Abstract
Introduction: Breastfeeding is the best way of providing ideal food for the optimal growth and development of an infant. Early initiation of breastfeeding (EIBF) within one hour of birth is one of the cost effective strategies to reduce neonatal mortality. The aim of the study was to find out the determinants of breastfeeding practice.
 Methods: This was a descriptive cross-sectional study conducted among 207 mothers who have child from birth to 12 months in Maternal and Child Health (MCH) Clinic of tertiary care referral hospital. The mothers for the study were selected using probability sampling technique. Variables were analysed using a multivariate logistic regression model to identify the determinants of EIBF.
 Results: The prevalence of EIBF in the study population was 47.3%. Caesarean delivery (AOR: 3.449, CI: 1.224-9.719, p = 0.019), mothers who have done more than one postnatal visit (AOR: 2.824, CI: 1.126-7.079, p = 0.027) and low birth weight babies (AOR: 7.973, CI: 1.571-40.465, p = 0.027) were more likely to delay initiation of breastfeeding.
 Conclusions: Less than half newborn receive breast milk within the first hour of birth. Mothers delivered by caesarean section, who have done more than two postnatal visit and low birth weight babies were more likely to delay initiation of breastfeeding. These are the major determinants of initiation of breastfeeding. Existing breastfeeding promotion program should be strengthened within the existing health care system.
Highlights
Breastfeeding is the best way of providing ideal food for the optimal growth and development of an infant
Variables that were significant on the bivariate analysis at p < 0.05 were further analysed in multivariate logistic regression to identify the determinants of breastfeeding practice
This study revealed that early initiation of breastfeeding was 47.3% which was comparable to the Nepal Demographic and health survey 2011(45%), but lower than the report of Nepal Demographic and health survey 2016 (55%).[10,12]
Summary
Breastfeeding is the best way of providing ideal food for the optimal growth and development of an infant. Appropriate breastfeeding practices are essential for the growth and development of infants. Initiation of breastfeeding is defined as feeding mothers’ breast milk to newborn infants within the first hour of birth.[1] In Nepal, every year 57,000 under-five children lose their lives. The World Health Organisation (WHO) recommends exclusive breastfeeding for the first six months of life, followed by a timely initiation of appropriate complementary foods.[3] In Nepal and in South Asia, suboptimal infant feeding practices have been associated with under nutrition, which is reflected by stunting, wasting, and mortality.[4] Delayed initiation of breastfeeding continues to be a problem in Nepal as only four in 10 newborn infants receive breast milk within the first hour of birth. Delayed initiation of breastfeeding continues to be a problem in Nepal as only four in 10 newborn infants receive breast milk within the first hour of birth. 5
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