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Articles in E-pub version are posted online ahead of regular printed publication.

Research Paper
Development of a predictive model for exclusive breastfeeding at 3 months using machine learning : a secondary analysis of a cross-sectional survey
Hyun Kyoung Kim
Received June 23, 2025  Accepted September 2, 2025  Published online October 28, 2025  
DOI: https://doi.org/10.4040/jkan.25086    [Epub ahead of print]
AbstractAbstract PDFePub
Purpose
This study aimed to develop a machine learning model to predict exclusive breastfeeding during the first 3 months after birth and to explore factors affecting breastfeeding outcomes.
Methods
Data from 2,579 participants in the Korean Early Childhood Education & Care Panel between March 1 and June 3, 2025 were analyzed using Python version 3.12.8 and Colab. The dataset was split into training and testing sets at an 80:20 ratio, and five classifiers (random forest, logistic regression, decision tree, AdaBoost, and XGBoost) were trained and evaluated using multiple performance metrics and feature importance analysis.
Results
The confusion matrix of the random forest classifier model demonstrated strong performance, with a precision of 86.6%, accuracy of 84.8%, recall of 96.8%, F1-score of 91.9%, and an area under the curve of 86.0%. Twenty-one features were analyzed, from which feeding plan, breastfeeding at 1 month, marriage period, maternal prenatal weight, self-respect, alcohol consumption, grit, value placed on children, maternal age, and depression emerged as important predictors of exclusive breastfeeding in the first 3 months.
Discussion
A robust model was developed to predict exclusive breastfeeding that identified feeding planning and breastfeeding at 1 month as the most influential predictors. The model could be implemented in clinical and community settings to guide tailored breastfeeding support strategies, coupled with the integration of maternal self-respect, grit, and the value placed on children in counseling programs to promote exclusive breastfeeding.
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