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. 2025 Aug 19;20(1):65.
doi: 10.1186/s13006-025-00759-9.

Determinants of breastfeeding initiation in thailand: multiple indicator cluster survey analysis

Salila Cetthakrikul  1 , Chompoonut Topothai  2   3 , Nisachol Cetthakrikul  4
Affiliations

Determinants of breastfeeding initiation in thailand: multiple indicator cluster survey analysis

Salila Cetthakrikul et al. Int Breastfeed J. .

Abstract

Background: Early initiation of breastfeeding, defined as breastfeeding within one hour of birth, is a critical indicator of optimal infant feeding practices with substantial health benefits for mothers and infants. Early initiation of breastfeeding rates in Thailand has declined over the past decade, necessitating an investigation into the underlying determinants. Therefore, this study aimed to identify trends in early initiation of breastfeeding prevalence and examine associated factors using national survey data from Thailand.

Methods: This study analysed secondary data from four rounds of the Thailand Multiple Indicator Cluster Survey (MICS4-7), conducted in 2012 (MICS4), 2015-2015 (MICS5), 2019 (MICS6), and 2022 (MICS7), including 13,063 mothers of children under 6 months. Logistic regression analysis was used to evaluate the association between geographic, socioeconomic, and maternal factors with early initiation of breastfeeding. Statistical significance was determined at 95% confidence and p-value < 0.05, and all analysis was conducted using STATA 17.

Results: Early initiation of breastfeeding prevalence declined from 54.9% in 2012 to 43.1% in 2022. Vaginal delivery increased adjusted odds by 2.1 times (95%CI 1.59, 2.85) while non-skin-to-skin contact reduced early initiation of breastfeeding likelihood by 57% (AOR 0.43, 95%CI 0.33, 0.57). Geographic disparities emerged, with almost all regions showing higher early initiation of breastfeeding rates than Bangkok: North (AOR 2.65, 95%CI 1.49, 4.72), Northeast (AOR 2.55, 95%CI 1.49, 4.35), and South (AOR 3.26, 95%CI 1.92, 5.52). Socioeconomic status and urban or rural residence showed inconsistent associations across survey rounds.

Conclusions: Early initiation of breastfeeding prevalence in Thailand remains low and is off track to meet the 2030 global target of 70%. Interventions to promote vaginal delivery and ensure immediate skin-to-skin contact in all births are critical. Regional variations highlight the importance of culturally tailored strategies to support breastfeeding practices. These findings provide critical evidence for policy development to improve maternal and child health outcomes in Thailand.

Keywords: Breastfeeding initiation; Factors; Multiple indicator cluster survey; Thailand.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The NSO conducted the MICS study under the Thai Statistical Act B.E. 2550 (2007). Respondents were informed of participation details, including confidentiality and the right to refuse, before providing verbal consent. The NSO authorized access to and utilization of the dataset for the purposes of this research, thus, ethical review was not required. No identifying participant information was provided. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The percentage of breastfeeding initiation within 1 hour of MICS4-7
See this image and copyright information in PMC

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