Colostrum avoidance practice and associated factors among postnatal mothers visiting Public Health centers of Gondar city, North West Ethiopia

Colostrum provides vital nutrition and immune protection for newborns. Despite WHO and UNICEF recommendations, colostrum avoidance remains common in Ethiopia and increases neonatal health risks. Evidence from Gondar City is limited.To assess the prevalence of colostrum avoidance and its associated factors among postnatal mothers attending public health centers in Gondar City, Northwest Ethiopia. An institution-based cross-sectional study was conducted among 323 postnatal mothers attending public health centers in Gondar City from July 1–30, 2025. Data were collected using a structured questionnaire and analyzed using descriptive statistics and logistic regression. Variables withp< 0.25 in bivariable analysis were entered into multivariable analysis. Associations were reported using AORs with 95% CIs, andp < 0.05 was considered significant. The prevalence of colostrum avoidance was 14.9% (95% CI: 11.1–18.9). Cultural beliefs (72.9%) and perceived illness risk (27.1%) were the main reasons. Prelacteal feeding was reported by 21.4% of mothers, and 58.8% initiated breastfeeding within one hour. Most mothers attended ANC (77.1%), received breastfeeding counseling (76.7%), had good knowledge (69.0%), and a positive attitude toward colostrum feeding (77.7%). ANC attendance was protective against colostrum avoidance (AOR = 0.05, 95% CI: 0.02–0.19), whereas cesarean delivery (AOR = 4.12, 95% CI: 1.26–13.42), poor knowledge (AOR = 4.89, 95% CI: 1.65–14.48), and a negative attitude (AOR = 15.35, 95% CI: 4.49–52.50) were associated with higher odds of avoidance. Colostrum avoidance was common among postnatal mothers in Gondar City. ANC attendance, mode of delivery, maternal knowledge, and attitude were significant predictors. Strengthened breastfeeding counseling, improved maternal awareness, and targeted support for cesarean mothers are recommended to reduce colostrum avoidance and improve neonatal health.