Empowering early breastfeeding: Determinants of timely initiation among the infants in a rural Indian medical centre

BACKGROUND Initiating breastfeeding within the first hour after birth is a proven intervention for improving newborn survival and long-term health outcomes. Despite its recognized advantages, early initiation of breastfeeding (EIBF) remains limited in India, and data from rural Maharashtra are scarce. AIM To determine the prevalence of EIBF and explore maternal and delivery-related factors influencing its practice among late preterm and term infants in a rural tertiary care hospital. METHODS This observational study was conducted over a period of 18 months, from May 2022 to October 2023 and included 380 neonates born at ≥ 34 weeks of gestation. Information on maternal sociodemographic profile, delivery characteristics, antenatal counselling, breastfeeding practices, and early maternal or neonatal health concerns was collected through a structured interview of the mothers and the accompanying attendants and hospital records at birth and within 6 hours of birth. Data were analysed using descriptive statistics. Appropriate association tests were applied. RESULTS EIBF was reported in 50.8% of newborns, higher than the National Family Health Survey-5 national estimate of 41.8%, but still below the desired levels. Mothers who received antenatal maternal counselling [P < 0.05, adjusted odds ratio (aOR) = 3.5], had prior breastfeeding experience (P < 0.05, aOR = 2.4), and had vaginal deliveries (P < 0.05, aOR = 2.4) were more likely to initiate breastfeeding within the first hour. Caesarean births (P < 0.05, aOR = 0.4), maternal illness (P < 0.05, aOR = 0.3), and lactation problems (P < 0.05, aOR = 0.2) were associated with delays. No significant relationships were observed between maternal age, residence, education, occupation, religion, parity, or birth spacing and the practice of giving prelacteal feeds. Among the modifiable influences, antenatal advice emerged as the strongest predictor of success. CONCLUSION Interventions focusing on antenatal counselling during pregnancy and providing enhanced lactation support for surgical deliveries, and addressing the lactational problems by appointing a dedicated nurse, may substantially improve EIBF. Strengthening these measures can improve neonatal outcomes and align with national and global child health targets.