question: Early initiation of breastfeeding, within one hour of birth, is vital for the health of newborns, and reduces morbidity and mortality. Secondary analysis of the 2016 Nepal Demographic and Health Survey (DHS) showed that early initiation of breastfeeding significantly reduced the risk of acute respiratory infection (ARI) in children under two years. Early initiation of breastfeeding requires maternal proximity. However, during the COVID-19 pandemic, guidance varied, with some recommending that infants and mothers with SARS-CoV-2 be isolated from one another. Nepal’s Ministry of Health and Population recommended non-separation, but the adherence to this guidance was inconsistent. Separation of infant and mother inhibits early initiation of breastfeeding and increases the risk that infants will suffer from ARIs. Maternal proximity, non-separation and early initiation of breastfeeding should be promoted in all birthing facilities.