Breastfeeding rates for infants have fallen sharply, shows NFHS

The proportion of babies being exclusively breastfed for the first six months has dropped from 64% in 2019-21 to about 56% in 2023-24, reversing the rising trend of the decade and more before that. This fact, revealed by the National Family Health Survey-6 has alarmed public health and nutrition experts who point out that exclusive breastfeeding for at least six months is the most cost-effective nutrition intervention with lifelong benefits for mothers and babies.

The reduction in breastfeeding rates is in almost all states barring a few like Kerala, Gujarat and West Bengal. Interestingly, however, the proportion of babies under three years who were breastfed within the first hour of birth has gone up significantly from about 42% in 2015-16 (NFHS-4) and 2019-21 (NFHS-5) to 50% in the latest survey. While most states have shown a marked improvement on this parameter, some like Punjab and West Bengal have recorded a decline.

Some of the states with the highest number of births showed a sharp fall in the proportion of babies exclusively breastfed in the first six months. For instance, in Uttar Pradesh the proportion fell from almost 60% in 2019-21 to just 35% in 2023-24. In the same period, it fell from 74% to 56% in Madhya Pradesh, from over 70% to 54% in Rajasthan and from 64% to 54% in Assam. Haryana saw the sharpest fall from almost 70% to 41%. Uttarakhand too recorded a fall from almost 53% to 41%.

In many states where breastfeeding within the first hour of birth was very low earlier, such as Jharkhand, Bihar and Chhattisgarh, the proportion has jumped – from 22% in 2019-21 to 46.8% in Jharkhand, from 31% to 52% in Bihar, and from 32% to almost 52% in Chhattisgarh.

In Kerala, the proportion of babies breastfed within the first hour has crossed 82%, followed by Andhra Pradesh with 67%. Kerala also has among the highest proportion of babies exclusively breastfed for the first six months, close to 73%, second to Chhattisgarh (76%).

The Breastfeeding Promotion Network of India (BPNI), a civil society organisation tasked with protecting breastfeeding practices and monitoring the marketing of infant foods, called for urgent action to rebuild the systems that enable mothers to breastfeed successfully. Rising C-sections along with health systems that wrongly assumed that women cannot breastfeed successfully after C-section, inadequate breastfeeding support in health facilities, and aggressive commercial marketing of infant milk substitutes and baby foods were undermining optimal infant feeding practices, said BPNI in its statement. It added that India was witnessing an unprecedented expansion of digital and indirect marketing of infant formula and commercial baby foods that normalised formula feeding and weakened breastfeeding practices.