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

Abstract

Objective: 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). Methods: 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). Results: 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’. Conclusions: 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.