Challenges in Exclusive Breastfeeding in India

Exclusive Breastfeeding in India: Key Insights and Data

Importance of Exclusive Breastfeeding (EBF)

• Health Benefits: EBF is crucial for infant survival and development, providing essential nutrients and antibodies that protect against illnesses.
• Maternal Health: Benefits include aiding recovery post-childbirth and reducing risks of breast and ovarian cancers.
• Recommendations: WHO & UNICEF advocate for initiating breastfeeding within one hour of birth and maintaining EBF for the first six months.

Current Trends in India

• National Family Health Survey (NFHS-6):
  • Institutional Deliveries: 90.6% of deliveries are institutional.
  • EBF Rates: Declined from 63.7% (NFHS-5) to 55.8% (NFHS-6).
  • Early Initiation of Breastfeeding: Increased from 41.8% to 50.1%.

Regional Variations

• Significant Declines:
  • Uttar Pradesh: EBF fell from 59.7% to 34.6%.
  • Haryana: From 69.5% to 41.2%.
  • Delhi: From 64.3% to 54%.
• Improvements: Kerala, Gujarat, and West Bengal saw increases in EBF rates.

Socioeconomic Factors Influencing EBF

• Rural vs Urban: EBF declined more sharply in rural areas (from 65.1% to 56.2%) compared to urban (from 59.6% to 54.5%).
• Challenges: Economic pressures, informal employment, lack of maternity protection, inadequate support, and cultural practices leading to early introduction of formula or other feeds.

Contributing Factors to Decline

• C-Section Rates: Increased from 21.5% to 27.2%, complicating early breastfeeding initiation.
• Migration and Employment: Many mothers return to work shortly after childbirth due to financial necessity.

Government Policies and Initiatives

• Maternity Benefits: Under the Maternity Benefit Act, 1961 (amended 2017), women in the organized sector are entitled to 26 weeks of paid maternity leave.
• Pradhan Mantri Matru Vandana Yojana: Provides financial support to pregnant and lactating women.
• Integrated Child Development Services (ICDS): Promotes breastfeeding and child nutrition.
• Infant Milk Substitutes (IMS) Act: Regulates the marketing of infant formula to protect breastfeeding.

Recommendations for Improvement

• Strengthening Support Systems: Enhance maternity benefits and breastfeeding support, particularly for women in the informal sector.
• Public Health Approach: Treat breastfeeding promotion as a public health measure rather than an individual lifestyle choice.
• Workplace Policies: Advocate for policies that provide breastfeeding breaks, crèche facilities, and lactation rooms for informal workers.

Economic Context

• Informal Sector Employment: Over 16.69 crore women registered in the unorganized sector as of 2025, where maternity protections are minimal.
• Inflation and Economic Pressure: Rising costs compel mothers to return to work prematurely, impacting their ability to exclusively breastfeed.

Conclusion

The decline in EBF rates amidst improvements in maternal and child health indicators highlights a gap between policy and practice. Addressing economic realities and enhancing support for mothers, particularly in the informal sector, is crucial for promoting exclusive breastfeeding in India.