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Exclusive breastfeeding in India: An ultimate need of infants

DOI:10.18502/npt.v6i1.387
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Shatrughan Pareek at Indian Railway health services
Shatrughan Pareek
  • Indian Railway health services
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Abstract

Breastfeeding is a general method of providing nutritional supplements to young infants and child by breast milk. Early initiation of breastfeeding is very important for the infants. Breastfeeding is the cheapest and simplest method of fulfilling the nutritional needs of infant. Poor infant feeding practices and its effects is an obstacle in desirable growth and development of the infant. Exclusive breastfeeding (EBF) is a method of providing only breast milk to infant up to 6 months age. There are lots of intrinsic and extrinsic factors which affect EBF. The prevalence of EBF is too low at global level. In the world, prevalence of EFB is 30-50% but it is 54.9% in India. The cultural, religious and geographic differences create wide range of EBF in India and it’s around 35.8-77.2%. The Exclusive breastfeeding is effective in decline the incidence of communicable and non-communicable diseases among infants which reduce the morbidity and mortality among infants. The prevalence of EBF is below the proposed level so there is a need of effective breastfeeding program in India. Special focus is needed in the area where prevalence of EBF is poor. National Family Health Survey (NFHS-4) revealed that there is a positive trend in India towards EBF. Social support and EBF program are needed to develop a positive attitude towards EBF and it will change the current scenario and reduce the disease burden among infants.
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Please cite this article as: Pareek S. Exclusive breastfeeding in India: An ultimate need of infants. Nurs Pract Today. 2019; 6(1):416-418
Journal of Nursing Practice Today
Narrative Review Article
Exclusive breastfeeding in India: An ultimate need of infants
Shatrughan Pareek
Department of Medicine, Northern Western Railway Divisional Hospital, Bikaner, Rajasthan, India
ARTICLE INFO
ABSTRACT
Received 06 November 2018
Revised 11 December 2018
Accepted 15 December 2018
ePublished 13 January 2019
Published 07 March 2019
Available online at:
http://npt.tums.ac.ir
Breastfeeding is a general method of providing nutritional supplements to young
infants and child by breast milk. Early initiation of breastfeeding is very important for the
infants. Breastfeeding is the cheapest and simplest method of fulfilling the nutritional needs
of infant. Poor infant feeding practices and its effects is an obstacle in desirable growth and
development of the infant. Exclusive breastfeeding (EBF) is a method of providing only
breast milk to infant up to 6 months age. There are lots of intrinsic and extrinsic factors
which affect EBF.
The prevalence of EBF is too low at global level. In the world, prevalence of EFB is
30-50% but it is 54.9% in India. The cultural, religious and geographic differences create
wide range of EBF in India and it’s around 35.8-77.2%. The Exclusive breastfeeding is
effective in decline the incidence of communicable and non-communicable diseases among
infants which reduce the morbidity and mortality among infants.
The prevalence of EBF is below the proposed level so there is a need of effective
breastfeeding program in India. Special focus is needed in the area where prevalence of EBF
is poor. National Family Health Survey (NFHS-4) revealed that there is a positive trend in
India towards EBF. Social support and EBF program are needed to develop a positive
attitude towards EBF and it will change the current scenario and reduce the disease burden
among infants.
Key words:
breastfeeding;
exclusive breastfeeding;
India;
prevalence;
infant
Introduction
1
Breastfeeding is a normal method of
providing nutrition to young infant by
breast milk. Breast feeding is the first
fundamental right of the child and it
provides a unique basis for the physical and
mental development of the child. According
to the WHO, Breastfeeding is equally
beneficial for the mother and the infant. It
should be initiated within 1hour of birth.
Breastfeeding is an important way of
providing ideal food for the better growth
and development of infants (1, 2). Infant
receive all the necessary nutritional
supplements from the mother via breast
milk. In India, breastfeeding practices are
affected by socio-cultural practices,
of Medicine, Northern Western Railway Divisional Hospital, Bikaner,
Rajasthan, India. Email: shatrughan.pareek@gmail.com
psychological status, literacy and residence.
Breastfeeding alone is more than enough to
fulfill the nutritional needs of infant for first
6 months. Breastfeeding is equally important
and beneficial for not only infant but also for
the mother (3). Exclusive breastfeeding
(EBF) is an optimal part of the breastfeeding.
According to the WHO, exclusive
breastfeeding is an important way of feeding
infants less than six months age. In EBF, no
top food is give in to the infant but
medicines and vitamin supplements are
allowed. EBF has a positive outcome on
child’s health but still it’s not in generalized
(4). There are lots of external and internal
factors, which affect EFB. These factors are
Socio-economic status, Religion and
religious values, Place of living (Rural),
Poor Social awareness, Cultural aspects,
Psychological aspects, Mother’s
employment, Mother’s health status
Tehran University of Medical Sciences
*Corresponding Author: Shatrughan Pareek, Postal Address: Department
Exclusive breastfeeding in India: An ultimate need of infants
Nursing Practice Today. 2019;6(1):416-418.
417
Lactation failure, Early weaning and. Lack
of social support system (5,6,7).
Exclusive breastfeeding is vital for
the newborn. There are lots of factors
behind the exclusive breastfeeding
practices. Various studies have been done
regarding initiation and duration of EBF.
Lack of EBF practice is a global concern.
The WHO estimated that nearly 2, 20000
children could be saved every year with
EBF (1). The prevalence of EFB is around
30-50% worldwide. In India, the prevalence
of EBF is little bit better than global level.
National family health survey (NFHS) has
released the data regarding EBF (5). As per
NFHS-3, prevalence of EFB was 46.4% but
there was a good hike in NFHS-4 and now
it is 54.9% (7). NFHS-4 reported that nearly
33% of all districts of India have 60%
prevalence of EBF. POSHAN has revealed
that prevalence of EBF is varying in India
and the rate was 35.8-77.2% (5). In 10th five
year plan, it is proposed to take EBF rate
around 80% (8). Various studies have been
done regarding prevalence of EBF in India.
Pooja et al reported that prevalence of EBF
was 63.4% in Karnataka (6) and Uma Devi
& Rashmi GP revealed that it was only
38% in Tamil Nadu (9). Shankar S. and SS
Balamuruga explore that EBF was 34% in
Tamil Nadu (10). The variation of
prevalence is due to spiritual, geographic
and cultural differences in India and these
all factors affect directly and indirectly
EBF.
Discussion
A study was conducted at KIMS,
Hubli to assess the breastfeeding practices
among 112 postnatal mothers. Data
collection was done by self-administered
questionnaire. The study revealed that
63.4% of the infants received EBF. The
main causes of early weaning were
unsatisfactory growth and lactation failure.
Only 24.1% infants were given pre-lacteal
feed. The study recommended need of
providing information regarding EBF to
women during prenatal and antenatal visits
(6). The investigators communicated that
only 34% children were exclusively
breastfed and 60.5% women initiated early
breastfeeding in Salem district, Tamil Nadu.
The main factor for giving bottle feed was
insufficient breast milk secretion. The study
revealed that socio-demographic factors had
a direct impact on EBF. The researchers
suggested promotion of EBF in the area to
enhance the prevalence of EBF (9).the
researchers revealed that in Tamil Nadu
among 250 women having children up to 3
years age. The prevalence of EBF was
38.8%. Only one third children were
breastfed within one hour after birth. The
mothers have poor knowledge regarding
EBF. The researchers advised that health
education camps and awareness programs
regarding EBF are needed for the mothers
and their family members (10).
Benefits of Exclusive breastfeeding:
benefits of breastfeeding depend on the
initiation of breastfeeding, its duration and
weaning process.
EBF is helpful in prevention of
following diseases and morbid conditions
(3,4, 6)
Conclusion
Breastfeeding is among the most
concern aspects at global level. It is a
process of giving nutrition to infant. The
early initiation and duration of
breastfeeding is very important for the
infant and the mother. Poor infant feeding
practices are an obstacle in proper growth
and development of infant. In EBF, only
breast milk is given to infant up to six
months. False beliefs and myths regarding
EFB practice are present in the country
which declines the practice. The prevalence
of EBF is around 38% at global level but in
India it is 54.9%. EFB is vital for the infant
because it decreases the morbidity and
mortality rate among the infants (11,12). It
may decrease the disease burden among
infants and children. In India, prevalence of
EBF is low so more focus is needed on
promotion of EBF. More attention is
needed on nutritional intervention and
breast feeding activities to enhance EBF.
Desirable psycho-social and health
development of infant may be achieved by
Exclusive breastfeeding in India: An ultimate need of infants
Nursing Practice Today. 2019;6(1):416-418.
418
promotion of EBF. Specific actions are
needed for poor EBF areas and the mothers
to enhance the breastfeeding. To increases
the rate of EBF, a sound EBF program is
necessary to change the current scenario in
India.
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References
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  • Jul 2021
In recent decades, as women entered the US workforce in increasing numbers, they faced the conundrum of how to maintain breastfeeding and hold down full-time jobs. In 2010, the Lactation at Work Law (an amendment to the US Fair Labor Standards Act) mandated accommodations for lactating women. This book examines the federal law and its state-level equivalent in Indiana, drawing on two waves of interviews with human resource personnel, supervising managers, and lactating workers. In many ways, this simple law - requiring break time and privacy for pumping - is a success story. Through advocacy by allies, education of managers, and employee initiative, many organizations created compliant accommodations. This book shows legal scholars how a successful civil rights law creates effective change; helps labor activists and management personnel understand how to approach new accommodations; and enables workers to understand the possibilities for amelioration of workplace problems through internal negotiations and legal reforms.
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ASSOCIATION OF INFANT FEEDING PRACTICES AND FOOD NEOPHOBIA AMONG PRE-SCHOOL CHILDREN IN OROGUN COMMUNITY, IBADAN
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  • Oct 2021
This study determined food neophobia (FN) and the relationship of infant feeding practice (IFP) and (FN) among pre-school children in Orogun community, Ibadan. Three hundred and seventy mothers of pre-school children were chosen using a systematic random sampling technique from a pre-survey house to house list of eligible children. A semi-structured questionnaire that included socio-demographic characteristics, retrospective breastfeeding practice, retrospective complementary feeding practice (CFP) and FN scales were used to collect information. Data were analyzed using descriptive and logistic regression. The exclusive breastfeeding (EBF) rate was 26.8% and 38% of the mothers had a good breastfeeding practice. Timely initiation of complementary feeding was 54%. The prevalence of FN was 35%. Logistic regression analysis showed that the odds for FN was higher among children who were initiated to breastfeeding late (OR = 1.45, 95% CI: 0.886 – 2.31), children that were not breastfed on demand (OR = 1.766, 95% CI: 0.925 – 3.372), those not exclusively breastfed for six months (OR = 1.366, 95% CI: 0.834 – 2.240) and children introduced to complementary food before 6 months (OR = 1.473, 95% CI: 0.787 – 2.760). Most rejected foods were from the fruits and vegetable group. There were suboptimal IFP in the study and prevalence of FN was high. Poor IFP were associated with FN. Community-based nutrition education programs should be encouraged to improve IFP.
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Background: An exclusive breastfeeding for 6 months and an extended breastfeeding for 24 months protects the infant from infectious disease and promotes child spacing. Therefore, the knowledge, attitude and practice about infant and child feeding is important to overcome morbid conditions prevailing among mothers and her child. The present study aimed at investigating the factors influencing an exclusive breastfeeding among currently married tribal women in Jharkhand, India.Methods: A cross sectional study was conducted among the 919 currently married Santal, Oraon, Mahli and Ho women in the age group of 15-29 years from forty villages of Purbi Singhbhum district of Jharkhand using interview schedule method.Results: The mean duration of exclusive breastfeeding and breastfeeding up to 24 months was found to be 4.1 and 12.9 months respectively. Also, not much difference in the average duration of exclusive breast feeding was found between working and non-working women. The results of multinomial regression showed maternal age (OR=1.92, p<0.05), place of delivery (OR=2.3, p<0.05), distance from health facility (OR=4, p<0.01) and sex of last child born (OR=2.5, p<0.01) among the significant determinants for exclusive Breastfeeding.Conclusions: The duration and initiation of breastfeeding in a marginalised society depends to a great extent on how family members participate and decide on the type of feeding for new-borns. Also, several public health education campaigns should be launched aiming at increasing the familiarity of family relations on exclusive breastfeeding.
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  • Dec 2015
Background: Exclusive 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. Methods: Data 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. Results: Overall 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. Conclusions: The 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.
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Importance of Exclusive Breastfeeding and Complementary Feeding among Infants
Article
Full-text available
  • Aug 2014
The aim of this review is to document the advantages of exclusive breastfeeding along with concerns which may hinder the practice of breastfeeding and focuses on the appropriateness of complementary feeding and feeding difficulties which infants encounter. Breastfeeding, as recommended by the World Health Organisation, is the most cost effective way for reducing childhood morbidity such as obesity, hypertension and gastroenteritis as well as mortality. There are several factors that either promote or act as barriers to good infant nutrition. Factors which influence breastfeeding practice in terms of initiation, exclusivity and duration are namely breast engorgement, sore nipples, milk insufficiency and availability of various infant formulas. On the other hand, introduction of complementary foods, also known as weaning, is done around 4 to 6 months and mothers usually should start with home-made nutritious food. Difficulties encountered during the weaning process are often refusal to eat followed by vomiting, colic, allergic reactions and diarrhoea.
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The Risk of Not Breastfeeding for Mothers and Infants
Article
Full-text available
  • Oct 2009
Health outcomes in developed countries differ substantially for mothers and infants who formula feed compared with those who breastfeed. For infants, not being breastfed is associated with an increased incidence of infectious morbidity, as well as elevated risks of childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden infant death syndrome. For mothers, failure to breastfeed is associated with an increased incidence of premenopausal breast cancer, ovarian cancer, retained gestational weight gain, type 2 diabetes, myocardial infarction, and the metabolic syndrome. Obstetricians are uniquely positioned to counsel mothers about the health impact of breastfeeding and to ensure that mothers and infants receive appropriate, evidence-based care, starting at birth.
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Prevalence of exclusive breastfeeding practices among rural women in Tamil Nadu
Article
  • Jan 2012
Background: Poor infant feeding practices and their consequences are one of the world′s major problems and a serious obstacle to social and economic development. Various studies have shown that infant feeding could be influenced by socioeconomic status, maternal education, place of living and many other factors. Hence a prevalence study on exclusive breastfeeding was conducted in rural Tamil Nadu. Aim and Objective: To assess the prevalence of exclusive breastfeeding practices and the factors influencing them among women in a rural area in Tamil Nadu. Materials and Methods: It is a cross-sectional study conducted in Attyampatti Panchyat Union, Salem district, Tamil Nadu, from March 2011-June 2011. All the 291 children in the age group of six months to two years in Attyampatti Panchayat Union were included in the study, irrespective of any sample. The data was analyzed using SPSS package. Results: Among the study population 52.6% were male children and 47.4% were females. Only 99 (34%) children were exclusively breastfed for six months. The majority of women (60.5%) initiated breastfeeding within half an hour after delivery. Various demographic factors like the education of the mother, type of delivery, type of family, occupation, number of children, monthly income, family size, age at marriage and religion had a direct influence on exclusive breastfeeding, which in turn influenced the weight of the baby and immune status of the child. Most of the mothers (44.7%) inferred that the main reason for giving bottle feed is because of inadequate breast milk secretion. Conclusion: The prevalence of exclusive breastfeeding is low in this particular area. Hence promotion of exclusive breastfeeding and focus on the factors affecting them is highly warranted in this area.
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World health organization, Regional office for South-east Asia. The optimal duration of Exclusive breastfeeding: a systematic Review
  • Jan 2002
  • J Clin Med Res
  • 102-108
  • B Abhay
  • Kavishwar
Abhay B Kavishwar. Determinants of Exclusive Breastfeeding in South Gujarat Region of India. J Clin Med Res. 2009;1(2):102-108. 2. World health organization, Regional office for South-east Asia. The optimal duration of Exclusive breastfeeding: a systematic Review. 2002
Factors Influencing Exclusive Breastfeeding Up To Six Months of Age in a Rural Community of North
  • P Basu
  • A Chakrabartty
  • U Dasgupta
  • K Bhattacharyya
  • K M Ali
Basu P, Chakrabartty A, Dasgupta U, Bhattacharyya K, Ali KM, et al. Factors Influencing Exclusive Breastfeeding Up To Six Months of Age in a Rural Community of North
  • Jan 2018
  • 181
  • India Parganas
Parganas, India. Indian J Nutri. 2018;5(1): 181.