Introduction: Promotion of exclusive breastfeeding for the first 6 months of life is thernmost effective preventive strategy for saving the lives in low-income settings, andrnsignificantly contributes to the reduction of child mortality. Baby friendly hospitalrninitiative is based on ten steps to successful breastfeeding; however which one of themrnare being implemented and associated with exclusive breastfeeding is not clear.rnObjective: To assess rate of exclusive breastfeeding; Examine whether the healthrnfacilities implementing 8 out of ten steps and Identify health facility support factorsrnassociated with exclusive breastfeeding.rnMethod and Materials: Community based cross-sectional study was conducted amongrn458 randomly selected mother-infant pairs and 45 health care providers in townrnadministrations of Wolaita Zone; Southern Ethiopia from January to February 2016. Datarnwere collected from mothers and health care providers using pretested and structuredrnquestionnaires. Bivariate and multivariate logistic regressions were performed to identifyrnthe presence and strength of association. Odds ratio with 95% confidence interval wasrnestimated to check for statistical significance.rnResult: The rate of exclusive breastfeeding was (93.2%) and 22.2% of health carernproviders received training. Facilities demonstrated higher compliance to Step 6, 7 and 9.rnIn multivariate logistic regression; antenatal care visit at government health facility 4.54rn(95% CI: 1.77, 11.65), receiving breastfeeding counselling during antenatal care visitrn3.05 (95% CI: 1.12, 8.29) and having information on breastfeeding support 3.20 (95% CI:rn1.23, 8.33) were statistically significantly association with exclusive breastfeeding.rnConclusion: Exclusive breastfeeding rate is high. However, relatively small proportionsrnof managers/staffs trained adequately. Facilities are not complied with majority of babyrnfriendly practices. Attending government health facility for antenatal care visit, receivingrnbreastfeeding counselling during antenatal care visit and having information onrnbreastfeeding support are associated with exclusive breastfeeding practice. These suggestrntraining of managers/staffs, providing support by trained health care providers duringrnantenatal care visit and information on breastfeeding support.rnKey Words: Exclusive breast feeding, Baby Friendly Hospital Initiative (BFHI), healthrncare providers, infant, Wolaita, Ethiopia