In India, 1.2 million children aged 0–59 months die yearly. An estimated 58% of these deaths occur during the neonatal period (ie, the first 28 days of life). A meta-analysis of three large trials conducted in Ghana, India and Nepal found that early initiation of breast feeding was associated with a 44% lower risk of neonatal mortality (RR 0.56; 95% CI 0.40 to 0.79). More recently, analyses on a large cohort of almost 100 000 newborns from three large trials in Ghana, India and Tanzania has shown that, compared with infants who initiated breast feeding within the first hour of life, the risk of neonatal death among children who initiated breast feeding between 2 and 23 hours after birth was 41% higher (RR 1.41; 95% CI 1.24 to 1.62), and 79% higher among those who initiated breast feeding at 24–96 hours of birth (RR 1.79; 95% CI 1.39 to 2.30).6 Therefore, supporting mothers to initiate breast feeding within 1 hour of delivery is a proven high-impact intervention for neonatal survival.