Promoting Equity in Early Breastfeeding Practices: Examining Associated Factors for Policy Improvements in Early Initiation and Exclusive Breastfeeding in Urban Informal Settlements

The initiation of early and exclusive breastfeeding practices, crucial for safeguarding newborn health remains suboptimal in low- and middle-income countries. This chapter aims to provide suggestions for policy improvements in early breastfeeding practices by assessing the extent and determinants of two indicators—early initiation of breastfeeding within the first hour after birth and exclusive breastfeeding practices during the first two days after birth. The recommendations are informed from an analysis of data collected from 1,049 mothers of children under two years of age in informal settlements in Mumbai, India. Findings suggest that only 33% reported breastfeeding within the first hour of birth while 65% reported breastfeeding exclusively for the first two days after birth. Determinants of early breastfeeding practices included individual and community-level factors such as education level and cultural practices, and institutional factors such as the type of delivery facility and type of delivery. Recommendations include implementing a four-fold approach for enabling individual and community-level changes such as awareness initiatives, and institutional and systemic changes such as training healthcare staff in counseling and postnatal support and monitoring delivery and breastfeeding outcomes to improve early breastfeeding practices.