Socio-cultural determinants of infant and young child feeding practices in rural India

Background: In India, proportion of women initiating timely breastfeeding and practicing exclusive breastfeeding is relatively constant over last decade. There is paucity of information about possible reasons for practice of ideal and recommended IYCF practices not being universal across country, in spite of existence of policy, programme guidelines. To develop and implement contextual intervention for improving the IYCF practices especially in rural India, knowledge about the key determinants; especially sociocultural is essential. The present study is undertaken to assess IYCF practices and study its association with sociocultural factors. Methodology: In this cross-sectional study, 612 women were included. WHO recommended ten guiding principles for IYCF were considered for developing the data collection tool. Respondents were mothers with children in the age group 0 to 23 months. The key outcome variables were timely initiation of breastfeeding, exclusive breastfeeding, timely initiation of complementary feeding and the choice and diversity of food for complementary feeding. Result: Timely initiation of breastfeeding was seen significantly more for female child (62.5%) compared to male (37.5%) (p<0.05). 36.3% exclusively breast feed their babies for a period of six months. Higher schooling and socioeconomic status was significantly associated exclusive breastfeeding (p<0.05). The exclusive breastfeeding rates in male and female infants were 59.5% and 40.5% respectively. Nearly 96 (46.1%) women started complementary feeding at 7 months and of these 50.2% initiated with liquid food like cow milk, lentil soup, and rice water soup. Study also identified a good practice of giving Sattu, a powder prepared from locally available roasted pulses, cereals and groundnuts. Conclusion: The present study highlighted the inadequate practices around early initiation of breastfeeding and exclusive breastfeeding in rural area. It also showed that the feeding decisions are influenced by social and cultural factors and experiences within family and social networks. The current approach to educate women on IYCF practices has limitations, as decision makers related to IYCF at household level are elders in household. There is a need for more comprehensive IYCF promotion program that are socially and culturally acceptable to women from rural area.