Background: Exclusive breastfeeding (EBF) is defined as feeding an infant only breast milk, with no additional foods or liquids, for the first six months of life. Ensuring adequate knowledge and fostering positive attitudes toward EBF among antenatal mothers is essential for its successful implementation.

Objective: To assess the knowledge, attitudes and self-efficacy regarding exclusive breastfeeding among antenatal mothers attending the antenatal clinic at Base Hospital Kahawatta, Sri Lanka.

Methodology: A descriptive cross-sectional study was conducted among 277 pregnant mothers at the Base Hospital Kahawatta, Sri Lanka, who were selected by a convenience sampling method. Data were collected through a pre-tested interviewer-administered questionnaire, which included sociodemographics, adapted tools for knowledge assessment on breastfeeding, the Iowa Infant Feeding Attitude Scale (IIFAS) and Breastfeeding Self- Efficacy Scale-short form (BSES-SF). Microsoft Excel 2011 and IBM SPSS (v. 26) were used for the data analysis. The study was conducted with ethical approval from the Ethics Review Committee-KIU, Sri Lanka (KIU_ERC_N_116).

Results: A total of 277 pregnant mothers with a mean age of 31 ± 5 years participated in the study. The majority of them were Sinhala (84%, n=232), Buddhist (83%, n=229), and from nuclear families (57%, n=157). Overall, 85% (n=234) demonstrated high knowledge on EBF, although misconceptions remained regarding cessation timing (29%, n=79), 72% (n=198) correctly identified the duration of EBF, while 98% (n=272) knew that complementary foods should be introduced after six months. Regarding attitudes, the majority (60%, n=167) reported neutral or moderate attitudes, while 40% (n=110) had strongly positive attitudes. The majority had moderate self-efficacy on breastfeeding (62%, n=172).

Conclusion: The study indicates that pregnant mothers possessed high knowledge, predominantly neutral or moderate attitudes, and moderate selfefficacy toward EBF; however, misconceptions about feeding adequacy and cessation timing persisted, and self-efficacy remained moderate. Strengthening antenatal education and providing postpartum support are recommended to enhance the mothers’ confidence and sustain EBF practices.

Keywords
Antenatal mothers , Exclusive breastfeeding , Sri Lanka