In India exclusive breast feeding at 6 months is practiced only by 46% of mothers and breast feeding initiated within half an hour of birth only by 26%. There are several problems faced by breast feeding mothers in the immediate postpartum period which affects successful initiation and sustenance of breast feeding. A study was conducted to identify these problems and suggest remedial measures. A cross sectional observational study was conducted on 150 mothers attending the hospital. Detailed information regarding antenatal counseling, initiation of breast feeding, prelacteal feeds and use of milk substitutes was obtained and recorded on a semistructured questionnaire. Mothers were also clinically examined for any breast abnormalities. Antenatal counseling was received by 71.3% of mothers. Pre-lacteal feeds and/or milk substitutes were given by 29% of mothers there being a significantly higher proportion among those who had not received antenatal counseling. The common problems faced by mothers in the immediate postpartum period were insufficient or no breast milk (38%), and engorged breast and/or breast tenderness (17%). There was no statistically significant difference in these problems between mothers who received and did not receive antenatal counseling. Antenatal counseling in the study area has not significantly impacted early initiation of lactation or helped in reducing problems faced by lactating mothers. However, the use of prelacteal feeds and the use of milk substitutues has reduced with counseling. The nature of counseling perhaps needs to be improved for better impact on lactation.