Exclusive breastfeeding drops despite rise in institutional births: NFHS-6

By A Representative 

The latest National Family Health Survey (NFHS-6, 2023–24) has raised serious concerns over infant and young child feeding practices in India, with the Breastfeeding Promotion Network of India (BPNI) warning that the sharp decline in exclusive breastfeeding despite high institutional delivery rates should be treated as a national public health priority.

In a statement, BPNI noted that while early initiation of breastfeeding within one hour of birth has improved from 41.8 per cent in NFHS-5 to 50.1 per cent in NFHS-6, the gap between institutional births and breastfeeding support remains wide. India now records nearly 95 per cent institutional births, but exclusive breastfeeding among infants below six months has dropped significantly from 63.7 per cent to 55.8 per cent.

BPNI described the decline as “deeply concerning” and said sustaining exclusive breastfeeding for the recommended first six months is becoming increasingly difficult for mothers. The organisation said the findings demand urgent national attention and public discussion to identify the reasons behind the reversal.

The survey also highlighted concerns over complementary feeding practices. According to the data, only 15.3 per cent of children aged 6–23 months receive a minimum adequate diet, indicating that nearly 85 per cent of young children are not getting nutritionally sufficient complementary feeding. BPNI stressed that improving food diversity, nutrition awareness and feeding practices at the household level remains essential.

While modest improvements have been recorded in stunting and underweight prevalence, child undernutrition continues to remain high. Nearly one in three children is still underweight, and wasting affects almost one in five children. BPNI said feeding practices during the first year of life have a direct bearing on these indicators.

The organisation also expressed concern over the sharp rise in caesarean section deliveries, which increased nationally from 21.5 per cent to 27.2 per cent. In urban areas, caesarean section rates have reportedly reached nearly 40 per cent. According to BPNI, such deliveries often interfere with immediate skin-to-skin contact, early initiation of breastfeeding, rooming-in practices and maternal confidence in breastfeeding. It said inadequate skills among health workers and weak lactation support systems may also contribute to breastfeeding failure after caesarean deliveries.

BPNI alleged that aggressive commercial marketing of infant milk substitutes, commercial baby foods and feeding products is undermining breastfeeding practices in the country. The organisation said digital and indirect marketing of formula products normalises formula feeding and weakens confidence in breastfeeding, while also violating the spirit and provisions of the IMS Act. It claimed that violations of the law are increasing and that authorities rarely take action on reported complaints.

The state-wise findings of NFHS-6 reveal significant regional variations in breastfeeding practices, with some states showing improvement while others recorded steep declines. BPNI said these differences point towards variations in health-system practices, breastfeeding counselling, caesarean rates and exposure to commercial marketing.

Calling the findings a “wake-up call” for policymakers, BPNI said India cannot address child malnutrition without protecting, promoting and supporting breastfeeding and appropriate complementary feeding. The organisation urged the Union and state governments, professional bodies, public health institutions and civil society organisations to rebuild systems that enable mothers to breastfeed successfully.

BPNI called for stronger enforcement of the IMS Act, mandatory breastfeeding counselling and lactation support in all maternity facilities, better support mechanisms during caesarean sections, revitalisation of the government’s MAA programme, improved maternity protection and workplace support, and strengthening of community-based counselling services through frontline health workers and women’s support systems.

The statement was issued by the Breastfeeding Promotion Network of India on May 29, 2026. It was signed by Dr. Arun Gupta, Founder of BPNI, Convenor of Nutrition Advocacy for Public Interest (NAPi), and former member of the Prime Minister’s Council on India’s Nutrition Challenges.