Abstract
ObjectivePromoting breastfeeding is major maternal and child health goal in India. It is unclear whether mothers receive additional food needed to support healthy breastfeeding. MethodsUsing the latest National Family and Health Survey (2005–2006), we applied multilevel linear regression models to document correlates of nutrition for (n = 20,764) breastfeeding women. We then compared consumption of pulses, eggs, meat, fish, dairy, fruit, and vegetables across a sample of breastfeeding, non-breastfeeding/pregnant (NBP), and pregnant women (n = 3,409) matched within households and five-year age bands. We tested whether breastfeeding women had greater advantages in the 18 high-focus states of India's National Rural Health Mission (NRHM). ResultsVegetarianism, caste, and religion were the strongest predictors of breastfeeding women's nutrition. Breastfeeding women had no nutritional advantage compared to NBP women, and were disadvantaged in their consumption of milk (b = −0.14) in low-focus states. Pregnant women were similarly disadvantaged in their consumption of milk in low-focus states (b = −0.32), but consumed vegetables more frequently (b = 0.12) than NBP women in high-focus states. ConclusionsBreastfeeding women do not receive nutritional advantages compared to NBP women. Targeted effort is needed to assess and improve nutritional adequacy for breastfeeding Indian women.
Highlights
India is in the midst of a rapid nutrition transition, characterized by high rates of malnutrition and rising obesity [1]
The evidence of active disadvantage in milk we found for both breastfeeding and pregnant women occurred in low- but not highfocus National Rural Health Mission (NRHM) states, which may point to the efficacy of programs targeting MCH in improving household food security and knowledge about the nutritional value of dairy for women
While we have examined the role of the NRHM, several countrylevel programmes in India more directly target income and food security, including the Midday Meal Scheme, which provides meals to school children; the National Rural Employment Guarantee, which guarantees work or provides income replacement in rural areas; the Public Distribution System, which provides subsidies for staple food items; and the Integrated Child Development Services Scheme, which offers a variety of healthcare and nutrition services for children and pregnant and lactating women, including nutritional
Summary
India is in the midst of a rapid nutrition transition, characterized by high rates of malnutrition and rising obesity [1]. The health benefits of breastfeeding are debated in high-income countries [6,7], there is virtually a consensus that breastfeeding is positive for children’s development in low- and middle-income settings [8,9]. Save the Children argues that “Mother’s milk is effectively a child’s first vaccination – and can often be the difference between life and Abbreviations: NBP, Non-breastfeeding, non-pregnant women; NRHM, National Rural Health Mission; NFHS, National Family Health Survey.
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