This paper provides information on optimal breastfeeding practices in the People’s Democratic Republic of Lao from data collected in the2011 Lao Social Indicator Survey. Results: Early initiation of breastfeeding within the first hour of life occurred among 39.6% of Laotian infants. After controlling for the effects of wealth, early initiation of breastfeeding was found to be most prevalent among mothers with higher education, those who received antenatal services, and those who delivered in a health facility. Avoidance of prelacteal feeds within the first three days of life occurred among 65% of Laotian infants, and was highest among ethnic Hmong and Khmer infants, and among those born in public versus private health facilities. Avoidance of prelacteal feeds was lowest after deliveries in which a traditional birth attendant was present. Exclusive breastfeeding through the first 5 months of age was reported among 40.8% of infants nationally. Ethnicity again played a role with the highest levels of exclusive breastfeeding found to occur among ethnic Khmer infants (69.4%, OR 2.8, CI: 1.5 - 5.1). Discussion: These results highlight the role that health care workers can have on early breastfeeding practices at the point of both antenatal counseling and in the delivery setting. Strengthening the quality of counseling on infant feeding can have a significant impact on early initiation of breastfeeding. Ethnic difference significantly impact both early and exclusive breastfeeding practices. Conclusion: A complexity of factors at different levels of care impact breastfeeding practices. A synergy of strategic approaches are needed to target antenatal counseling as well as post-delivery practices, all which account for the unique social and cultural attitudes towards infant feeding. Stronger community-based interventions that account for cultural attitudes and practices are most likely to be successful in promoting exclusive and continued breastfeeding practices.