Associations between infant and young child feeding practices and diarrhoea in Indian children: a regional analysis

Abstract Background: There are limited data on the association between infant and young child feeding (IYCF) practices and diarrhoea across regional India, to inform policy initiatives and advocacy. The present study examined the association between IYCF practices and diarrhoea in regional India. Method: The study used a weighted sample of 90,596 maternal responses from the 2015-16 National Family Health Survey in India. Prevalence estimates of diarrhoea by IYCF indicators were estimated for each administrative region, namely: North (n=11,200), South (n=16,469), East (n=23,317), West (n=11,512), Central (n=24,870) and North-East (n=3,228). Multivariate logistic regressions that adjust for clustering and sampling weights were used to investigate the association between IYCF and diarrhoea in regional India. The IYCF indicators include early initiation of breastfeeding, exclusive breastfeeding (EBF), predominant breastfeeding, bottle feeding, continued breastfeeding at one year, continued breastfeeding at two years, children ever breastfed and the introduction of solid, semi-solid or soft foods. Results: The prevalence of diarrhoea was lower among infants and young children who were breastfed within 1-hour of birth and those who were exclusively breastfed. Children whose mothers continued breastfeeding at one and two years, and infants who were introduced to complementary foods had a higher prevalence of diarrhoea. Early initiation of breastfeeding and EBF were protective against diarrhoea in the North, East and Central regions of India. However, predominant breastfeeding, bottle-feeding and introduction of complementary foods were risk factors for diarrhoea in Central India. Continued breastfeeding at two years was a risk factor for diarrhoea in Western India. Conclusion: Our study suggests that early initiation of breastfeeding and EBF were protective against diarrhoea in Northern, Eastern and Central India, while predominant breastfeeding, bottle feeding, continued breastfeeding at two years and introduction of solid, semi–solid or soft foods were risk factors for diarrhoea in various India regions. Improvements in IYCF practices are likely to reduce the burden of diarrhoea-related morbidity and mortality across India regions.