BREASTFEEDING AND COMPLEMENTARY FEEDING:

SITUATION IN INDIA

DR. SHRIRAM V GOSAVI PG COMMUNITY MEDICINE DEPT.

MGIMS, SEVAGRAM

GLOBAL RECOMMENDATIONS FOR INFANT AND YOUNG CHILD FEEDING

Initiation of early BF

Exclusive breastfeeding

Introduction of Complementary feeding

RISK OF NEONATAL MORTALITY ACCORDINGTO TIME OF INITIATION OF BF

If increasing delay in initiation of breastfeeding

American Academy of Pediatrics Overall late initiation (after day 1) was associated with a 2.6-fold

risk of death from infectious disease

Partial breastfeeding during first month associated with 6 fold adjusted risk of death from infectious disease

Source: Pediatr, 2005; 115:496–506.

U-5 Deaths & Breastfeeding

PROGRESS IN EXCLUSIVE BREASTFEEDING RATES IN <6 MTHS OLD CHILD IN WORLD

AFRICA ASIA DEVELPOING COUNTRIES

05

1015202530354045

26

383332

4237

AROUND 1996 AROUND 2008

TRENDS IN THREE INDICATOR OF Breastfeeding IN INDIA

020406080

15.841.2 3524.5

46.4 56.750

80 75

NFHS-2 (98-99) NFHS-3 (2005-06) Tenth Plan Goal

State wise situation of early initiation of Breastfeeding with in 1 hr, NFHS-3 (2005-06)

Mizoram

Goa

Tamil Nadu

Maharashtra

Jharkhand

Uttar Pradesh

Bihar

India

Tenth Plan Goal

0 10 20 30 40 50 60 7066.4

59.4

58.8

52

10.7

7.3

3.7

24.5

50

Early initiation of Breastfeeding & education of mother, NFHS-3 (2005-06)

0

20

40

60

80

1627.6 27 31.6 33 33.516.7

28.628

33 34.4 34.643.161.4 61.8 67.7 69.8 71.6

With in half an hour of birth With in one hour of birthWith in one day of birth

Early initiation of breastfeeding & wealth status, NFHS-3 (2005-06)

Lowest Secondary Middle Fourth Highest Total01020304050607080

17 19.725 27.7 31

23.617.9 20.6 2629 32 24.5

45.3 4757

64.4 68.7

55.3

Within half an hour of birth Within one hour of birth Within one day of birth

Early initiation of breastfeeding & the place of delivery, NFHS-3 (2005-06)

Health facility At home01020304050607080

33

16.9

34

17.8

71.3

44.1

With in half an hour of birth With in one hour of birthWith in one day of birth

State wise situation of Exclusive Breastfeeding (0-6 Mths), NFHS-3 (2005-06)

Chhattisgarh

Assam

Andhra Pradesh

Maharashtra

Madhya Pradesh

Goa

Haryana

India

Tenth Plan Goal

0 10 20 30 40 50 60 70 80 9082

63.1

62.1

53

21.6

17.7

16.9

46.4

80

State wise situation of complementary feeding (6-9 Mths), NFHS-3 (2005-06)

Kerala

Sikkim

Mizoram

Maharashtra

Uttar Pradesh

Hryana

Rajasthan

India

Tenth Plan Goal

0 10 20 30 40 50 60 70 80 90 10093.6

89.6

84.6

47.8

45.5

44.8

38.7

56.7

75

POSSIBLE REASONS FOR SUBOPTIMAL BREASTFEEDING & COMPLEMENTRY FEEDING

Lack of proper information to mothers Lack of counseling on feeding of infants Lack of proper feeding skill’s Inadequate health care support Inability of health care providers to help mothers experiencing

breastfeeding difficulty Aggressive promotion of baby foods by commercial

industries & Lack of proper support structures at community & work place

like maternity entitlements & crèches

References National Family Health Survey - 3. International Institute for

Population Sciences. Available at: http://www.nfhsindia.org/nfhs3_national_report.html

WHO/UNICEF Global Strategy for Infant and Young Child Feeding, World Health Organization (WHO), 2002. Available at: http://www.who.int/child-adolescent health/NUTRITION/ global_strategy.htm American Academy of Pediatrics. Section on breastfeeding -

Breastfeeding and the use of human milk. Pediatr 2005; 115: 496–506.

Dr. Arun Gupta et al. Breastfeeding and Complementary Feeding as a Public Health Intervention for Child Survival in India,

Indian Journal of Pediatric, Jan-2010.