Gavine A, Shinwell SC, Buchanan P, et al., 2022, Support for Healthy Breastfeeding Mothers with Healthy Term Babies. Cochrane Database of Systematic Reviews, 2022(10): CD001141. https://doi.org/10.1002/14651858.CD001141.pub6

Moini A, Heidari F, Eftekhariyazdi M, et al., 2023, Breastfeeding Success and Perceived Social Support in Lactating Women with a History of COVID 19 Infection: A Prospective Cohort Study. International Breastfeeding Journal, 2023(18): 65.

Lok KYW, Choi MSL, Ko RWT, et al., 2024, Effectiveness of a Home-based Peer Support Programme for Chinese Mothers with Low Breastfeeding Self-efficacy to Increase the Exclusivity and Duration of Breastfeeding: Study Protocol of a Randomised Control Trial. BMJ Open, 14(7): e081897.

Tadesse F, Alemayehu Y, Shine S, et al., 2019, Exclusive Breastfeeding and Maternal Employment among Mothers of Infants from Three to Five Months Old in the Fafan Zone, Somali Regional State of Ethiopia: A Comparative Cross-sectional Study. BMC Public Health, 2019(19): 1015.

Xiao X, Loke AY, Zhu SN, et al., 2020, “The Sweet and the Bitter”: Mothers’ Experiences of Breastfeeding in the Early Postpartum Period: A Qualitative Exploratory Study in China. International Breastfeeding Journal, 2020(15): 12.

Baker P, Russ K, Kang M, et al., 2021, Globalization, First-foods Systems Transformations and Corporate Power: A Synthesis of Literature and Data on the Market and Political Practices of the Transnational Baby Food Industry. Global Health, 2021(17): 58.

Segura-Pérez S, Hromi-Fiedler A, Adnew M, et al., 2021, Impact of Breastfeeding Interventions among United States Minority Women on Breastfeeding Outcomes: A Systematic Review. International Journal for Equity in Health, 2021(20): 72.

Sosseh SAL, Barrow A, Lu ZJ, 2023, Cultural Beliefs, Attitudes and Perceptions of Lactating Mothers on Exclusive Breastfeeding in The Gambia: An Ethnographic Study. BMC Women’s Health, 2023(23): 18.

Aronsson AE, Vidaurre-Teixidó P, Jensen MR, et al., 2023, The Health Consequences of Informal Employment among Female Workers and their Children: A Systematic Review. Global Health, 2023(19): 59.