Background and aimsFirst-time mothers often need help with breastfeeding and may feel isolated and uncertain about whom they can turn to for help with breastfeeding challenges. Exploration of whether access to breastfeeding advice helps new mothers initiate and continue breastfeeding is necessary. This study investigated the associations between ease of access to breastfeeding advice for first-time mothers and breastfeeding initiation and duration.MethodsThis was a prospective, longitudinal cohort study of 3,006 women who delivered their first child in Pennsylvania, USA; with prenatal and postpartum interviews. At 1-month postpartum participants reported the extent to which they had access to “Someone to give you advice about breastfeeding if you needed it”, via a 5-point scale ranging from “none of the time” to “all of the time”.ResultsThere were 132 women (4.4%) who reported that they had access to someone to give them advice about breastfeeding “none of the time”; 697 (23.3%) reported access “a little of the time” or “some of the time”; and 2,167 (72.3%) reported access “most of the time” or “all of the time”. While the majority of the new mothers were breastfeeding at 1-month postpartum (72.5%), less than half were still breastfeeding at 6-months postpartum (44.5%). The higher the level of access to advice about breastfeeding the more likely women were to establish breastfeeding by 1-month postpartum and to still be breastfeeding at 6-months.ConclusionsFor first-time mothers, ease of access to someone who can give them advice about breastfeeding facilitates breastfeeding establishment and continuation.