The first 1,000 days of a child's life are crucial for holistic growth and development. A significant part of this development depends on healthcare, nutrition, early stimulation, early learning opportunities, and responsive caregiving.
The optimal provision of these elements of Nurturing Care is critical and sets the course for a child’s progress into adulthood. This period is significant, considering that over 85 per cent of a child's cumulative brain development occurs by the time they are 5 years old.
Breastfeeding: The foundation for responsive parenting and early nutrition
Poor feeding practices during the first 1000 days result in malnutrition, leading to impaired cognitive and social development, poor school performance and reduced productivity in later life.
According to UNICEF and the World Health Organisation, exclusive breastfeeding for the first six months, ideally initiated within the golden first hour after birth, is a global standard. The holistic nutritional needs of an infant till 6 months of age should be met by breastfeeding alone. Further, colostrum, the milk the mother secretes in the first few days, is rich in antibodies and protective factors that help fight infections—the first 'immunisation' the child receives.
Breastfeeding is the first touch, food and stimulation for the child. It establishes the emotional bond between the mother and the child, cultivates responsive behaviour naturally, and has a long-term impact on parent-child bonding. After six months, complementary feeding must be initiated with liquid (porridge) and semi-solid foods (mashed food items). During toddlerhood, breast milk provides 35-40 per cent of a toddler's energy needs, along with vital proteins, vitamins, and immune-protective compounds.
An important factor for effective breastfeeding is the care of the mother and her nutritional needs. Herein comes responsive parenting. It is not only the mother, but also an enabling environment and the role of other caregivers, such as the father and immediate family members, that are important for holistic care.
Where do we stand?
According to the NFHS 5 (National Family Health Survey), there is a significant gap between institutional delivery (88.6 per cent) and early initiation of breastfeeding (41.8 per cent). While exclusive breastfeeding rates stand at 63.7 per cent, only 41.8 per cent of infants are breastfed within the golden first hour of birth.
Complementary feeding practices remain poor, with just 45.9 per cent of infants aged 6-8 months receiving complementary foods. Many women also struggle with milk supply, pain, fatigue, or pressure to introduce formula. Further, proactive counselling, reassurance from healthcare providers, and encouragement from family and community are not available.
According to a recent World Breastfeeding Trends Initiative (WBTi) assessment of breastfeeding policy and programme 2024-25 conducted by Breastfeeding Promotion Network of India (BPNI), urgent attention is required for: a clear breastfeeding policy, early initiation of breast feeding, support to mothers for exclusive breastfeeding till 6 months, trained staff, response to baby's breastfeeding needs and connecting families with community breastfeeding support after discharge.
Government provisioning: Challenges in implementation
The government of India has recognised the importance of the first 1000 days and breastfeeding. However, urgent action is required for implementation.
The centrally sponsored scheme 'Mother's Absolute Affection' (MAA) was launched in 2016 to promote, protect and support breastfeeding practices. In 2017, the Government of India launched national operational guidelines to involve families as active partners in the care of sick newborns. Considering the scale of beneficiaries (as per the Civil Registration System report 2022, India recorded around 2.5 crore births in 2022), challenges continue in terms of effective implementation and budget allocation.
PMMVY (Pradhan Mantri Matru Vandana Yojana), launched in 2022, is India's maternity benefit scheme providing Rs 5000 in three instalments and an additional Rs 1000. However, its effectiveness is compromised due to instalments not reaching beneficiaries promptly. Paid maternity leave for 26 weeks is available through the Maternity Benefit Act, 2017—but this is limited to only women working in formal establishments.
The female participation in the labour force has increased from 23.3 per cent in 2017-18 to 41.7 per cent in 2023-24. However, there are only approximately 3000 creches functional across the country under the Palna scheme, insufficient compared to the need and number of working women.
Paving the way for holistic care: Why creches matter
Breastfeeding must be positioned within a wider approach to care for children. It must be integrated with nutrition, early stimulation, responsive caregiving, and protection. Crèches can be used as locations for providing holistic care addressing the above-mentioned needs.
Crèches currently function mostly as custodial or feeding centres. With added facilities such as private breastfeeding rooms, storage for expressed milk, and trained staff to counsel mothers, these could become critical enablers of extended breastfeeding. With regular training, healthcare workers, anganwadi staff, and childcare providers can guide mothers through extended breastfeeding, safe weaning practices, and strategies for other aspects of early care.
Workplace policies have a vital role through the provision of creches, flexible breaks for breastfeeding, and supportive guidelines. In the organised sector, provisions under the Maternity Benefit (Amendment) Act 2017 support working mothers. These benefits should be extended to women in the informal sector, while also considering paternity leave provisions to encourage shared responsibility.
Community-based support systems
Home and community-based practices promoting breastfeeding and responsive parenting will enable the elimination of harmful social and cultural stereotypes. These practices need to focus on the role of fathers and the larger family in providing support to the mother. Sarpanches and other local leaders, along with experienced mothers, can also help build an enabling environment. Public health campaigns that help normalise longer breastfeeding periods can shift attitudes across entire communities. Awareness generation on how breastfeeding provides nutrition and immunity is important to demystify the belief that the responsibility is solely the mother’s.
Children are the nation's future; their development needs to be a priority. Human capital development cannot happen if they are not prioritised during their early childhood. Development of the young child requires a comprehensive framework that includes nurturing care and support, early stimulation and family support to provide health, nutrition, and responsive parenting. Breastfeeding is at its core as it provides the early needs of the child's nutrition, stimulation, health, care and emotional security.
- By Rekha Sharma Sen, Steering Committee Member, Alliance for the Rights to Early Childhood care and Development (Alliance for the Rights to ECD); Nupur Bidla, National Coordinator, Breastfeeding Promotion Network of India (BPNI); and Aparajita Sharma, National Secretariat, Forum for Creches and Childcare Services (FORCES)
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
