Abstract
Despite efforts to promote infant and young child feeding (IYCF) practices, there is no collective review of evidence on IYCF enablers and barriers in India. This review was conducted using 2015 Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Six computerized bibliographic databases, Scopus, PubMed, PsycINFO, CINAHL, Embase, and Ovid MEDLINE, were searched for published studies on factors associated with IYCF practices in India from 1 January 1993, to 30 April 2020. IYCF practices examined were early initiation of breastfeeding, exclusive breastfeeding, continued breastfeeding at one year, introduction to solid semi-solid or soft foods, minimum dietary diversity, minimum meal frequency, minimum acceptable diet, continued breastfeeding at two years, predominant breastfeeding, and bottle feeding. In total, 6968 articles were retrieved, and 46 studies met the inclusion criteria. The common enablers of IYCF were higher maternal socioeconomic status (SES) and more frequent antenatal care visits (ANC) (≥3). Common barriers to IYCF practices were low SES and less frequent ANC. The review showed that the factors associated with IYCF practices in India are largely modifiable and multi-factorial. Improving IYCF practices would require the adoption of both facilities- and community-based policy interventions at the subnational and national levels in India.
Highlights
We found that middle or high socioeconomic status [18,57,58,61], access to media [24,61], male children [30], high birth order [18,58], high maternal education [30,31,37,57,58], high parity [57], urban residence [18], frequent antenatal care visits (ANC) visits [37,60]
We found that high socioeconomic status [62], high maternal education [63], private hospital birthing [62], and increasing urbanicity [63] were associated with breastfeeding discontinuation before 24 months
Higher socioeconomic status and better media exposure [69] may translate into better awareness about appropriate infant and young child feeding (IYCF) practices, which may in turn influence a mother’s decision to improve child-related health outcomes, including nutrition [70]
Summary
Appropriate infant and young child feeding (IYCF, comprising of breastfeeding and complementary feeding) play important roles in optimal child growth and development. This is because appropriate breastfeeding is associated with a lower prevalence of childhood diarrhea [1,2], upper respiratory tract infection and obesity, and maternal diseases like diabetes mellitus [3]. Higher socio-economic status (North, East), urban women (West), higher birth order (Central), frequent (Eastern and Central) were positively associated. Central, North East), higher maternal education (North, Central), woman’s autonomy over power of earnings (South), higher birth order (North, South, East, West, frequent ANC visits (≥4) (East) were positively associated.
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