Early breastfeeding initiation (EBI) is defined as feeding a newborn with breastmilk within 1 h from birth (World Health Organization and United Nations Children's Fund, 2021a). EBI has been shown to offer several benefits for newborns. These benefits, attributed to the colostrum's rich content of immunoglobulin G for a stronger immune system, reduced risk of diarrhea, and improved survival rate (Abie & Goshu, 2019). For mothers, immediate EBI facilitates uterine contraction, thereby reducing the risk of postpartum bleeding (Gonzales Jr., 2020). Breastfeeding mothers show higher uterine contractions frequency and better postpartum bleeding control than non-breastfeeding counterparts (Masuzawa & Yaeko, 2017). In addition, EBI influences prolonged breastfeeding (Nguyen et al., 2020) and emotional bonding through skin-to-skin contact (Crenshaw, 2019), promoting longer and optimal breastfeeding practices (Sakib et al., 2021; World Health Organization, 2021). Moreover, EBI is linked to a 33 % reduction in newborn mortality (Mugadza et al., 2018).

Although numerous global efforts have been made to promote early breastfeeding (Arts et al., 2017), only 42 % of newborns breastfed within 1 h of birth in 2017 (United Nations Children's Fund, 2018). Based on the WHO Global Survey on Maternal and Perinatal Health conducted with 24 developing countries from 2004 to 2008, 57.6 % of mothers practice EBI; in particular, the Philippines had one of the lowest rates, with only 39.9 % of mothers practicing EBI (Takahashi et al., 2017). The Philippine government introduced key initiatives, including the Mother-Baby Friendly Hospital Initiative (MBFHI) and the implementation of Rooming-in and Breastfeeding Act (Republic Act 7600), in 1992 aimed at promoting and supporting breastfeeding in health facilities specializing in maternal and newborn care (Labbok, 2012; Philippine Commission on Women, 1992). These facilities also undergo MBFHI accreditation and re-accreditation every three years (World Health Organization, 2015), with a focus on discouraging the use of breastmilk substitutes as mandated by Executive Order 51, also known as the Philippine Milk Code (National Nutrition Council Philippines, 2021). Despite these efforts, a more recent study reported a prevalence of 63.1 % for EBI among Filipino mothers (Saniel et al., 2021); however, this still falls short of the 90 % target set by Philippine health authorities in 2016 (WHO Western Pacific Region & Department of Health Philippines, 2015) and the 70 % target set by the WHO for 2030 (World Health Organization, 2019).

In the Philippines, studies on infant feeding practices have been limited and conducted only in selected provinces, failing to reflect the national breastfeeding practices and lacking the use of the EBI conceptual framework in understanding the associated factors (Guirindola et al., 2017; Saniel et al., 2021). Considering the high under-five mortality rate in the Southeast Asia region, particularly in the Philippines (United Nations Inter-agency Group for Child Mortality Estimation, 2018), there is a need for empirical studies on EBI to inform policy interventions and programs aimed at improving breastfeeding practices and reducing child deaths. Therefore, this study aims to investigate the prevalence and determinants of EBI in the Philippines, using the nationally-representative data from the Philippine National Demographic and Health Survey (PNDHS) conducted in 2017. The findings of the study will serve as crucial insights for healthcare professionals, guiding the development of targeted interventions and programs focused on enhancing EBI in the Philippines.