Background. Breastfeeding is the act of milk conveyance from the mother to the infant. Adequate nutrition during infancy and early childhood are mandatory to ensure growth, health, and development of children to their maximum potential. The positioning of the baby’s body is important for maintaining good attachment and successful breastfeeding. Most difficulties of breastfeeding can be avoided altogether if good attachment and positioning can be achieved at the first and early feeds. Plenty of studies have been conducted to explore factors affecting breastfeeding practice in general; however, there is a meagerness of evidence that assesses factors affecting attachment and positioning during breastfeeding specifically. Therefore, the current study was aimed to assess positioning and attachment during breastfeeding among lactating mothers visiting health facilities of Areka town. Methods. an institution-based cross-sectional study was conducted by using observational checklist adopted from the World Health Organization breastfeeding observation form. Maternal-related characteristics were collected by using a structured and pretested questionnaire. The study was conducted from April to June 2017. Respondents were selected by using a systematic random sampling technique. Descriptive summaries were done to present pertinent findings and a chi-square test was used to check association between variables. Result. There was poorer positioning among primipara mothers (47.1%) than multipara mothers (28.7%). A poor attachment was also more apparent among primipara mothers which were more (31.1%) than the multipara (27.1%) mothers. Conclusion. Younger mothers (<20 years old), the primipara, and those who have no formal education deserve more attention, support, and direction to make sure that they can achieve proper positioning and attachment during breastfeeding at the first and early feeds.