Breastfeeding is the foundation of good nutrition and provides the basis for health throughout the life span. The WHO and the Chinese Ministry of Public Health recommend exclusive breastfeeding to six months of age. The practice of giving prelacteal feeds may interfere with the establishment of good breastfeeding practices and is contrary to the principles of Baby Friendly Hospital accreditation. The objective of this study was to investigate the prevalence of prelacteal feeds in a hospital in Hangzhou and the influence of this practice on breastfeeding at discharge. A longitudinal study of infant feeding was conducted in Hangzhou, China and a total of 638 mothers were recruited and interviewed while in hospital. The questionnaire included full details of infant feeding methods and factors likely to influence the initiation and duration of breastfeeding. Binary logistic regression was used to analyse factors influencing breastfeeding on discharge. In Hangzhou almost all babies are born in hospital, the median length of stay was 5.6 days and 77% of births were by caesarian section. In 26% of births the infants were given formula, water or milk as their first feed. At the time of discharge from hospital 91% of infants were receiving some breastmilk, but only 36% of mothers were exclusively breastfeeding. Breastfeeding on discharge from hospital was inversely related to giving prelacteal feeds (OR 0.115, 95% CI 0.055-0.238). While in hospital just over one quarter of infants received prelacteal feeds and these infants had a lower rate of breastfeeding on discharge.