In Bangladesh, many programs and projects have been promoting breastfeeding since the late 1980s. Breastfeeding practices, however, have not improved accordingly. Alive & Thrive (A&T) sought to identify program-relevant issues to improve breastfeeding in infancy using quantitative and qualitative data including a Trials of Improved Practices (TIPs) to determine how best to design further interventions. The analysis focused on five breastfeeding practices recommended by the World Health Organization. The biggest gaps were found to be in putting baby to the breast within the first hour of birth (76% gap), feeding colostrum and not giving other fluids, foods or substances within the first three days (54% gap), and exclusive breastfeeding from birth through 180 days (90% gap). Lack of knowledge about dangers of delaying initiation beyond the first hour and giving other fluids, foods or substances, and the common perception of "insufficient milk" were main reasons given by mothers for these practices. The findings showed that huge gaps continue to exist in breastfeeding behaviors, mostly due to lack of awareness as to why the recommended breastfeeding practices are beneficial, the risks of not practicing them, as well as how to practice them. Health workers' interactions for promoting and supporting optimal breastfeeding are extremely low. Counseling techniques should be used to reinforce specific, priority messages by health facility staff and community-based workers at all contact points with mothers of young infants.