BACKGROUND:The Old Order Mennonites (OOM) of rural Ontario have a lifestyle that is very distinct from the rest of Canada. Breastfeeding practices among this community have not been described previously. OBJECTIVES:This study aimed to estimate the prevalence of exclusive breastfeeding (EBF) at 2, 4, and 6 months; to compare the prevalence of EBF among OOM and Canadian women; to investigate factors associated with EBF at 6 months; and to gain qualitative insight into the breastfeeding practices of OOM women. METHODS:Data on maternal characteristics, delivery factors, and infant feeding methods at birth and at 2, 4, and 6 months were obtained from medical records at the Elmira Medical Centre for all births to OOM women between January 2006 and December 2011. Semi-structured interviews were carried out with 2 lactation consultants working at the Elmira Medical Centre. RESULTS:Complete breastfeeding data were available for 195 of 225 OOM women (77.4%). The majority of OOM women initiated breastfeeding (87.9%); 81.4% continued to breastfeed exclusively at 2 months, 74.0% to 4 months, and 36.8% to 6 months. Women who had a homebirth (12.3%) had 2.6-fold higher odds of EBF at 6 months (odds ratio, 2.59; 95% confidence interval, 1.03-6.53) compared with women who delivered in a hospital. Cultural and religious influences and community support were suggested as reasons for the relatively high prevalence of EBF. CONCLUSION:Breastfeeding rates among OOM women are consistently higher in the first 6 months of life compared to the general Canadian population. Homebirth independently predicted increased odds of EBF at 6 months.