Introduction: It is realistic that Exclusive breast feeding can significantly reduce the burden of under-five death. About 41% of global under five deaths occur in Sub-Saharan Africa (SSA) mainly due to inadequate breastfeeding practices in combination with high levels of disease. Despite the universal practice of breastfeeding, most women do not practice exclusive breast feeding in many developing countries including Ethiopia. Methods: A community-based cross sectional study was conducted. A total of 819 mothers with 6-12 month aged infants were included in the study. All mothers from randomly selected kebeles were included in the study through cluster sampling technique in Mecha District, Amhara Region in April 2012. Structured interview was conducted in data collection. Both bivariate and multivariate logistic regression techniques were used to analyze the data with 95% CI. Results: The prevalence of exclusive breast feeding (EBF) was 47.13% (95% CI; 43.7% - 50.56%). Mothers who reported having 3 and more antenatal visit during pregnancy (AOR=1.7; 95% CI:1.09 – 2.67) ,who got PNC counseling on infant feeding (AOR=2.27; 95% CI: 1.56-3.30),who initiated breast feeding(BF) immediately after birth with in the first one hour (AOR=2.98;95% CI:2.11-4.22) and who have adequate knowledge on BF(AOR=2.06;95% CI:1.47-2.88) were more likely to exclusively breastfeed than their counterparts. Mothers from urban areas were less likely to exclusive breast fed than rural mothers (AOR=0.38; 95% CI: 0.23-0.62).

Conclusions: The prevalence of exclusive breast feeding in the study area was below the WHO recommended level 90%. Residence, three and above ANC visit, NC counseling on infant feeding, immediate initiation of breast feeding (BF) within an hour, maternal knowledge of BF were found to be associated with EBF practice. Strengthening ANC and PNC service, educate pregnant mothers on immediate BF initiation, counseling mothers on infant feeding during PNC, prioritizing urban areas for BF promotion in line with newly launched UHEP and other promotional efforts to improve maternal BF knowledge are recommended.