Background: This study aimed to investigate maternal knowledge, attitude, and practice towards breastfeeding and mastitis.

Method: This cross-sectional study was conducted between March and August 2023 in author's Hospital, using a self-administered questionnaire.

Results: A total of 682 (an average age of 28.83 ± 4.86 years) valid questionnaires were enrolled, including 372 (54.55%) married. The mean knowledge, attitude and practice scores were 8.96 ± 4.66 (possible range: 0-22), 51.65 ± 11.55 (possible range: 15-75), and 63.83 ± 17.05 (possible range: 18-90), respectively. Multivariate logistic regression analysis showed that urban area (OR = 2.031, 95% CI: 1.194-3.454, P = 0.009), high school or vocational school (OR = 0.355, 95% CI: 0.153-0.825, P = 0.016), non-working (OR = 0.484, 95% CI: 0.31-0.756, P = 0.001), history of breast surgery (OR = 0.572, 95% CI: 0.361-0.906, P = 0.017) were independently associated with knowledge. Junior college or bachelor's degree (OR = 2.288, 95% CI: 1.365-3.836, P = 0.002), monthly household income more than 10,000 CNY (OR = 1.538, 95% CI: 1.013-2.336, P = 0.044), history of breast surgery (OR = 0.595, 95% CI: 0.428-0.829, P = 0.002) were independently associated with attitude. Attitude (OR = 1.016, 95% CI: 1.001-1.03, P = 0.032), and maternity insurance (OR = 1.435, 95% CI: 1.02-2.019, P = 0.038) were independently associated with practice.

Conclusion: Mothers had inadequate knowledge, suboptimal attitude and proactive practice towards breastfeeding and mastitis. It's recommended to target interventions for breastfeeding knowledge in urban areas, enhance attitudes among higher-educated individuals and those with a history of breast surgery, and prioritize support for maternity insurance to promote better breastfeeding practices and mastitis prevention in clinical practice.