Strengthening Adherence to Early Initiation of Breastfeeding and Exclusive Breastfeeding

This project aims to strengthen adherence to Early Initiation of Breastfeeding and Exclusive Breastfeeding through a behavioural approach. Through diagnostic research, we identified behavioural barriers and the underlying decision-making norms, biases and cultural and emotional influences around breastfeeding decisions. Using this foundational understanding and behavioural science principles, we are designing interventions to help families navigate those barriers and sustain their commitment to the practices. We will work closely with government partners to evaluate these.

The practice of breastfeeding is a cost-effective and crucial protective measure against the leading causes of morbidity and mortality for children under the age of 5 years. Multiple government initiatives over the years have successfully supported improving rates of breastfeeding. But recent NFHS-V data shows a stagnation (and, in some cases, a decline) in breastfeeding indicators. The current national rate of EBF is 63.7%, while that of EIBF is 41.8%; in UP, the current EBF rate stands at 59.7%, and that of EIBF is 23.9%. In such a case, having a targeted behavioural science approach to address these barriers can provide a powerful pathway.

To understand the current challenges related to performing the desired behaviours of EBF and EIBF, we conducted a literature review and policy review, studied findings from other organisations, and conducted a deeper inquiry through a qualitative field diagnostic. The field research explored the context, influences and barriers and was conducted in Chitrakoot, Fatehpur and Varanasi districts of Uttar Pradesh. Our key finding for Early Initiation of Breastfeeding (EIBF) is that in order to initiate greater compliance with it, we need to focus on ways to make EIBF a supported, normative and planned behaviour. The vulnerable nature of the circumstance of EIBF (point of delivery) indicates the need for women to be supported, which currently is not consistently being provided due to the low staff-nurse-to-patient ratio in government institutions.

In order to initiate greater compliance to Exclusive Breastfeeding (EBF) practices, there is a need to increase the salience of negative consequences of deviations and actively recognise the points of deviations (such as triggers to the provision of supplements and the practice of micro-dosing) Since child care such as breastfeeding is influenced by household norms, there is a need to shift current household norms, and include influential women of the household in counselling as well.

Our report, Behavioural Diagnostic Report on Practices of Early Initiation and Exclusive Breastfeeding in districts of Uttar Pradesh provides further details on the context, methods and details around these findings.

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