Breastfeeding Practices, Sociocultural Influences, and Health-System Determinants Among Mothers in Rural Etawah, Uttar Pradesh: A Community-Based Cross-Sectional Study
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Abstract
Background: Breastfeeding is a critical determinant of child survival and maternal health. Despite global and national policy commitments, suboptimal breastfeeding practices persist in rural India, driven by a complex interplay of sociocultural norms, health-system gaps, and knowledge deficits. Uttar Pradesh (UP) consistently records among the lowest exclusive breastfeeding (EBF) rates nationally, making community-level evidence urgently required.
Objectives: To assess breastfeeding initiation, exclusive breastfeeding rates, and associated sociocultural and health-system determinants among mothers residing in rural Etawah district, Uttar Pradesh.
Methods: A community-based cross-sectional study was conducted among 99 mothers purposively selected from rural Etawah, UP. A pre-tested, structured interview schedule captured data on breastfeeding practices, reasons for delayed initiation or non-exclusive breastfeeding, supplementary feeding patterns, traditional beliefs, family support, and healthcare provider interactions. Descriptive statistics were used for analysis; frequencies and proportions are reported.
Results : Antenatal care (ANC) coverage was 85.9%, and institutional delivery was reported in 92.9% of cases. Early initiation of breastfeeding within one hour of birth was observed among 65.7% of mothers, while 34.3% experienced delayed initiation, primarily due to maternal health issues (44.7%) and post-delivery fatigue (42.1%). Exclusive breastfeeding for six months was practiced by 70.4% of mothers (69/98). Among mothers who did not practice exclusive breastfeeding (n=29), perceived insufficient milk supply was the most commonly reported reason (51.9%). Traditional beliefs influenced breastfeeding practices in 12.4% of cases, with honey and gutti administration reported for religious and cultural reasons. Family support for breastfeeding was high (92.9%), and the mother-in-law emerged as the principal influencer of infant feeding decisions (68.5%). Healthcare providers discussed the benefits of breastfeeding with 79.6% of mothers, while 54.1% received breastfeeding-related educational materials.
Conclusion: While EBF rates and early initiation in this cohort exceed state averages, gaps remain attributable to perceived milk insufficiency, maternal fatigue, and persistent traditional practices. Strengthening frontline worker counselling, community-based demand generation, and family-inclusive lactation support are recommended.
Keywords: Breastfeeding; exclusive breastfeeding; early initiation; rural India; Uttar Pradesh; sociocultural determinants; community-based study
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