India’s exclusive breastfeeding rate for infants under six months fell from 63.7 per cent to 55.8 per cent between the two most recent National Family Health Surveys, according to data published during World Breastfeeding Week. The 7.9-percentage-point decline, reported by researchers Sonali Mishra and Karan Babbar, marks a reversal of earlier gains and has prompted fresh scrutiny of the barriers that cause mothers to stop breastfeeding early.

Several common but correctable obstacles can undermine breastfeeding, lactation specialists say. In Indonesia, Dr Anastasia Lilian S., a lactation consultant at Rumah Sakit Pondok Indah-Puri Indah, cautioned that forcing milk from engorged breasts through hard pumping can damage breast tissue and raise the risk of mastitis, an infection that may require antibiotics. She recommended gentle massage and cold compresses for engorgement, and warm compresses only when the breast is not painful. In Malaysia, consultant paediatrician Dr Chan Pei Sing noted that tongue-tie – a condition where a tight band of tissue restricts the tongue’s movement – affects 4 to 10 per cent of newborns and can cause painful, ineffective feeding that leads to sore nipples or mastitis. Surgery is not always necessary, she said, as the tissue may lengthen naturally with growth.

Improper storage of expressed breast milk also poses risks. A study by Universitas Airlangga and RSUD Dr. Soetomo found that 76 per cent of expressed milk samples were contaminated with bacteria after two hours at room temperature, and all samples were contaminated after six hours. Paediatric guidelines stress the need for clean containers, clear date labels, and gradual thawing in a refrigerator rather than a microwave.

Mishra and Babbar linked the Indian decline in part to a rise in C-section deliveries, which are associated with delayed initiation of breastfeeding, and to insufficient support services from hospital to workplace. They called for urgent improvements in maternal support. The next milestone will be whether India’s health authorities respond to the NFHS-6 data with targeted interventions to reverse the trend.