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Commentary
Early initiation of breast feeding on the rise in India
  1. Víctor M Aguayo1,
  2. Gagan Gupta2,
  3. Gayatri Singh2,
  4. Rakesh Kumar3
  1. 1United Nations Children's Fund (UNICEF) Regional Office for South Asia, Kathmandu, Nepal
  2. 2UNICEF Country Office, New Delhi, India
  3. 3Ministry of Health and Family Welfare, New Delhi, India
  1. Correspondence to Dr Víctor M Aguayo; vaguayo{at}unicef.org

https://doi.org/10.1136/bmjgh-2016-000043

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    Summary Box

    • In India, a multipronged strategy including large scale programmes, effective capacity building initiatives, strong partnerships, community-based action, and strategic mass media communication led to an increase in the rates of early initiation of breastfeeding from 24.5% in 2006 to 44.6% in 2014 (i.e. a 1.8-fold increase).

    • In the seven states of India with the highest burden of neonatal mortality, the combined rate of early initiation of breastfeeding increased from 12.5% in 2006 to 34.4% in 2014 (i.e. a 2.7-fold increase).

    • But there is room for further improvement – in 2014, 81.1% of deliveries were attended by a skilled health provider, while only 44.6% of newborns were breast fed within 1 hour of birth, indicating that rates of early initiation of breast feeding could double if all newborns delivered by a health provider were breast fed within 1 hour of birth.

    • There is an urgent need to continue to strengthen national and state policies, hospital and maternity practices, and the knowledge and skills of birth attendants—physicians, midwives and nurses—to support early initiation of breast feeding as a key component of essential newborn care.

    In India, 1.2 million children aged 0–59 months die yearly. An estimated 58% of these deaths occur during the neonatal period (ie, the first 28 days of life).1 A meta-analysis of three large trials conducted in Ghana, India and Nepal found that early initiation of breast feeding was associated with a 44% lower risk of neonatal mortality (RR 0.56; 95% CI 0.40 to 0.79).2–5 More recently, analyses on a large cohort of almost 100 000 newborns from three large trials in Ghana, India and Tanzania has shown that, compared with infants who initiated breast feeding within the first hour of life, the risk of neonatal death among children who initiated breast feeding between 2 and 23 hours after birth …

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