Background: Early detection and timely management of issues pertaining to breastfeeding in the immediate postpartum period are of utmost importance since these challenges are the important risk factors for lactation problems. To assess breastfeeding difficulties in the immediate postpartum period, breastfeeding practice among participants as per IMNCI (Integrated Management of Neonatal and Childhood Illness) Guidelines, and various determinants of breastfeeding difficulties.
Methods: This hospital-based cross-sectional study assessed recently delivered mothers in the postnatal ward during the first 48 hours postpartum conducted at Ahmedabad, India. The inclusion criteria entailed being admitted to the postpartum/postnatal ward, normal/cesarean delivery, and provision of written consent. After applying the exclusion criteria, 343 participants were included in final analysis. Observations were made regarding signs of good position and attachments as per IMNCI guidelines.
Results: More than half of the participants (56.9%) were aged 21-25 years, and 53.6% of them had primary/secondary school education. Breast pain was the most common difficulty reported (47.52%), followed by less secretion of milk (25.07%). Other difficulties reported were sore nipples, breast heaviness, inverted nipples, backache, giddiness, as well as headache and perineal pain  at the site of stitches. "Good attachment" and "good positioning" were found in 62.16% and 60.96% of participants, respectively. The majority of participants (52.08%) had the perception that their newborn was not sucking effectively.
Conclusion: Mothers' age, numbers of live births, and mixed feeding were statistically significantly associated with good attachment. Good positioning was statistically significantly correlated with less secretion of milk. Duration of starting breastfeeding after birth and breast pain were significantly associated with both.