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Abstract
Breastfeeding infants with phenylketonuria (PKU) requires complex management combining limited breastfeeding with phenylalanine-free formula to maintain therapeutic levels. This cross-sectional study described breastfeeding prevalence, duration, and maternal experiences in the United States and Canada. Phase 1 included 103 mothers completing an online survey on demographics and feeding history; descriptive statistics summarized responses. Phase 2 involved semi-structured interviews with 10 mothers of children under 36 months, analyzed thematically. Results highlight variability in breastfeeding duration and significant maternal effort to sustain breastfeeding despite challenges, underscoring the need for clinical support and education to optimize feeding practices in PKU management.