Table 1. Breastfeeding counseling and support at routine contact points within the Mozambique health system.

Antenatal Care
One-on-one counseling	During antenatal care visits, nutritional counseling is often limited to maternal diet. The opportunity for counseling on early initiation of breastfeeding and appropriate breastfeeding techniques, and for providing encouragement or making a plan to ensure EBF for six months is missed.
Group talks	Each day, before consultations begin, maternal and child health nurses often provide group health education sessions on a range of topics, including family planning, care during pregnancy, breastfeeding, hygiene and sanitation, among others. As observed in Phase 1, group education sessions focusing on breastfeeding seldom included practical support for breastfeeding or use of job aids to explain crucial breastfeeding techniques and how to manage common breastfeeding challenges and problems.
Maternity services
48-hour hospital stay	Maternity registers indicate that most mothers put their babies to the breast within one hour after birth. During routine visits to maternity wards conducted by MCSP staff, one-on-one counseling and practical support were rarely observed.
Group talks	Daily group education sessions are an opportunity to provide new mothers with information on newborn care and feeding, so that all mothers have the essential information they need before discharge. Counseling on breastfeeding focuses on the promotion of EBF for the first six months of life. Some practical support may be provided to mothers facing difficulties.
Postnatal care and child visits
Group breastfeeding promotion talks	Breastfeeding talks are the most common breastfeeding promotion activity at the health facility level. Breastfeeding talks aim to motivate mothers to exclusively breastfeed for six months. While the talks were not designed to solve or manage breastfeeding problems, breastfeeding promotion activities at the community and health facility levels were cited as an opportunity to strengthen EBF counseling.
Child health visits	Every day prior to the start of well child visits (CCS), mothers are invited to participate in educational talks that last about 10 minutes, with a different topic covered each day, including EBF. Children under five years of age are seen during CCS for growth monitoring (weight and height assessment), vaccination, micronutrient supplementation beginning at six months, and deworming (at one year of age). In the first year of life, children are seen monthly and if the child is growing well with no problems diagnosed, they are seen for bi-monthly consultations after one year of age. While mothers reported participating in lectures on breastfeeding during CCS, they did not report receiving individual advice on breastfeeding during CCS consultations.