A Cross-Sectional Study of Input-Output Performance of Health Facilities Under LaQshya: Evidence from Western Gujarat, India

Background: In the delivery room, immediate infant care techniques including skin-to-skin contact (SSC) and early breastfeeding initiation (EBFI) offer several advantages, including improved survival. The techniques have not been extensively embraced despite the evidence. Through a series of plan-do-study-act (PDSA) cycles, we employed a point-of-care quality improvement (QI) to adopt and maintain these two immediate infant care procedures in our delivery room over a period of two years. Aims: The aim of the study was to assess the effectiveness of Nurse Led Mentoring using Quality improvement methodology for health care workers in improving maternal and neonatal outcomes at selected tertiary care hospitals in Delhi. Maternal outcome: It refers to initiation of breast feeding in first hour after delivery with no or minimum complication of third stage of labor. Neonatal outcome: It refers to skin-to-skin touch of mother and receiving breast feeding within first hour of delivery. Methodology:  A root cause analysis was conducted by a group of obstetricians, nurses and nursing students to determine the potential causes of an increase in early initiation of breastfeeding (EIBF). The areas of improvement in delivering maternal and neonatal care were assessed by using standard tool NQAS (National Quality Assurance Standard. The group made use of fish bone analysis and process flow mapping. In order to enhance the current data, several modifications could be implemented via successive Plan-Do-Study-Act (PDSA) cycles. Results: A total 10 numbers of nurses participated in this QI study, which conducted from November 2021 to May 2022. Over the course of the study, SSC significantly increased from a baseline of 0% to 68% and EIBF from a baseline of 38% to 82%. This study discovered a 44% major gap closure in EIBF and 68% in SSC. Conclusion: The Nurse Led Intervention's effectiveness in enhancing maternal and newborn outcomes has thus been shown. Making skin-to-skin contact with newborns shortly after delivery and EIBF as a part of pre-natal preparation and recording by a QI project might be continued without the need for any extra resources.

Third stage of labour is very crucial period in a women’s life. Previously uneventful first and second stage can become abnormal within a minute with disastrous consequences. In the third stage, the mothers face many problems like haemorrhage, retained placenta and inversion of the uterus. Early skin to skin contact at birth along with the breastfeeding process is protective against the incidence and severity of PPH. This study was conducted to determine the effectiveness of skin to skin contact between mother and baby at birth on maternal and neonatal outcomes among parturients.The objectives were to determine the effectiveness of skin to skin contact between mother and baby at birth on maternal outcomes among parturients and to determine the effectiveness of skin to skin contact between mother and baby at birth on neonatal outcomes among parturients. A quasi experimental research approach was used for the study. After obtaining permission from institutional ethical committee a total of 70 parturients admitted at labour room, Medical college hospital, Kottayam (35 each in control and experimental group) were selected for the study by purposive sampling technique. The data collection instruments were socio – personal and clinical data sheet, APGAR newborn scoring chart, observation checklist during third stage of labour, infant breastfeeding assessment tool (IBFAT), LATCH scale and modified maternal breastfeeding satisfaction evaluation scale (MBFES). Skin to skin contact between mother and baby at birth implemented in experimental group immediately after normal vaginal delivery for 30 minutes. Post-test for duration of third stage of labour, blood loss during third stage of labour, initiation of breast feeding, quality of first breast feeding and maternal satisfaction were performed within 80 minutes after normal vaginal delivery in control and experimental group. The data were tabulated and analyzed using descriptive and inferential statistics.The results of the study revealed that skin to skin contact between mother and baby at birth had statistically significant effect on maternal outcomes (duration of third stage of labour, blood loss during third stage of labour and maternal satisfaction) and neonatal outcomes (initiation of breastfeeding, quality of first breastfeeding and time of initiation of first breastfeeding) (p < 0.05).The result revealed that skin to skin contact between mother and baby at birth had effect on reducing duration of third stage of labour and blood loss during third stage of labour, improving maternal satisfaction, initiation of breastfeeding, quality of first breastfeeding and time of initiation of first breastfeeding.

Background: Lactation is the secretion of milk by the mammary glands. The action of suckling an infant. Early initiation of breastfeeding is the first step in the success of a baby to learn to suckle first early after birth so that breast milk remains in production. Breast feeding is one of the oldest practices known to mankind for all infant, breast feeding remains the simple. Healthier and least expensive feeding method that fulfills the infant needs. It is considering as the most complete nutritional source for infants because breast milk contains the essential fats, carbohydrates, protein &immunological factors early initiation of breast feeding with one hours of birth is associated with a reduced risk of neonatal mortality. Methods: A observational research study was undertaken in labor room of Pravara Rural Hospital Loni Bk. A total of 60 intranatal mothers was selected with the help of systematic random sampling technique was used to assess the lactation initiation practices among intanatal mothers and to assess the maternal and neonatal outcome Latch score and APGAR SCORE was used to assess the neonatal outcome. Observational checklist was used to assess the lactation initiation practices and maternal outcome. Study Findings: The result showed that (81%) new born had all essential newborn care after the birth only the 5% of it did not get enough new born care. in relation to LATCH score was assessed the score shows that mean score was (2±1.92) which indicates poor score of latching where as in audible swallowing mean score was (0.67±0.81) it also indicates poor latch score in type of nipple mean score was (2.41±7.71) it indicates moderate latch score comfortable position mean score was 1.91±0.86 it indicates poor score Holding position mean score (2.15±0.94) it indicates poor score. Frequency and Percentage wise distribution LACH Score neonatal shows that L-in that highest frequency and percentage i.e. score 0 shows 38(63%), score 1shows 35(58%),Score 2shows 34(17%), A-Audible swallowing in that 0score shows 20(33%),1score shows22(36%),2 score s19(31%), T-Type of nipple in that 0score shows that 43(18%) 1Score shows 18(30%) score 2 shows 16(26% ) C-Comfort level in which 0 score shows 56(38%) 1 score shows 63(38%) 2 score shows 63(35%) H-Holding position 0score shows 35(58%) 1score shows 43(17%) 2 score shows 42(70%).APGAR score after the delivery within 15min new born APGAR score 91% newborn were mild depression ,5%were moderately depressed, 5% were severe depression it interprets that no neonatal mortality and morbidity. Conclusion: The intranatal mothers have lack of knowledge about breast feeding practices. This problem significantly have impact on maternal and fetal outcome, it was evident that nursing interventions such as lactation initiation practices does have significant impact in enhancing the maternal and fetal outcome.

Pregnancy and childbirth are universally celebrated events, Yet childbirth is one of the most common stressed and painful situation which adversely affect the maternal health. The present study was to assess the effectiveness of selected nursing intervention on maternal and newborn outcome among primigravida mothers at selected hospitals, Tamil Nadu. The objective of the study was 1. To assess the maternal and newborn outcome in experimental and control group among primigravida mothers. 2. To evaluate the effectiveness of selected nursing intervention on maternal and newborn outcome among experimental and control group. 3. To find out the association between post test scores on maternal and newborn outcome among experimental and control group with their selected demographic variables. Design: A one group true experimental post-test only design was adopted for the study. Setting: Annai Theresa hospital and Narayanaa hospital, Chennai. By using simple random sampling 230 primigravida mothers completed 36 weeks of gestation were selected. Methods: Nursing interventions like breathing exercise, massage, position changes implemented during intrapartum period and level of pain perception assessed with universal pain assessment tool during uterine contractions of first stage of labour. Followed by the delivery, early initiation of breast feeding done through breast crawl technique. Effectiveness of selected nursing intervention on Maternal and Newborn outcome among primigravida mothers were measured by Visual Analogue Scale, observational check list and Apgar score chart. Results: The selected nursing interventions are effective in experimental group, the maternal outcome t test value was 10.69(p<0.005) significant, Apgar score t test value was 3.14(p<0.005) significant, newborn outcome t test value was 8.95(p<0.005) significant than control group. Conclusion: The results of the study showed that selected nursing interventions was effective in reducing the level of pain and promote maternal and newborn outcome.

Weaknesses within the maternal health continuum, including antenatal, delivery, and postnatal services, contribute to the high maternal mortality rate in Nigeria. The deficiencies in the health system primarily stem from a lack of skilled health workers, equipment, and health commodities, which prevent the delivery of quality services. Antenatal services, as the first point of contact for pregnant women with the health system, play an important role in improving maternal and child health outcomes and ultimately reducing maternal and neonatal mortality. Most public health facilities in Nigeria are unable to deliver quality ANC services due to an inadequate skilled health workforce, medicines, commodities, and infrastructure, which ultimately result in the unacceptably high maternal mortality rate. This study assessed the readiness of health facilities within AMAC, FCT, to provide antenatal services so as to gain insights into the level of service provision and identify bottlenecks that hinder the delivery of quality care. The research employed a cross-sectional study design, utilizing health facility assessments of general hospitals to determine readiness using the WHO Service Availability and Assessment framework (SARA). ANC service readiness was generally good, with all facilities showing 100% compliance for basic equipment and diagnostic capacity. This high level of readiness for ANC services encourages ANC visits, boosts facility deliveries, and ultimately improves maternal outcomes. Due to the lack of training on antenatal services observed in some hospitals during this study, it is recommended that a strong and well-trained monitoring and evaluation team be established for effective supervision of health facilities in areas such as staff training, capacity building, and the availability of work aids. Additionally, readiness assessments for ANC services should be conducted annually.

Background: Breast crawl technique is keeping the newborn directly on the mother's abdomen (nose in the midline of the mother's chest, eyes at the level of the nipples) soon after birth and allowed to crawl on their own up to the breast and then latch on.The aim of this study was to evaluate the effectiveness of breast crawl technique to initiate breast feeding in newborn and to find out its impact on newborn and maternal outcome during early postpartum period Methods: The mothers admitted in labor room were selected by purposive sampling technique and random assignment to experimental and control groups was done.The breast crawl technique was introduced to the experimental group after normal labor outcome.Effectiveness of breast crawl technique was assessed by the modified LATCH breast feeding assessment tool and a structured proforma was used to observe time of initiation of breast feeding in newborn.The newborn outcome, temperature and heart rate were assessed at zero, 1 and 2 hours after birth.Blood glucose of newborn was monitored at 2 hours after birth.The maternal outcome, establishment of lactation and maternal infant attachment was assessed by an observation checklist administered 12 hours after delivery.The statistical analysis was done using descriptive and inferential statistics. Results:The newborn with breast crawl technique had early initiation of breast feeding than the newborn in the control group.The results were statistically better in experimental group and breast crawl technique made a difference in early metabolic adaptation of newborn and promoted early establishment of lactation and maternal infant attachment. Conclusion:Breast crawl technique was effective to initiate breast feeding in newborn and had positive impact on newborn and maternal outcome in early postpartum period.

BackgroundTimely initiation of breastfeeding, also known as early initiation of breastfeeding, is a well-recognized life-saving intervention to reduce neonatal mortality. However, only one quarter of newborns in Uttar Pradesh, India were breastfed in the first hour of life. This paper aims to understand the association of community-based prenatal counselling and postnatal support at place of delivery with early initiation of breastfeeding in Uttar Pradesh, India.MethodsData from a cross-sectional survey of 9124 eligible women (who had a live birth in 59 days preceding the survey) conducted in 25 districts of Uttar Pradesh, India, in 2018, were used. Simple random sampling was used to randomly select 40 Community Development Blocks (sub district administrative units) in 25 districts. The Primary Sampling Units (PSUs), health service delivery unit for frontline workers, were selected randomly from a linelisting of PSUs in each selected Community Development Block. Bivariate and multivariate logistic regression analyses were performed to assess the association of prenatal counselling and postnatal support on early initiation of breastfeeding in public, private and home deliveries.ResultsOverall 48.1% of mothers initiated breastfeeding within an hour, with major variation by place of delivery (61.2% public, 23.6% private and 32.6% home). The adjusted odds ratio (aOR) of early initiation of breastfeeding was highest among mothers who received both counselling and support (aOR 2.67; 95% CI 2.30, 3.11), followed by those who received only support (aOR 1.99; 95% CI 1.73, 2.28), and only counselling (aOR 1.40; 95% CI 1.18, 1.67) compared to mothers who received none. The odds of early initiation of breastfeeding was highest among mothers who received both prenatal counselling and postnatal support irrespective of delivery at public health facilities (aOR 2.49; 95% CI 2.07, 3.01), private health facilities (aOR 3.50; 95% CI 2.25, 5.44), or home (aOR 2.84; 95% CI 2.02, 3.98).ConclusionsA significant association of prenatal counselling and postnatal support immediately after birth on improving early initiation of breastfeeding, irrespective of place of delivery, indicates the importance of enhancing coverage of both the interventions through community and facility-based programs in Uttar Pradesh.

Angka Kematian Bayi di Kota Bogor tertinggi di Jawa Barat yaitu 26 per 1000 kelahiran1. Inisiasi menyusu dini atau pemberian ASI langsung pada bayi baru lahir, dapat mencegah kematian anak. Belum semua bidan melaksanakan Inisiasi Menyusu Dini, hal ini sangat dipengaruhi oleh pengetahuan bidan yang akan berdampak pada perilaku bidan dalam melaksanakan IMD. Tujuan penelitian adalah mengetahui hubungan antara pengetahuan dengan perilaku bidan praktik swasta dalam pelaksanaan IMD pada ibu bersalin di wilayah Kota Bogor.
 Penelitian ini adalah penelitian analitik dengan pendekatan Crossectional dimana independent variable yaitu pengetahuan bidan, sedangkan dependent variable yaitu perilaku bidan dalam pelaksanaan IMD . Instrumen penelitian menggunakan kuesioner untuk mengukur pengetahuan dan lembar observasi untuk mengukur perilaku. Responden dalam penelitian ini 96 bidan praktik swasta yang diambil secara proporsional random sampling. Metoda analisis yang digunakan adalah chi square. Sebagian besar (66,7%) responden berpengetahuan baik, 64,6% melakukan Inisiasi menyusu Dini dan secara uji statistik tidak ada hubungan antara pengetahuan dengan perilaku bidan dalam pelaksanaan program IMD, dimana nilai (p>0.05). Dinas Kesehatan dan organisasi profesi perlu meningkatkan pengetahuan bidan tentang IMD dengan melakukan penyegaran melalui pelatihan APN update atau seminar IMD. Dalam pendidikan bidan perlu penekanan lebih kepada mahasiswa mengenai materi IMD dalam pembelajaran.

Background: The period of the first month of life is a critical moment for the sustainability of breastfeeding practices. Therefore optimal efforts are needed to maintain the breastfeeding practices. Early initiation of breastfeeding can help increase maternal confidence and support psychological condition of mothers in order to continue breastfeeding practices.Objective: To evaluate the impact of the early initiation of breastfeeding on breastfeeding practices in the first month of infant life.Method: The study was observational with cohort prospective study design using quantitative and qualitative approaches. Samples were 106 pairs of mothers and babies. The group from Pahandut Public Health Center (PHC) consisted of 53 women with early initiation of breastfeeding (exposed group) and the group from Tangkiling PHC consisted of 53 women without early initiation of breastfeeding (non exposed group). In both groups, dissemination on early initiation of complete breastfeeding and exclusive breastfeeding practices followed with one month breastfeeding practices was given. The quantitative data analysis was done in three stages. In addition, qualitative data analysis used exploration of in depth interview.Results: The result of mutivariable analysis with modeling showed that there was a significant relationship between early initiation of breastfeeding and breastfeeding practices in the first month of life (by controlling the variables of the decision to breastfeed, nipple condition, residence and gestational age) that could give contribution as much as 49% for breastfeeding practices in the first month of life. The result of in depth interview showed that breastfeeding practices were highly infuenced by information obtained by the women when checking up their pregnancy so that the decision to breastfeed could be made in advance and the women perceived the beneft of breastfeeding practices for her and her infant’s health. There were some reasons why the mother did not give complete breastfeeding, among others were the abnormal nipple condition and the mother’s fear on her child’s health for preterm baby.Conclusion: Breastfeeding practices in the first month of life occured more in mothers who practiced early initiation of breastfeeding than in those who did not. Mothers with at term delivery, nipple normal condition, breastfeeding decision prior to delivery, and residence in rural areas had greater chance of practicing breastfeeding in the first month of life.

Introduction: Exclusive breastfeeding plays an important role in preventing morbidity and mortality in infants and young children. However, exclusive breastfeeding coverage remains low, especially among working mothers. This study aimed to examine the relationship between early initiation of breastfeeding and prevalence of exclusive breastfeeding among working mothers in Bantul District, Yogyakarta Special Region, Indonesia. Methods: This study used a cross-sectional design. The population were all women in reproductive age who worked in middle and large companies. Samples included mothers whose infants were aged six to 12 months and were selected by probability proportional to size sampling technique. Main outcome was exclusive breastfeeding, while the independent variable was the early initiation of breastfeeding. Statistical analysis were descriptive statistics test, chi-square test, and multiple logistic regression at the level of significance of 0.05. Results: Exclusive breastfeeding coverage was around 22%, whilst the early initiation of breastfeeding coverage was 10%. Early initiation of breastfeeding was associated with exclusive breastfeeding practice (adjusted OR = 2.93; 95% CI: 1.04 - 8.28). Variables that were not significantly related to exclusive breastfeeding included being a first-time mother, maternal age, maternal educational level, breastfeeding counselling during antenatal visits, and delivery methods. Conclusions: Early initiation of breastfeeding is associated with higher prevalence of exclusive breastfeeding among working mothers. To increase exclusive breastfeeding coverage, particularly among employed women, it is highly recommended to enhance early initiation of breastfeeding program.

Introduction: Early initiation of breastfeeding (EIBF), placing the newborn to the breast within the first hour after birth, is one of the most effective and low-cost strategies to improve neonatal survival and maternal outcomes. Despite strong global advocacy, EIBF rates remain below the World Health Organization (WHO) target of 70%. Aim: This narrative review synthesizes recent evidence (2018–2025) on midwives’ roles in promoting and supporting EIBF, highlighting institutional, educational, and socio-cultural factors that influence breastfeeding initiation and continuation. Place and Duration of Study: Majmaah University, Al-Majmaah, 11952, Saudi Arabia from October 2025 till December 2025. Methods: A structured narrative review guided by the Joanna Briggs Institute (JBI) methodology and the PRISMAScR framework was conducted. Searches were performed in PubMed, CINAHL, Scopus, and Google Scholar.Studies addressing breastfeeding initiation, midwifery support, or postpartum education were included. Findings: eleven peer-reviewed studies met inclusion criteria. Evidence showed that midwives’ education and training significantly improve EIBF outcomes. Institutional policies such as Baby-Friendly Hospital Initiative (BFHI) accreditation, rooming-in, and skin-to-skin contact enhance breastfeeding success. Mothers valued empathetic communication, practical assistance, and continuity of care. Barriers included Cesarean delivery, inadequate staff training, and limited institutional support. Conclusion: Midwives are pivotal in achieving optimal breastfeeding outcomes through immediate postpartum support, advocacy, and culturally sensitive counselling. Strengthening professional education, enforcing BFHI standards, and expanding family-inclusive community programs are essential to meet WHO and Saudi Vision 2030 targets.

Background: Proper feeding practices during the first two years of life is essential for growth nutrition and development of young children. Optimum infant and young child feeding can reduce childhood mortality and morbidity significantly. Present study was done to know the infant and young child feeding pattern in the children of 0-23 months of age attending out patient department of an urban hospital.Methods: This cross sectional study was conducted among 314 mother/child pair attending the outpatient department of an urban hospital during the period of September 2014 to December 2014.Result: 68.5% children had early initiation of breast feeding and exclusive breast feeding among children below 6 months was 66.8%.Continued breast feeding among the children of 12 to 15 months was 80.4% and 84.2 % children were given solid food at 6 months of age. Adequate minimum dietary diversity, minimum meal frequency and minimal acceptable diet among children 6-23 months were 61.4%,57.3% and 39.4% respectively.64.5%% children were taking iron rich food or supplementation.Conclusion: Early initiation of breast feeding(0-23mo) and Exclusive breastfeeding(0- 6mo) were satisfactory in the study children but IYCF practice in children of 6-23 months was not optimum and far away from the HPNSDP 2011-2016 target of 52% of children to be fed with minimum acceptable diet.Bangladesh J Child Health 2016; VOL 40 (2) :92-97

Background: The Covid-19 pandemic is thought to affect a number of causes of stunting, including exclusive breastfeeding, early breastfeeding initiation, and illness exposure. Objectives: This study aims to investigate the effect of early initiation of breastfeeding, exclusive breastfeeding, and infectious diseases on stunting during the Covid-19 pandemic. Methods: The study was conducted in 6 stunting focus location villages in 2 subdistricts in Balangan Regency in June 2022. Children aged 6-23 months, both stunted and normal, served as the case samples in thecase-controlresearch design. Utilizing the Lemeshow formula, 66 samples with a 1:2 comparison were selected using asimple random samplingtechnique. In thecaseandcontrolgroups, the characteristics were equalized based on gender and age. Statistical analysis was conducted using thechi-square testandbinary logistic regression. Results: early initiation of breastfeeding (p=0.001, OR=6.806, CI=2.185-21.201), exclusive breastfeeding (p=0.021, OR=4.080, CI=1.363-12.209) and infectious diseases (p=0.000, OR=12.244, CI=3.118-48.086). Infectious diseases had the most influence on the incidence of stunting during the Covid-19 pandemic, proved by the magnitude of the OR value. Conclusions: During the Covid-19 pandemic, the rate of stunting was influenced by early breastfeeding initiation, exclusive breastfeeding, and infectious diseases.

Early initiation of breast feeding has great importance for both mothers and newborns. Despite, recommendations for exclusive and early initiation of breast feeding within one hour of birth, Ethiopia reports that 58% of infants under six months of age are exclusively breastfed. Cesarean deliveries may affect timing of breastfeeding initiation, establishment of milk supply and infant breastfeeding interest compared to vaginal deliveries. The aim of this study was to assess the impact of cesarean delivery on breastfeeding initiation. A cross-sectional study was conducted with a total of 7115 study participants from the 2016 Ethiopian Demographic Health Survey (EDHS). Both descriptive and analytical statistical analysis was employed. Univariable and multivariable logistic regression analyses were used to identify anyassociations between variables. Odds ratios with its corresponding 95% confidence intervals (CI) were reported. During multivariable analysis, variables with p-value < 0.05 were considered as statistically significant. The prevalence of late initiation of breast feeding among women with their last live birth was 25.03% (95%CI; 20.5-32.2). Significant factors associated with late initiation of breastfeeding were cesarean delivery [AOR = 4.06 (95%CI, 2.66-6.2)], primipara mother [AOR = 1.45(95%CI, 1.13-1.7)], and having an unplanned pregnancy [AOR = 1.35(95%CI, 1.1-1.65)]. Positively associated with early initiation of breastfeeding was the mother's age, for women between 20-34 years-old. This association, reported as a negative association of late initiation of breast feeding was [AOR = 0.77(95%CI, 0.61-0.98)]. Cesarean delivery adversely affects the initiation of breast feeding. Cesarean delivery, unplanned pregnancy, and being primiparous, were associated with late initiation of breastfeeding. Women between the ages of 20-34 years of age had a reduced chance of late initiation of breastfeeding. Providing counseling regarding the strategy and importance of early initiation of breast feeding, could have crucial importance for the mother and her newborn.

BackgroundEarly initiation of breast feeding has great importance for both mothers and newborns. Despite, recommendations for exclusive and early initiation of breast feeding within one hour of birth, Ethiopia reports that 58% of infants under six months of age are exclusively breastfed. Cesarean deliveries may affect timing of breastfeeding initiation, establishment of milk supply and infant breastfeeding interest compared to vaginal deliveries. The aim of this study was to assess the impact of cesarean delivery on breastfeeding initiation.MethodsA cross-sectional study was conducted with a total of 7115 study participants from the 2016 Ethiopian Demographic Health Survey (EDHS). Both descriptive and analytical statistical analysis was employed. Univariable and multivariable logistic regression analyses were used to identify anyassociations between variables. Odds ratios with its corresponding 95% confidence intervals (CI) were reported. During multivariable analysis, variables with p-value < 0.05 were considered as statistically significant.ResultsThe prevalence of late initiation of breast feeding among women with their last live birth was 25.03% (95%CI; 20.5–32.2). Significant factors associated with late initiation of breastfeeding were cesarean delivery [AOR = 4.06 (95%CI, 2.66–6.2)], primipara mother [AOR = 1.45(95%CI, 1.13–1.7)], and having an unplanned pregnancy [AOR = 1.35(95%CI, 1.1–1.65)]. Positively associated with early initiation of breastfeeding was the mother’s age, for women between 20–34 years-old. This association, reported as a negative association of late initiation of breast feeding was [AOR = 0.77(95%CI, 0.61–0.98)].ConclusionCesarean delivery adversely affects the initiation of breast feeding. Cesarean delivery, unplanned pregnancy, and being primiparous, were associated with late initiation of breastfeeding. Women between the ages of 20–34 years of age had a reduced chance of late initiation of breastfeeding. Providing counseling regarding the strategy and importance of early initiation of breast feeding, could have crucial importance for the mother and her newborn.