A strength of this study is the unique opportunity to study breast feeding initiation across a woman’s reproductive span and to demonstrate the importance of breastfeeding experiences at the time of the first birth. Additionally, our study design also allowed us to compare breastfeeding initiation rates across obstetrical exposures and events, including vaginal versus cesarean birth. Given the rising cesarean rate in the U.S., the impact of cesarean delivery cannot be overstated. Finally, a strength of this analysis is the relatively large study population size, providing adequate power for investigating relevant exposures.