Background: Delayed initiation of breastfeeding for more than one hour after birth is associated with increased neonatal morbidity and mortality. Aim: The aim of this meta-synthesis was to examine women’s perceptions and experiences of barriers and facilities for breastfeeding initiation during the postpartum period. Method: The study design was a qualitative meta-synthesis focusing on maternal perceptions and experiences of breastfeeding initiation. Eighteen qualitative articles with several methodologies were included after assessment of relevance and quality. The analysis was based on meta-ethnographic method. Result: The meta-synthesis report identified three categories and 28 sub-categories. Category I: Barriers to establishing breastfeeding described factors that had an impact on breastfeeding initiation. Category II: Facilitators to establish breast-feeding describes supportive factors as experienced by the mothers to initiate breastfeeding. In Category III: Satisfaction maternal confidence for breastfeeding support services was identified. Conclusion: This meta-synthesis study identified factors that impacted maternal confidence. Based on these, it is recommended that there is a need for evidence-based practical knowledge regarding initiation of breastfeeding, social and community awareness, husband and family support, and prenatal and antenatal breastfeeding education. These factors also showed the importance of health workers and midwives providing skilled guidance on breastfeeding initiation and help to resolve difficulties. Clinical implications and further research: The findings from this study can be used for educational purposes, and to create awareness about the evidence for midwifery care. Further country specific research is suggested with both qualitative and quantitative approaches.