Proper positioning and attachment are key for exclusive breastfeeding; incorrect techniques cause poor milk transfer and early discontinuation. This hospital-based mixed-methods study in Puducherry assessed breastfeeding techniques among 99 postnatal mothers and identified factors associated with improper positioning and poor attachment. 45 staff nurses ranked action points to improve poor breastfeeding practices. About 28.3% and 27.3% of mothers showed improper positioning and poor attachment, respectively. Factors influencing poor techniques included young maternal age, being a housewife, infants <10 days old, and lack of breastfeeding counseling. Priority actions suggested include poster displays, staff training, targeted counseling, and assistance. Implementing these can help achieve Baby Friendly Hospital standards. © 2022 Elsevier B.V., All rights reserved.