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

doi:10.5409/wjcp.118218

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World Journal of Clinical Pediatrics

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2219-2808

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Pediatr. Sep 9, 2026; 15(3): 118218
Published online Sep 9, 2026. doi: 10.5409/wjcp.118218

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

Dipika M Mashalkar, Mahesh N Sonar, Dattatray V Kulkarni, Vidyadevi D Kendre, Basawraj S Warad, Basavraj S Nagoba

Dipika M Mashalkar, Mahesh N Sonar, Vidyadevi D Kendre, Department of Pediatrics, Maharashtra Institute of Medical Sciences and Research (Medical College), Latur 413531, India

Dattatray V Kulkarni, Department of Pediatrics, Medicover Hospital, Pune 411026, India

Basawraj S Warad, Department of Surgery, Maharashtra Institute of Medical Sciences and Research (Medical College), Latur 413531, India

Basavraj S Nagoba, Department of Microbiology, Maharashtra Institute of Medical Sciences and Research (Medical College), Latur 413531, India

Author contributions: Mashalkar DM and Sonar MN conceptualised and designed the study, developed the study outline, and coordinated manuscript preparation; Kendre VD, Kulkarni DV, Warad BS and Nagoba BS made substantial contributions to the study design, data interpretation, and critical discussion of the manuscript; Mashalkar DM, Sonar MN and Nagoba BS drafted, critically revised, and edited the manuscript for important intellectual content and contributed to the literature review. All authors approved the final version of the manuscript to be published.

Institutional review board statement: The study was approved by the Institutional Ethical Committee vide its letter dated 04/10/2022, No. MIMSR/YCRH/PEDS/44/2022.

Informed consent statement: Written informed consent was obtained from all the mothers, and those who did not give consent were excluded from the study.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: Will be made available by the corresponding author upon reasonable request.

Corresponding author: Basavraj S Nagoba, PhD, Professor, Department of Microbiology, Maharashtra Institute of Medical Sciences and Research (Medical College), Vishwanathpuram, Ambajogai Road, Latur 413531, India. dr_bsnagoba@yahoo.com

Received: December 28, 2025
Revised: February 2, 2026
Accepted: March 4, 2026
Published online: September 9, 2026
Processing time: 215 Days and 7.7 Hours

Abstract

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.

Keywords: Early initiation of breastfeeding; Lactation problems; Antenatal counselling; Colostrum; Prelacteal feeding; First hour

Core Tip: This study reveals that while early initiation of breastfeeding in a rural area of Maharashtra (50.8%) exceeds national averages, it remains suboptimal. Antenatal counselling emerged as the most significant modifiable predictor of success, whereas caesarean sections and maternal illness were primary barriers. To meet global health targets, clinical interventions must prioritise standardised prenatal breastfeeding education and provide enhanced lactation support for surgical deliveries to ensure the vital “first-hour” window is utilised.