In the present study, we tried to determine the prevalence of early ignition of breastfeeding (EIBF) and investigate the associated factors of EIBF among mothers living in Rajshahi district, Bangladesh. It was noted that the prevalence of EIBF among mothers in Rajshahi district, Bangladesh was 88.40%. The national survey of Bangladesh showed that 51.0% children were breastfed within one hour after birth (early ignition of breastfeeding) and 89% were breastfed within one day after delivery, and 55.0% under age 6 months were exclusively breastfed . However, more recently published the key indicators of BDHS 2017–2018 showed that 65% of infants under age 6 months were exclusively breastfed (EB) in 2017, it was a markedly higher level than in 2014, and they did not publish the rate of EIBF . BDHS-2014 found that 98% children who were born in the two years proceeding of their survey were breastfed at some point in their life, breastfeeding was almost universal in Bangladesh . The rate of breastfeeding for every stage has been increasing with increasing the medical facilities in Bangladesh. Mothers can easily get advice regarding the benefit of breastfeeding from health providers or family planning workers; they are working with mothers of reproductive age. Also, it was found that the practices to provide EIBF to new born increased with increasing the literacy rate with awareness on the benefit of early initiation of breastfeeding especially among rural women in Bangladesh .
The prevalence of EIBF among mothers in Rajshahi district was also higher than south Asian countries like India (21%) , Pakistan (8.5%) , other developing countries like Nigeria (34.7%) , Iran (32.2%)  and South Sudan (48%) . The rate was close to the developing countries Ethiopia which was 83.7% .
Mothers who delivered at home were more likely to provide EIBF to their infant than mothers delivered at private hospitals. The present finding coincided with another Chinese study . But our results was not supported by BDHS survey data conducted in 2014  and a study from Nicaragua  showing no significant association between EIBF and place of delivery. It was noted that mothers living in poor income were more interested to provide their initial breast milk to their infants than middle incoming family, however BDHS-2014 indicated no significant association between EIBF and wealth index .
We found that primary or uneducated husbands’ wives had more chance to give their initial breast milk to their infants than higher educated husbands’ wives. This finding was supported by another study . They also found that husband’s educational level was significantly associated with EIFB.
The nutritional status of mothers was an important predictor of initial breastfeeding, and it was observed that under nourished mothers were more likely to provide their breast milk to their infants than healthy and over nourished mothers, same results had been in our nationally representative samples . Similar observation was also mentioned by several studies [30, 32–34]. This study found that highly reproductive mothers (age, 20–34) had more likely to provide EIBF to their children than mothers aged 35 years and above. Our result was also supported by a global survey [35–36]. Again, in this study, it was found that husband’s occupation is an important factor for EIBF, i.e. farmers’ wives had higher chance to give EIBF to their children than others professional husbands’ wives. Our result was also in line with another study in India , but disagreed with other study in Sudan .
In this study, we have found that place of delivery, family income, husbands’ education level and mothers’ nutritional status are important factor for providing initial breast milk to new born among mothers in Rajshahi district. These four factors are very much related each to other in developing country like Bangladesh. Most of the home delivery mothers are living in poor family. In Bangladesh, wife is dominated by her husband, and most of the females are dependent on their husband income, and income is dependent on education level. Usually, uneducated or primary educated husbands are farmer or day labors living in rural or slum area, their income is not sufficient to maintain their family, and they cannot able to provide sufficient food to their family members, consequently, they suffer from under nutrition. Mothers living in poor family cannot able to go hospital/clinic for delivering, most of them delivery at home in presence their close relative without proper nursing. Traditional custom and culture in the society of Bangladesh, after delivery immediately mother wants to provide her breast milk to her new born, it is possible for most of the mothers who delivered by vaginal. It is mentionable that all home deliveries are vaginal. On the other hand, mothers living in middle or rich family, usually they delivery at hospital/clinic with proper nursing but now a days most of the delivery occur by caesarian, after delivery sometimes mothers stay at operating theatre more than one hour, she cannot able to provide their breast milk to their infant in time (within one hour of delivery). One of the most reasons that mothers living in poor family is more likely to provide their breast milk to their new born than mothers living in rich family, similar results are found in other Bangladeshi study . More number of healthy and over nourished mothers is living in rich family, and most of them underwent caesarean section, it might be higher risk of cephalo-pelvic disproportion and relatively poor progress due to maternal fatigue . This is one of the most important reasons for the differences seen in the practice of EIBF between under nourished and healthy/over nourished mothers. Healthy and over nourished mothers should be the focus of education on the potential benefits of EIBF. We found that mothers got pregnancy with proper planning and took advice regarding the benefit of EIBF were more likely to provide EIBF than their counterparts. Family planning workers who are closely working with pregnancy mothers, and health provided can play a good rule to increase the rate of EIBF and exclusive breastfeeding in Bangladesh.
Strength and limitations of this study
Perhaps, this was first time we attempt to investigate the early initiation of breastfeeding and its influential factors among mothers in Rajshahi district, Bangladesh. We considered two new factors; (i) getting pregnancy with planning and (ii) mothers taking advice regarding the benefit of breastfeeding during their pregnancy, which were not considered in our national survey. However, there are several limitations of our present project. Firstly, in this study we considered only Rajshahi district as our study area which is small part of Bangladesh. Secondly, we used quantitative study which can determine only risk factors but cannot do research in-depth. For complete study, mixed research (qualitative and quantitative) is important. Thirdly, we selected some socio-economic, demographic, anthropometric and behavioral factors as independent variables but other important factors were not considered in this study. On the basis on our limitation, we may proclaim further many more researches will be required on breastfeeding among Bangladeshi mothers.