In India, a multipronged strategy including large scale programmes, effective capacity building initiatives, strong partnerships, community-based action, and strategic mass media communication led to an increase in the rates of early initiation of breastfeeding from 24.5% in 2006 to 44.6% in 2014 (i.e. a 1.8-fold increase).

In the seven states of India with the highest burden of neonatal mortality, the combined rate of early initiation of breastfeeding increased from 12.5% in 2006 to 34.4% in 2014 (i.e. a 2.7-fold increase).

But there is room for further improvement – in 2014, 81.1% of deliveries were attended by a skilled health provider, while only 44.6% of newborns were breast fed within 1 hour of birth, indicating that rates of early initiation of breast feeding could double if all newborns delivered by a health provider were breast fed within 1 hour of birth.

There is an urgent need to continue to strengthen national and state policies, hospital and maternity practices, and the knowledge and skills of birth attendants—physicians, midwives and nurses—to support early initiation of breast feeding as a key component of essential newborn care.