Abstract
BackgroundExclusive breastfeeding up to six months is considered to be beneficial for the health and wellbeing of infants and mothers. To guide policy makers in the development of targeted breastfeeding promotion strategies, changes in the effect of predictor variables on exclusive breastfeeding practices in India were examined.MethodsData from two rounds of the National Family Health Survey (NFHS) carried out in India during 1992–93 (NFHS-1), and 2005–06 (NFHS-3) were analysed. A total of 34,176 and 25,459 births under three years of age in NFHS-1 and NFHS-3 respectively comprised the sample. Exclusive breastfeeding was defined as infants zero to five months of age who received only breast milk in previous 24 h. The practice of exclusive breastfeeding was examined at different ages (1, 4 and 6 months) against a set of predictor variables using bivariate and multinomial logistic regression in conjunction with the multiple classification analysis.ResultsOverall 46.3 per cent and 48.6 per cent of infants under six months of age were exclusively breastfed in NFHS-1 and NFHS-3 respectively. The proportion declined with each additional month of age, and at four months only 24 per cent infants in NFHS-1 and 31 per cent infants in NFHS-3 were exclusively breastfeeding. In the NFHS-1 a higher proportion of infants perceived to be small size at birth and those with mothers in gainful employment were exclusively breastfed. While in infants of mothers living in urban areas, older mothers (aged ≥ 35 years), more literate mothers, belonging to a higher standard of living index, preceding birth interval less than two years, and in those who had antenatal/natal care, a lower proportion of exclusive breastfeeding was observed at different ages of the infant. However, in the NFHS-3, children of older mothers and of those who were less educated the proportion of exclusive breastfeeding was significantly greater at one month of age. In the age segment one to four months; exclusive breastfeeding was significantly lower in infants born to older mothers, from medium standard of living households and perceived to be of small size at birth. Infants of mothers who were more educated, aged ≥ 35 years, living in urban areas and who had antenatal/natal care were the factors associated with a lower proportion of exclusive breastfeeding at six months of age.ConclusionsThe rate of exclusive breastfeeding in India continues to be sub-optimal with no appreciable gains in the last ten to fifteen years. Interventions that seek to increase exclusive breastfeeding should be timely with an increased focus on mothers with infants four to six months of age and in those who are most at risk of early discontinuation of exclusive breastfeeding.
Highlights
Exclusive breastfeeding up to six months is considered to be beneficial for the health and wellbeing of infants and mothers
Detailed information was obtained on antenatal and delivery care, breastfeeding duration and practices, vaccination and recent illnesses for the recent births which had occurred for each eligible woman during the four years preceding the survey in National Family Health Survey (NFHS)-1and five years preceding the survey in NFHS-3
Two-third (66.7%) of children in NFHS-1 and half (49.7%) in NFHS-3 were from mothers who had not received any formal education
Summary
Exclusive breastfeeding up to six months is considered to be beneficial for the health and wellbeing of infants and mothers. The World Health Organization (WHO) recommends exclusive breastfeeding (EBF) to six months of age [1, 2]. During this six month period, no other liquid, semi solid or solid food or breastfeeding substitute should be given to the infants except for medicine and/or oral rehydration solution. EBF is beneficial to the health and wellbeing of infants and mothers [3]. Since varying levels of interventions, giving due emphasis to key messages of exclusive breastfeeding, are being given both at health institution and community level
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