Adhikari, SantoshBhattarai, TribhuwanKarki, PrakritiKunwar, KshitijDhakal, RameshBhatta, Lok RajRimal, SabinGaire, ManishaNepal, Raj KumarBhattarai, SrijanaSuthar, Praveen2026-08-252026-08-252025https://hdl.handle.net/20.500.14572/7452Santosh Adhikari Shankarapur Hospital Pvt. Ltd, Kathmandu, Nepal https://orcid.org/0000-0003-4345-6131 Tribhuwan Bhattarai Province Hospital, Karnali Province, Surkhet https://orcid.org/0009-0002-1732-2084 Prakriti Karki 1Shankarapur Hospital Pvt. Ltd, Kathmandu, Nepal Kshitij Kunwar Research and Innovation Foundation Nepal Ramesh Dhakal Shankarapur Hospital Pvt. Ltd, Kathmandu, Nepal Lok Raj Bhatta Epidemiology and Disease Control Divison, Kathmandu Sabin Rimal Kanti Childrens Hospital, Kathmandu https://orcid.org/0000-0003-1223-2063 Manisha Gaire Chitwan Medical College, Bharatpur https://orcid.org/0009-0002-6437-790X Raj Kumar Nepal District Hospital, Shankhuwasabha Srijana Bhattarai Research and Innovation Foundation Nepal Praveen Suthar Parul University, IndiaAbstract: Background: Deficits in maternal knowledge and perceptions can lead to suboptimal infant feeding and incomplete immunization, impacting child health. Given a lack of recent data in culturally diverse Eastern Kathmandu, this study explores pregnant women’s knowledge and attitudes regarding infant feeding and immunization. Methods: A cross-sectional study was conducted among pregnant women at antenatal clinics in Eastern Kathmandu (Feb-Mar 2025). Data were collected via a validated, self-administered questionnaire after informed consent. Multivariable logistic regression identified predictors of knowledge and attitudes on infant feeding and immunization. Statistical significance was set at p < 0.05. Results: A total of 371 pregnant women participated. There was high knowledge gap in infant feeding practice 208 (56.1%) and high knowledge in immunization 277 (74.7%). Positive attitudes were observed in 341 (93.2%) intending to exclusively breastfeed and 369 (98.4%) believing immunization is safe. Lower knowledge was linked to younger age (<21 years; AOR 0.27, 95% CI 0.07–0.78) and lack of formal education (AOR 0.22, 95% CI 0.03–0.97 for feeding; AOR 0.11, 95% CI 0.03–0.39 for immunization). Positive attitudes were more common among homemakers (AOR 4.86, 95% CI 2.44–9.93) and women with higher parity (AOR 6.14, 95% CI 2.60–15.61 for third or higher). Conclusions: The study reveals a significant gap in knowledge regarding infant feeding practices, especially among younger and less educated pregnant women in Eastern Kathmandu. Although attitudes are positive, targeted interventions are needed to address knowledge gaps, especially regarding exclusive breastfeeding.en-USAttitudeImmunizationInfant FeedingKnowledgePregnant WomenArticle