The promotion of optimal infant feeding practices is the most cost-effective of all interventions to reduce infant mortality. In spite of the recommendation of the WHO for optimal breastfeeding practices, several studies in Nigeria on early infant feeding practices have indicated a need for continuous auditing of feeding practices among mothers to make improvements. Objective: This study evaluated the early infant feeding practices of mothers and associated factors. Methods: A cross-sectional,

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... escriptive, multi-centre, questionnaire-based survey was conducted among 2,287 mother-infant pairs in 13 Baby Friendly Hospitals in Southeast Nigeria. Results: The rate of early initiation of breastfeeding [EIBF] within the first one hour of birth was 22.9%, while the exclusive breastfeeding [EBF] rate was 39.3%. The main deterrent to EBF was early introduction of water [94.0%], formula [40.9%] and complementary feeds [85.7%]. There was a statistically significant difference [p<0.001] between the nutritional status of the exclusively breastfed infants and those non-exclusively breastfed, with moderate underweight, and severe underweight malnutrition in the non-exclusively breastfed group. Sociodemographic factors associated with EBF were infant's birth order [p<0.001], maternal age [p=0.010], mother's and spouse's education [p<0.001 and p<0.001], mother's and spouse's occupation [p<0.001 and p<0.001]. Conclusion: Policies and measures to promote hospital deliveries targeting all mothers, with special focus on the poor, rural, working, and primiparous mothers, should become a top priority to improve the rate of EIBF. Promotion of EBF with emphasis on the dangers of early introduction of water, formula and complementary feeding should be intensified.