Early Initiation of Breastfeeding and Associated Maternal, Delivery, and Neonatal Factors: A Prospective Observational Study

Background: Objectives: To find the prevalence of early initiation of breastfeeding and assess the association of maternal, delivery, and neonatal characteristics with delayed initiation of breastfeeding in postnatal mothers. Material and Methods: This prospective observational study, done in the postnatal ward of a tertiary care hospital for the period of 6 months from January to June 2026, included 99 mother–baby dyads who met the eligibility criteria. Sociodemographic and obstetric parameters, neonatal characteristics, breastfeeding practices, and reasons for delayed initiation were recorded at discharge using a structured proforma. Early initiation of breastfeeding was defined as initiation within one hour of birth. Results: Early initiation of breastfeeding was noted among 30 (30.30%) mothers, and delayed initiation in 69 (69.70%) mothers. Breastfeeding was initiated within 1 hour in 30 (30.30%), between 1–24 hours in 51 (51.52%), and after 24 hours in 18 (18.18%) mothers. Vaginal delivery showed a significant association with early initiation in comparison with cesarean delivery (76.67% vs. 55.07%; p=0.042). Moreover, breastfeeding counselling showed a significant positive impact on early breastfeeding (63.33% vs 26.09%, p=0.0004). Maternal age, residence, education, parity, antenatal visits, neonatal sex, gestational age, birth weight, and APGAR score showed no significant association with breastfeeding initiation. Conclusion: Early initiation of breastfeeding was suboptimal in 30.3% cases. Vaginal mode of delivery and breastfeeding counselling were significantly associated with early breastfeeding initiation. Strengthening antenatal breastfeeding counseling, facilitating vaginal deliveries and improving post-cesarean lactation support, may facilitate early initiation.

Keywords: Birth weight, colostrum, counselling, gestational age, infants, lactation.