Determinants of exclusive breastfeeding failure in newborns: A prospective longitudinal observational study.
DOI:
https://doi.org/10.51168/eawh9m67Keywords:
Exclusive breastfeeding, EBF failure, infant feeding practices, breastfeeding determinants, antenatal counselling, India, UttarakhandAbstract
Background
Exclusive breastfeeding (EBF) during the first six months of life is an important strategy for improving infant health and reducing morbidity and mortality. Despite its recognized benefits, EBF remains suboptimal in many settings. This study evaluated the determinants of EBF failure among mother-newborn dyads during the first six months of life.
Methods
This prospective longitudinal observational study included 200 mother-newborn dyads at Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun. Maternal sociodemographic, obstetric, infant-feeding, breastfeeding-counselling, and lactation-related factors were assessed using structured questionnaires. Participants were followed at 48 hours after delivery, 2.5 months, and 6 months. Chi-square tests and binary logistic regression were used to identify factors associated with EBF outcomes.
Results
The study assessed maternal sociodemographic characteristics including age, education, occupation, parity, and family type. At 2.5 months, 169 (84.5%) dyads maintained EBF, while 31 (15.5%) had discontinued. At 6 months, 138 (81.7%) of the remaining 169 dyads continued EBF. Pre-discharge formula supplementation (χ²=41.25, p<0.001), breastfeeding initiation after two hours (χ²=31.4, p<0.001), lack of antenatal counselling (χ²=12.56, p=0.001), and breastfeeding difficulties were significantly associated with EBF failure.
Conclusion
EBF failure was associated with modifiable clinical, educational, and social factors, particularly unnecessary formula supplementation, delayed breastfeeding initiation, inadequate counselling, and unresolved lactation difficulties.
Recommendation
Early initiation of breastfeeding, avoidance of unnecessary pre-discharge formula supplementation, and structured antenatal and postnatal breastfeeding counselling should be strengthened. Hospital-based Baby-Friendly practices and continued lactation support should be integrated into routine maternal and newborn care.
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Copyright (c) 2026 Monika Kashyap, Ragini Singh, Vishal Kaushik, Priyanka Gandhi (Author)
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