Breastfeeding is an essential and effective method to ensure the health and survival of children, playing a significant role in their growth and development. As the best source of nourishment for infants and young children, breast milk profoundly impacts a child's survival, health, nutrition, and overall development [1-3]. Breast milk provides all the necessary nutrients, vitamins, and minerals required for an infant's body's growth and development. Additionally, it carries antibodies from the mother, helping to combat diseases and protect the child's health [3]. Shockingly, in 2010, approximately 7.6 million children died globally before reaching their fifth birthday, with 40% of these deaths occurring in the neonatal period. Pakistan, unfortunately, has one of the highest neonatal mortality rates worldwide [4].

Exclusive breastfeeding, as defined by the World Health Organization (WHO), means that the infant receives only breast milk, with no other liquids or solids given, not even water, except for oral rehydration solutions, vitamins, minerals, or medicines in drops/syrups [5]. The WHO recommends breastfeeding for a minimum of 2 years for all infants [6]. Surprisingly, if all infants were breastfed within an hour of birth, exclusively breastfed for the first 6 months, and continued breastfeeding up to the age of 2 years, about 220,000 child lives could be saved annually. However, less than 40% of infants under six months of age are exclusively breastfed worldwide. Increasing the promotion of EBF is one of the most efficient approaches to reducing infant morbidity and mortality globally [7].

Breastfeeding not only positively affects child health but also provides crucial protection to mothers. Extended lactation duration in postmenopausal women is associated with a lower prevalence of hypertension, diabetes, hyperlipidemia, and cardiovascular disease [8]. Following the WHO's recommendations on breastfeeding could save around 800,000 children's lives annually. Furthermore, infants who are exclusively breastfed are more likely to crawl and walk sooner than those who are not [9]. Studies also show that infants exclusively breastfed for 6 months experience less morbidity from gastrointestinal tract infections compared to those breastfed for less than 6 months [10]. Additionally, breastfed children have a decreased risk of post-neonatal death [11].

Despite the critical role of exclusive breastfeeding in child health and survival, there has been limited research conducted on this topic in Khyber Pukhtunkhwa (KP). This study aims to fill this knowledge gap and establish a baseline in KP regarding exclusive breastfeeding practices. Given the lack of awareness and knowledge about this essential practice, there is a pressing need for comprehensive studies to address the issue effectively in KP. By enhancing our understanding of exclusive breastfeeding and its benefits, the study will significantly contribute to raising awareness among mothers, healthcare providers, and the community at large. Moreover, the findings will serve as a valuable resource for developing targeted educational programs to promote exclusive breastfeeding. Through the dissemination of the study's results across both rural and urban areas, we can effectively advocate for and reinforce the significance of exclusive breastfeeding, ultimately leading to healthier babies and improved maternal well-being.