Horii N. auteur aut IRD Allman J. auteur aut IRD Martin-Prével Yves auteur aut IRD Waltisperger D. auteur aut IRD text journalArticle eng text/pdf reformatted digital access Background: Most child deaths are preventable and caused by behaviorally modifiable factors. By promoting optimal breastfeeding, we can reduce neonatal and child mortality risks by 45%. This paper provides new family and community based perspectives to identify factors interfering with the program impact on promoting early initiation of breastfeeding among the most vulnerable populations in rural Niger. Methods: A secondary analysis of a retrospective cross-sectional study evaluated a UNICEF behavior change program on child healthcare. The study sample is based on a post-hoc constitution of two groups exposed and unexposed to the program. All women (n = 1026) aged 14-49 years having at least one child below 24 months of age were included. We measured crude and adjusted odds ratios with chi-square and multivariate logistic regression models. Results: Independent variables shown to be associated with early breastfeeding include sales activities compared to household work with no direct income (AOR 7.7; 95% CI 1.3, 47.8) and mutual decision for harvest use (AOR 8.6; 95% CI 2.0, 36.8). Antenatal care did not modify the timing of breastfeeding initiation. Conclusions: A high risk group of mothers with social and economic vulnerability are prone to suboptimal breastfeeding within the first hour of birth. Support from family and neighbors positively influenced early breastfeeding. Those who had no direct income and limited access to health services were a high-risk group, prone to delayed initiation of breastfeeding. specialized Determinants Breastfeeding Behavior change Community health NIGER 054 108 12 art. 41 [10 ] 2017 1746-4358 https://www.documentation.ird.fr/hor/fdi:010071221 10.1186/s13006-017-0134-9 1746-4358 [F B010071221] https://www.documentation.ird.fr/hor/fdi:010071221 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers17-10/010071221.pdf IRD - Base Horizon / Pleins textes 2017-10-31 2025-01-17 fdi:010071221 fre