The Effectiveness of Antenatal and Postnatal Counselling in Improving Exclusive Breastfeeding Practice: A Cross Sectional Study in Tabuk, Saudi Arabia

Abstract

Background: Exclusive breastfeeding (EBF) in the first 6 months of life is an essential approach in health for infants, providing them with the best nutrition and protective ability against infections. Although EBF initiation rates are high in Saudi Arabia, the continuation of this practice decreases significantly after the early postnatal period. Antenatal and postnatal counseling interventions are recognized as impactful interventions to enhance breastfeeding, but this is still relatively limited in Tabuk.

Objective: This study conducted to assess the potential of antenatal and postnatal counseling to enhance breastfeeding in mothers in Tabuk, as well as to determine the percentage of infants ≤6 months who are exclusively breastfed.

Method: A cross-sectional questionnaire survey was distributed to 386 mothers of infants ≤6 months at primary health care centers in Tabuk, March-May 2025. The data collection was followed by simple random selection. Data included a structured Arabic questionnaire regarding sociodemographic, feeding practices, maternal beliefs, artificial feeding, and counseling exposure. Chi-square tests and multivariate logistic regression were used to detect the predictors of exclusive breastfeeding.

Result: The rate of exclusive breastfeeding was 19.4%. The feeding practices were influenced by maternal beliefs, employment, and mode of delivery. Counseling was an important factor: maternal counseling at the antenatal level increased the likelihood of breastfeeding initiation, whereas postnatal counseling resulted in significant improvement in breastfeeding continuation. As would be expected from a logistic regression study, both antenatal and postnatal counseling independently increased the odds of exclusive breastfeeding (OR > 2.0, 95% CI 1.5–2.5).

Conclusion: Exclusive breastfeeding rates in Tabuk are still below recommended levels. Structured counseling interventions before and after delivery profoundly improve breastfeeding efforts. Integrating counseling into routine maternal care is recommended to boost infant nutrition and meet the national goal for breastfeeding services