The latest report on India’s Breastfeeding and Infant and Young Child Feeding policy and programs was recently launched, offering valuable insights into the country’s practices in this essential health area. The report, the fifth of its kind, was prepared by a collaborative effort of diverse public health groups, including governmental departments, the All India Institute of Medical Sciences (AIIMS), UNICEF, under the umbrella of the World Breastfeeding Trends Initiative (WBTI).
The Key Findings
India’s performance in infant and young child feeding practices is relatively strong, scoring 34 out of a possible 50 across five measurement parameters. However, despite increases in institutional deliveries, six out of 10 newborn infants are still not starting to breastfeed within an hour of birth. This delay is attributed to unsupportive working environments for mothers, shortfalls in healthcare providers’ skills, and high rates of caesarian section deliveries.
There has been some improvement in breastfeeding initiation, which increased from 23.4% to 41.5% within an hour of birth between NFHS-3 in 2005-06 and NFHS-4 in 2015-16. Yet these advances have not maintained pace with the doubling of institutional delivery rates in the same period.
Policy vs Implementation
India’s score for policy and programs is lower than its feeding practices score at 45 out of 100. Despite initiatives for infant and child nutrition from the Ministry of Health and Family Welfare and the Ministry for Women and Child Development, the report indicates that lack of an overarching official policy hampers strategic action plans and budgets.
The WHO and UNICEF Baby Friendly Hospitals Initiative was replaced with the Indian health ministry’s Mother’s Absolute Affection programme. The latter, however, does not offer accreditation to ‘baby-friendly’ hospitals, nor does it apply to private sector facilities where a significant number of births occur.
Regulation and Legislation
India’s regulation of breastmilk substitutes marketing has deteriorated since the last assessment with companies becoming more aggressive due to weak law enforcement. Although India instigated a strong law on infant milk substitutes in 1992, there is a significant lack of government officers to enforce it, resulting in reliance on NGOs to monitor adherence.
Nutrition Standards and Maternity Protection
Progress has been made in maternity protection through the Indian Government’s Maternity Benefits Act, 2017. This Act extended maternity leave from 12 weeks to 26 weeks; however, it fails to cover many women working in the informal sector.
The first hour after birth is critical for newborns to receive their mothers’ colostrum, a nutrient and antibody-rich milk. Sole reliance on breastfeeding up to six months, followed by complementary feeding along with continued breastfeeding up to two years or longer, is advocated by WHO and UNICEF. In addition to children’s health benefits, breastfeeding also lowers the risk of breast and ovarian cancer in mothers and reduces future obesity and diabetes risks in children.
The Way Forward
For India to improve its nutrition standards, it needs to elevate its Infant and Child Feeding guidelines to policy status. Enforcement of the Infant Milk Substitutes Act must be strengthened with better monitoring and stricter action against infringers. Furthermore, the Maternity Benefit Act should provide better support for women in the informal sector, along with a comprehensive application of the Pradhan Mantri Matritva Vandana Yojana.
