Background: The World Health Organization (WHO) recommends exclusive breastfeeding (EBF) for the first six months of life. Despite well-established immunological, nutritional, and epidemiological benefits, EBF practice remains persistently low among working-class women globally, and evidence from urban Cameroon is limited. This study assessed the knowledge, practice, and occupational barriers to EBF among working-class women in Douala, Cameroon.

Methods: A descriptive cross-sectional study was conducted from March to June 2023. A minimum sample size of 277 was calculated using the Fischer formula; 457 working-class breastfeeding mothers with infants aged 0–6 months were enrolled by simple random sampling. Data were collected via a structured bilingual (English/French) questionnaire administered through Google Forms and face-to-face interviews and analysed using SPSS Version 26 and Microsoft Excel 2019.

Results: The majority of participants (32.2%) were aged 20–25 years. The overall EBF knowledge score was 67.8% (moderate), with 75.5% having heard of EBF and only 53.0% correctly defining it. However, only 30.6% were currently practising EBF. Early breastfeeding initiation within one hour of delivery was reported by 46.4%. The predominant barriers were difficulty combining work and breastfeeding (79.7%), the perception that breast milk alone is nutritionally insufficient (67.8%), short maternity leave (61.5%), and breastfeeding being time-consuming (55.1%).