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ObjectiveTo compare the impact of postnatal lactational counseling on the weight gain and frequency of mixed feeding in full term neonates.DesignObservational study.SettingMother-infant pairs were observed in the maternity section of a multispecialty general hospital in Mumbai during two time periods.Participants260 mothers who delivered a full term, healthy, appropriate for gestational age neonate with birth weight >2.2 kg.MethodsBetween 18 November, 2007 and 4 March, 2008, 126 mothers received unstructured verbal encouragement to maintain breastfeeding from the maternity staff. From 1 June, 2008 to 16 December, 2008, 134 mothers were counseled about breastfeeding by the pediatric residents and nurses with the help of charts, literature and verbal advice. They were supervised and helped during the first feed and subsequently until discharge.Main outcome measureWeight gain (g/kg/day) of neonate at 28 days of life.ResultsThe mean (SD) weight gain was significantly higher in the counseled group in comparison to historical control group [9.2 (4.5) g/kg/d vs. 7.9 (5.1) g/kg/d; P=0.03]. Mixed feeding occurred less frequently in [RR 0.36, 95% CI 0.13, 0.98; P=0.046] the counseled group (5/134) as compared to control group (13/126).ConclusionsPostnatal lactational counseling leads to higher weight gain, and lesser chances of mixed feeding in the neonatal period.