Objective: The aim of this systematic review and meta-analysis was to investigate the association of gender of new-born, antenatal care (ANC) and postnatal care (PNC) with TIBF and EBF. Design: Systematic review and meta-analysis Methods: PubMed, EMBASE, CINAHL, WHO Global Health Library, Web of Science and SCOPUS databases systematically searched for all available literature, complemented by manual searches. Newcastle-Ottawa Scale (NOS) was used for quality check; Egger regression test for publication bias at p-value threshold ≤ 0.01; and Cochran Q X2 test and I2 statistics for heterogeneity. A meta-analysis using a weighted inverse variance random-effects model was performed. Results: Of 523 articles retrieved, 16 studies on TIBF and 23 on EBF fulfilled the eligibility criteria. Antenatal care (Odds ratio (OR) = 1.61, 95% CI 1.01 - 2.57) was significantly associated with TIBF but not gender of new-born (OR = 1.03, 95% CI 0.84 - 1.26). In addition, antenatal (OR = 2.25, 95% CI 1.63 - 3.10) and postnatal care (OR = 1.86, 95% CI 1.41 - 2.47) significantly associated with exclusive breastfeeding (EBF) but not gender of new-born (OR = 1.08, 95% CI 0.86 - 1.36). Conclusions: Optimal care during pregnancy and after birth is important to ensure adequate breastfeeding. In addition, there was no difference in breastfeeding between male and female new-born. This meta-analysis study provided evidence on breastfeeding practice and its associated factors in an Ethiopian context, which can be useful for cross-country and cross-cultural comparison and for breastfeeding improvement initiative in Ethiopia. Protocol registration and publication: CRD42017056768 and 10.1136/BMJOPEN-2017-017437