For decades, breastfeeding has been regarded as one of the most effective public health interventions for improving infant survival and maternal health. Yet recent findings from the National Family Health Survey (NFHS) suggest that breastfeeding practices in India are showing signs of decline in certain indicators, raising questions that extend beyond infant nutrition alone.

The issue is not merely whether babies are being breastfed. It is whether mothers are receiving adequate support during the weeks and months following childbirth. A fall in breastfeeding rates often reflects larger gaps in postnatal care, an area that continues to receive less attention than pregnancy and delivery.

The postpartum period is a phase of significant physical and emotional adjustment. While antenatal visits and institutional deliveries have improved considerably across India, many women continue to navigate the early weeks after childbirth with limited access to professional guidance. Challenges such as breast pain, poor latch, delayed milk production, sleep deprivation, fatigue, anxiety and recovery from childbirth can directly affect breastfeeding practices.

According to the World Health Organization (WHO), exclusive breastfeeding for the first six months provides all the nutrition an infant requires while reducing the risk of diarrheal diseases, respiratory infections and several childhood illnesses. Breast milk also contains antibodies and bioactive components that help strengthen the developing immune system.

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For mothers, breastfeeding is associated with several health benefits, including:

  • Faster uterine recovery after childbirth
  • Reduced postpartum bleeding
  • Lower risk of breast cancer
  • Lower risk of ovarian cancer
  • Reduced likelihood of developing type 2 diabetes later in life

The consequences of inadequate breastfeeding support can be significant. Early discontinuation may increase the risk of infections and hospitalisations in infants, particularly during the first year of life. For mothers, unresolved breastfeeding difficulties can contribute to emotional distress, feelings of inadequacy and worsening postpartum anxiety.

Several factors appear to be contributing to the challenge.

  1. Limited postnatal follow up: The first few weeks after delivery are often when breastfeeding difficulties emerge. However, many women receive minimal structured follow up once discharged from hospital. Without timely intervention, manageable concerns can become reasons for discontinuing breastfeeding.
  2. Growing nuclear family structures: Traditional support systems that previously assisted new mothers are becoming less common in urban settings. Many women are expected to manage newborn care with limited practical help, increasing physical and emotional strain during the postpartum period.
  3. Workplace pressures: Although maternity leave provisions exist, many women employed in informal sectors or demanding work environments face pressure to return to work early. Lack of dedicated breastfeeding spaces and inadequate facilities for expressing and storing breast milk can further complicate continuation.
  4. Mental health concerns: Postpartum depression and anxiety can directly influence breastfeeding outcomes. International studies have consistently demonstrated a bidirectional relationship, where mental health challenges may affect breastfeeding success, while unresolved breastfeeding difficulties can worsen psychological distress.
  5. Misinformation and unrealistic expectations: The widespread availability of online information has created awareness but has also contributed to confusion. Many mothers may assume breastfeeding should occur naturally and effortlessly. When difficulties arise, delays in seeking professional guidance are common.

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Strengthening postnatal care requires viewing breastfeeding as part of a broader maternal health framework rather than an isolated feeding practice. Key areas that warrant greater attention include:

  • Routine access to trained lactation consultants during the immediate postpartum period
  • Scheduled postnatal consultations focused on feeding, maternal recovery and emotional wellbeing
  • Screening for postpartum depression and anxiety
  • Workplace policies that support breastfeeding continuation
  • Greater involvement of partners and family members in postnatal counselling
  • Community-based awareness programmes that address common breastfeeding concerns

The NFHS -6 India data about declining breastfeeding rates offers an important insight into how effectively mothers are being supported after childbirth. When breastfeeding rates fall, it often signals unmet needs during one of the most vulnerable phases of a woman's healthcare journey.

(By Dr Mohini Soni, Senior Consultant, Obstetrics & Gynaecology, Fortis La Femme)



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