Abstract

Background: Early initiation of breastfeeding, defined as breastfeeding within one hour of birth, is a critical indicator of optimal infant feeding practices with substantial health benefits for mothers and infants. Early initiation of breastfeeding rates in Thailand has declined over the past decade, necessitating an investigation into the underlying determinants. Therefore, this study aimed to identify trends in early initiation of breastfeeding prevalence and examine associated factors using national survey data from Thailand. Methods: This study analysed secondary data from four rounds of the Thailand Multiple Indicator Cluster Survey (MICS4-7), conducted in 2012 (MICS4), 2015–2015 (MICS5), 2019 (MICS6), and 2022 (MICS7), including 13,063 mothers of children under 6 months. Logistic regression analysis was used to evaluate the association between geographic, socioeconomic, and maternal factors with early initiation of breastfeeding. Statistical significance was determined at 95% confidence and p-value < 0.05, and all analysis was conducted using STATA 17. Results: Early initiation of breastfeeding prevalence declined from 54.9% in 2012 to 43.1% in 2022. Vaginal delivery increased adjusted odds by 2.1 times (95%CI 1.59, 2.85) while non-skin-to-skin contact reduced early initiation of breastfeeding likelihood by 57% (AOR 0.43, 95%CI 0.33, 0.57). Geographic disparities emerged, with almost all regions showing higher early initiation of breastfeeding rates than Bangkok: North (AOR 2.65, 95%CI 1.49, 4.72), Northeast (AOR 2.55, 95%CI 1.49, 4.35), and South (AOR 3.26, 95%CI 1.92, 5.52). Socioeconomic status and urban or rural residence showed inconsistent associations across survey rounds. Conclusions: Early initiation of breastfeeding prevalence in Thailand remains low and is off track to meet the 2030 global target of 70%. Interventions to promote vaginal delivery and ensure immediate skin-to-skin contact in all births are critical. Regional variations highlight the importance of culturally tailored strategies to support breastfeeding practices. These findings provide critical evidence for policy development to improve maternal and child health outcomes in Thailand.