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Background: Exclusive breastfeeding (BF) up to six months is recommended in Sri Lanka because it is known to be the best food for the infants and it provides vast benefits to the mother as well. Since exclusive BF rates decline with the advancing age of the baby, it is quite obvious that mothers face difficulties in BF.  Objective: To describe the factors associated with difficulties in BF in mothers with neonates attending selected lactation management centres in the Colombo district. Method: A hospital based cross sectional study was conducted at lactation management centres in De Soysa Maternity Hospital and Colombo South Teaching Hospital from August to September 2015. Mothers who paid their first visit with the corresponding neonates were selected. Sample size was 288. They were selected by systematic random sampling method, proportionate to their monthly admissions excluding neonates with congenital hypothyroidism. Study instruments used were a structured interviewer administered questionnaire, Breast Feeding Observation Form and a checklist of the neonate. Chi squared test and Fisher’s exact test where relevant were used for statistical analysis. Results: One hundred and sixty three (56.6%) had difficulty in BF. Among the sociodemographic factors studied, being in extended family ( p = 0.012) was significantly associated. Among the maternal factors, not receiving antenatal health education after getting admitted to the ward ( p = 0.03), having pain ( p = 0.016) and discomfort ( p = 0.01) during BF, not having previous experience in BF ( p = 0.006) and being discharged within 24 hours after delivery ( p =0.03) were significantly associated after controlling for confounding factors.  Conclusions: Being in an extended family, not receiving antenatal health education, having pain and discomfort during BF, not having previous experience in BF and being discharged within 24 hours after delivery were significantly associated with BF difficulties in mothers with neonates attending selected  lactation management centres in the Colombo district Sri Lanka Journal of Child Health , 2017; 46 (4): 337-342

Why do mothers fail to breastfeed successfully? A descriptive study done at selected lactation management centres in Sri Lanka