Background

Breastfeeding rates are progressively increasing worldwide while optimal breastfeeding practices are lagging behind, especially in rural and low resource settings like India.

Objectives

This study estimated the prevalence of and factors associated with suboptimal breastfeeding practices among mother-infant dyads in rural southern India.

Methods

This is a cross-sectional analysis of data collected in Mysore District from 2008-2011 from 1294 mother-infant dyads. All women answered an interviewer-administered survey, which included maternal, infant, and sociodemographic information and breastfeeding-related characteristics. Logistic regressions were conducted to determine factors associated with suboptimal breastfeeding practice.

Findings

About 20% (n = 281) of mothers reported delayed initiation of breastfeeding. Mothers who were unsatisfied with the infant's gender had higher odds of delayed breastfeeding (adjusted odds ratio [AOR]: 1.42, 95% confidence interval [CI]: 1.00, 2.00). Odds of delayed initiation were significantly lower among mothers who received 7-10 antenatal checkups (AOR: 0.59, 95% CI: 0.41, 0.87) and assistance during breastfeeding (AOR: 0.73, 95% CI: 0.57, 0.95). About half (51.4%) the sample did not breastfeed exclusively for the first 6 months. Older age was associated with lower odds of nonexclusive breastfeeding (AOR: 0.95, 95% CI: 0.92, 1.00). Compared with mothers with no education, mothers with primary education (AOR: 1.94, 95% CI: 1.35, 2.79) or more than primary education (AOR: 1.58, 95% CI: 1.10, 2.26) had higher odds of nonexclusive breastfeeding.

Conclusions

Optimal breastfeeding practices were influenced by a multitude of factors, including maternal age, education, number of antenatal checkups, receiving assistance with breastfeeding, and satisfaction with the infant's gender. Health promotion efforts should focus on encouraging mothers to attend antenatal care visits. Early antenatal education and counseling should include breastfeeding education in early antenatal visits. Further research should examine how to mitigate the effect of gender preference on initiation of breastfeeding.