Impact of structured antenatal breastfeeding counselling on early initiation of breastfeeding: A comparative study from Central India

Objectives To determine the effectiveness of structured antenatal breastfeeding counselling on early initiation of breastfeeding (EIBF) within 1 hour of birth and its determinants among mothers delivering at a tertiary-care hospital in central India. Methods A prospective, non-randomized (quasi-experimental) study was conducted in the Department of Pediatrics, Bhopal, from June 2024 to September 2025. The intervention group included third-trimester antenatal women who received one to three structured counselling sessions on selected Anganwadi centre days, while the comparison group included postpartum mothers with no prior counselling. Counselling was based on the Facility-Based Newborn Care (FBNC) module. Data were collected using a pre-tested semi-structured questionnaire and analyzed using STATA v14.2. Differences between groups were assessed using the χ 2 test and t-test. Multivariable logistic regression was additionally used to identify independent predictors of EIBF after adjustment for measured sociodemographic and obstetric covariates. A p -value <0.05 was considered statistically significant. Results Among 496 mothers analysed (246 intervention; 250 comparison), baseline characteristics were largely comparable. EIBF within 1 hour was achieved by 58.0% of counselled mothers compared with 42.0% of controls, demonstrating an absolute improvement of 16 percentage points (95% CI: 9.6–26.8; p < 0.001). Higher maternal education ( p < 0.001), working status ( p = 0.016), higher socioeconomic status ( p < 0.001), urban residence ( p < 0.001), multiparity ( p < 0.001), absence of pregnancy-related complications ( p = 0.010), receipt of ≥4 ANC visits ( p < 0.001), vaginal delivery ( p < 0.001), and absence of prelacteal feeding ( p < 0.001) were significant facilitators of early initiation. After adjustment for these covariates in a multivariable logistic regression model, structured counselling remained an independent predictor of EIBF (adjusted OR 1.68, 95% CI 1.12–2.52; p = 0.012), as did graduate-level education, multiparity, ≥4 ANC visits, and vaginal delivery. Conclusion Structured antenatal breastfeeding counselling was independently associated with improved early initiation of breastfeeding in this non-randomized comparative study. These findings support incorporating structured counselling into antenatal care programmes, pending confirmation in larger, multi-centre, and ideally randomized trials.