Trends in breastfeeding indicators across Indian states and Union Territories (1993-2021): Estimating progress towards the 2030 Global Nutrition Target.

Abstract

Using five waves of National Family Health Survey data (1993-2021), we analyzed trends in six breastfeeding indicators across 36 Indian states and Union Territories (UTs): ever breastfed (EvBF), early initiation of breastfeeding (EIBF), exclusive breastfeeding for the first two days, exclusive breastfeeding for six months (EBF), mixed milk feeding (MixMF), and continued breastfeeding (CBF). We calculated prevalence and Standardized Annualized Change for each indicator. Additionally, we estimated the Required Annualized Change (RAC) to attain the 60% EBF Global Nutrition Target (GNT). Between 1993 and 2021, the prevalence of EvBF and CBF remained consistently high (>95% and > 75%, respectively); meanwhile, EIBF increased from 9.6% to 41.2%, and EBF rose from 43.5% to 63.9%. MixMF increased by nine percentage points, reflecting a deteriorating trend. Positive annualized changes were observed for EIBF (1.05 percentage points) and EBF (0.68 percentage points). RAC estimates revealed that 23 states/UTs have already 'achieved' the 2030 EBF target and are expected to sustain it, while five others remain 'on-target'. Six states/UTs are projected to remain 'off-target'. Heterogeneity in progress across breastfeeding indicators among states/UTs warrants localized interventions. Prioritizing EIBF and reducing MixMF could accelerate EBF gains in 'off-target' states/UTs to meet 2030 targets.