Expert SpeakHealth Express
Published on Aug 07, 2026
India has built a strong breastfeeding policy framework, but declining exclusive breastfeeding rates show that implementation—not policy design—is now the critical gap
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As India charts its course towards becoming a developed nation by 2047, conversations around human capital have largely centred on education, digital innovation, skills, and employment. Yet, one of the country’s most transformative investments starts in the first hour after birth. The theme of World Breastfeeding Week (WBW) 2026, “Breastfeeding for a Sustainable Start in Life: Strengthen What Works”, offers an important policy message. The evidence is no longer in question. Breastfeeding saves lives, improves cognitive development, strengthens economies, reduces health-care costs, and contributes to environmental sustainability. The challenge today is not discovering new interventions but ensuring that proven interventions reach every mother and every child equitably. The World Health Organization (WHO) emphasises that the priority should now be to scale evidence-based interventions through stronger health systems, supportive workplaces, community engagement, and sustained political commitment rather than relying solely on awareness campaigns.
India has made remarkable gains in maternal and child health over the past decade through initiatives such as POSHAN Abhiyaan, the National Health Mission, Home-Based Newborn Care, and expanded institutional deliveries. However, the recently released National FamilyHealth Survey (NFHS-6, 2023–24) reveals that despite improvements across several health indicators, one of the country’s most effective child survival interventions is losing momentum. Exclusive breastfeeding among infants below six months declined from 63.7 percent in NFHS-5 (2019–21) to 55.8 percent in NFHS-6 (2023–24), while early initiation of breastfeeding increased modestly to around 50 percent, remaining well below universal coverage. These findings suggest that improvements in service coverage alone cannot guarantee optimal infant feeding practices unless breastfeeding support is embedded throughout the continuum of maternal and newborn care.
Breastfeeding is the world’s first sustainable food system. It is locally produced, nutritionally complete, safe, renewable, and requires no packaging, transportation, refrigeration, or waste disposal. The WHO increasingly frames breastfeeding not merely as a child survival strategy, but as an essential component of sustainable food systems and resilient health systems. Breastfeeding is also a child’s first immunisation, as breast milk contains antibodies, immune cells, enzymes, hormones, and bioactive compounds that protect infants against diarrhoea, pneumonia, and numerous infectious diseases. The WHO estimates that optimal breastfeeding could prevent nearly 400,000 deaths among children under five each year, while undernutrition contributes to nearly 45 percent of child deaths globally.
Breastfeeding has been recognised as one of the highest-return investments in human capital because its benefits extend well beyond infancy
Breastfeeding has been recognised as one of the highest-return investments in human capital because its benefits extend well beyond infancy.Evidence synthesised by The Lancet demonstrates that breastfed children have lower risks of infectious diseases during childhood, a reduced likelihood of obesity and type 2 diabetes later in life, and improved cognitive performance. Longer periods of breastfeeding have been associated with higher intelligence scores, improved school readiness, better educational attainment, and increased lifetime earnings. These developmental gains accumulate across populations, strengthening labour productivity and national economic growth. For India, where nearly one-fifth of the world’s children reside and where demographic advantage is expected to drive future economic expansion, these benefits carry substantial weight.
WHO highlights that investments in breastfeeding support of US$1 can generate returns of US$59, along with reduced health-care costs, improved educational outcomes, and enhanced workforce productivity. Breastfeeding also benefits women across the life course and lowers risks of breast cancer, ovarian cancer, and type 2 diabetes, while also supporting improved postpartum recovery. These maternal health gains further reduce health-care expenditure and strengthen family well-being, reinforcing breastfeeding as a population-level public health intervention rather than solely an individual maternal choice.
The WBW 2026 theme deliberately shifts the conversation from promotion to implementation. The evidence is unequivocal: countries do not need new breastfeeding interventions; they need to strengthen those that have already proven effective. India has built one of the world’s most comprehensive policy ecosystems supporting breastfeeding. The Integrated Child Development Services (ICDS), Pradhan Mantri Matru Vandana Yojana, National Health Mission, Janani Suraksha Yojana, and Infant and Young Child Feeding (IYCF) guidelines collectively provide a strong policy foundation. The country also enacted one of the strongest legal frameworks globally through the Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) Act (IMS Act), restricting inappropriate marketing of breast-milk substitutes. Yet policies alone do not guarantee outcomes.
Countries do not need new breastfeeding interventions; they need to strengthen those that have already proven effective
WHO’s evidence review released for WBW 2026 demonstrates that these interventions work. Skilled breastfeeding counselling delivered across health facilities, households, and communities increases exclusive breastfeeding rates by 58 percent. Implementation of the Baby-Friendly Hospital Initiative increases exclusive breastfeeding at six months by 45 percent, while paid maternity leave is associated with a 52 percent increase in exclusive breastfeeding. Countries that effectively implement the International Code of Marketing of Breast-milk Substitutes report notably higher breastfeeding rates than countries with weak legislative enforcement.
The most effective interventions remain notably consistent. They include initiating breastfeeding within one hour of birth, exclusive breastfeeding for the first six months, and continued breastfeeding alongside complementary feeding until two years and beyond. Equally important are skilled lactation counselling during antenatal and postnatal care, implementation of the Baby-Friendly Hospital Initiative (BFHI), and community-based support through Accredited Social Health Activists (ASHAs), Auxiliary Nurse Midwives (ANMs), Anganwadi workers, and mother support groups.
Despite a strong policy architecture, the latest evidence suggests that India is entering a new phase of the breastfeeding challenge, one where coverage of maternal health services has improved, but continuity of breastfeeding support remains inadequate. The decline in exclusive breastfeeding reported by NFHS-6 underscores that breastfeeding is no longer primarily an issue of awareness; it is a systems challenge that requires coordinated action across health, labour, nutrition, social protection, and digital governance.
India also faces emerging challenges arising from rapid urbanisation, rising female labour force participation, the growth of nuclear families, and changing employment patterns. Maternity protection has not kept pace with these shifts. The Maternity Benefit (Amendment) Act, 2017, which provides 26 weeks of paid maternity leave, is among the most progressive globally — yet its benefits remain confined largely to women employed in the organised sector.
Nearly 90 percent of India’s women workers are employed in the informal economy, where maternity protection, paid leave, breastfeeding breaks, and workplace childcare remain largely inaccessible. Expanding maternity protection through social protection mechanisms and creating breastfeeding-friendly workplaces are therefore critical if India is to sustain breastfeeding while also increasing women’s labour-force participation.
As India advances towards the vision of Viksit Bharat 2047, strengthening breastfeeding should be recognised as an investment in national development itself
Equally concerning is the growing influence of digital marketing by manufacturers of breast milk substitutes. The IMS Act operationalises many provisions of the International Code of Marketing of Breast-milk Substitutes. However, online advertising, influencer marketing, and cross-border digital promotions increasingly circumvent conventional regulatory mechanisms. WHO and the United Nations Children’s Fund (UNICEF) continue to call for stronger monitoring and enforcement of the Code, particularly in digital environments where parents are increasingly exposed to commercial messaging.
The next phase should focus on improving implementation quality and ensuring equitable access across states and socioeconomic groups. As India advances towards the vision of Viksit Bharat 2047, strengthening breastfeeding should be recognised as an investment in national development itself. The science is unequivocal, the policy framework is largely in place, and the interventions are well established. What remains is the political will to scale them equitably, monitor them rigorously, and protect them consistently. The call of World Breastfeeding Week 2026 is therefore not simply to promote breastfeeding, but to strengthen what works.
Shoba Suri is a Senior Fellow with theHealth Initiative at the Observer Research Foundation
The author acknowledges the use of ChatGPT for language editing
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Shoba Suri
Dr. Shoba Suri is a Senior Fellow with ORFs Health Initiative.
Shoba is a nutritionist with experience in community and clinical research. She has worked on nutrition
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Strong Policies, Falling Rates: India’s Breastfeeding Challenge
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Aug 07, 2026
