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Postnatal Lactational Counseling and Neonatal Weight Pattern. OBJECTIVE: To compare the impact of postnatal lactational counseling on the weight gain and frequency of mixed feeding in full term neonates. DESIGN: Observational study. SETTING: Mother-infant pairs were observed in the maternity section of a multispecialty general hospital in Mumbai during two time periods. PARTICIPANTS: 260 mothers who delivered a full term, healthy, appropriate for gestational age neonate with birth weight >2.2 kg. METHODS: Between 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 MEASURES: Weight gain (g/kg/day) of neonate at 28 days of life. RESULTS: The 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). CONCLUSIONS: Postnatal lactational counseling leads to higher weight gain, and lesser chances of mixed feeding in the neonatal period.