Introduction <p>The importance of exclusive breastfeeding for infants’ healthy growth and development cannot be overstated, as it has been proven to lower the chances of infant morbidity and mortality. Nevertheless, there exists a notable discrepancy in exclusive breastfeeding rates between mothers who are employed and those who are unemployed. There is a significant difference in the proportion of postnatal mothers who exclusively breastfeed between the unemployed and employed. The study found that the unemployed had a higher rate of exclusive breastfeeding compared to the employed. This disparity was observed among postnatal mothers who attended a health facility. Therefore, the aim of this study is to assess the factors contributing to the disparity in exclusive breastfeeding practices between employed and unemployed postnatal mothers who attend health facilities in Ethiopia.</p> Methods <p>A systematic sampling method was used to select 381 study participants for a comparative cross-sectional study. Stata version 17.0 was used to analyze the data. A multivariate decomposition analysis was conducted to explain the disparity between employed and unemployed individuals in exclusive breastfeeding practice. This analysis was divided into two components: covariate effects based on residence and coefficient effects based on differences in the effect of determinants on the outcome. The results were consistent across various decomposition weighting schemes.</p> Results <p>The proportion of exclusive breastfeeding practice among postnatal mothers in the North Shao district was 63.25% (95% CI (58.28, 67.96). Only covariate factors explained the unemployed-employed disparity of breastfeeding practice with the proportion of 76.61%. The variables that contribute to the explained difference in the proportion of exclusive breastfeeding practice were maternal education status, knowledge about exclusive breastfeeding practice, and attitude about exclusive breastfeeding practice.</p> Conclusion <p>The study revealed that exclusive breastfeeding practice among postnatal mothers in the North Shao district was within a moderate range. A larger portion of the unemployed-employed exclusive breastfeeding practice disparity was explained by the covariates on the outcome (differences in characteristics). The predictors of disparity were maternal education status, knowledge about breastfeeding practice, and attitude about exclusive breastfeeding practice. Target interventions towards improving maternal education status, and further explore cultural beliefs, social norms, and healthcare provider roles in promoting exclusive breastfeeding.</p>