{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:51:59Z","timestamp":1792054319371,"version":"4.4.0"},"reference-count":47,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Although existing literature heavily focuses on the health outcomes of exclusive breastfeeding (EBF) in India, studies addressing socioeconomic inequalities across a broad spectrum of breastfeeding indicators remain scarce. We utilized five waves of National Family Health Survey data (1993\u20132021) to analyze temporal trends and socioeconomic inequalities, proxied by maternal education (no formal schooling, 1st\u20135th grade, 6th\u20138th grade, 9th\u201312th grade, and above 12th grade) and household wealth (poorest, poorer, middle, richer, and richest) across six World Health Organization\u2010recommended indicators: ever breastfed, early initiation of breastfeeding (EIBF), exclusive breastfeeding for the first 2 days after birth, EBF, mixed milk feeding (MixMF), and continued breastfeeding. We estimated absolute and relative inequalities between the lowest and highest categories of each socioeconomic marker, followed by the computation of the Annual Absolute Change to assess progress over time (1993\u20132021). Between 1993 and 2021, absolute inequality in EIBF remained stagnant between the two extreme maternal education levels. EBF disparities shifted significantly; the initial advantage held by mothers with no formal schooling in 1993 narrowed as the gap closed, a trend mirrored across household wealth quintiles where the poorest maintained a higher, albeit diminishing, lead in EBF prevalence. EIBF increased at an equal annualized rate across both the lowest and highest education strata, and MixMF rose more sharply among the poorest households. Addressing these shifting socioeconomic disparities is critical for achieving equitable breastfeeding outcomes across all strata, especially given the recent (2024) reported decline in EBF prevalence nationally.<\/jats:p>","DOI":"10.1111\/mcn.70258","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:43:01Z","timestamp":1792053781000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Three Decades of Socioeconomic Inequality in India's Breastfeeding Indicators, 1993\u20132021"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5249-9937","authenticated-orcid":false,"given":"Rajesh Kumar","family":"Rai","sequence":"first","affiliation":[{"name":"Division of Global Health Management and Policy, School of Public Health San Diego State University San Diego California USA"},{"name":"Birbhum Population Project Society for Health and Demographic Surveillance Suri West Bengal India"},{"name":"ImpactLoop LTD London UK"},{"name":"Human Nutrition Unit, Institute of Nutrition Mahidol University Phutthamonthon Nakhon Pathom Thailand"},{"name":"Department of Global Health and Population Harvard T H Chan School of Public Health Boston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0090-8249","authenticated-orcid":false,"given":"Jan\u2010Walter","family":"De Neve","sequence":"additional","affiliation":[{"name":"Division of Global Health Management and Policy, School of Public Health San Diego State University San Diego California USA"},{"name":"Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6552-4871","authenticated-orcid":false,"given":"Sabri","family":"Bromage","sequence":"additional","affiliation":[{"name":"Community Nutrition Unit, Institute of Nutrition Mahidol University Phutthamonthon Nakhon Pathom Thailand"},{"name":"Department of Nutrition Harvard T H Chan School of Public Health Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9864-3957","authenticated-orcid":false,"given":"Rockli","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Health Policy and Management, College of Health Science Korea University Seoul South Korea"},{"name":"Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences Graduate School of Korea University Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2365-4165","authenticated-orcid":false,"given":"S. V.","family":"Subramanian","sequence":"additional","affiliation":[{"name":"Harvard Center for Population and Development Studies Cambridge Massachusetts USA"},{"name":"Department of Social and Behavioral Sciences Harvard T H Chan School of Public Health Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-024-00695-0"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41430-019-0406-0"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2010.00614.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/wber\/lhp020"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001390"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(25)00300-6"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2010.300062"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.14.04026"},{"key":"e_1_2_10_10_1","volume-title":"Guide to DHS Statistics","author":"Croft T. N.","year":"2023"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2017.1104"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-021-00359-3"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1353\/dem.2001.0003"},{"issue":"4","key":"e_1_2_10_14_1","first-page":"272","article-title":"Socio\u2010Economic Differences in Health, Nutrition, and Population Within Developing Countries: An Overview","volume":"10","author":"Gwatkin D. R.","year":"2007","journal-title":"Nigerian Journal of Clinical Practice"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2010.00587.x"},{"key":"e_1_2_10_16_1","volume-title":"National Family Health Survey (MCH and Family Planning), India 1992\u201093","author":"International Institute for Population Sciences (IIPS)","year":"1995"},{"key":"e_1_2_10_17_1","volume-title":"National Family Health Survey (NFHS\u20106), 2023\u201024: India and State\/UT Fact Sheets","author":"International Institute for Population Sciences (IIPS)","year":"2026"},{"key":"e_1_2_10_18_1","volume-title":"National Family Health Survey (NFHS\u20104), 2015\u201016: India","author":"International Institute for Population Sciences (IIPS) and ICF","year":"2017"},{"key":"e_1_2_10_19_1","volume-title":"National Family Health Survey (NFHS\u20105), 2019\u201021: India: Volume I","author":"International Institute for Population Sciences (IIPS) and ICF","year":"2021"},{"key":"e_1_2_10_20_1","volume-title":"National Family Health Survey (NFHS\u20103), 2005\u201306: India: Volume I","author":"International Institute for Population Sciences (IIPS) & Macro International","year":"2007"},{"key":"e_1_2_10_21_1","volume-title":"National Family Health Survey (NFHS\u20102), 1998\u201399: India","author":"International Institute for Population Sciences (IIPS) and ORC Macro","year":"2000"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2024-016386"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu17071134"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13668-022-00414-3"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-025-00744-2"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5774"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-025-00209-z"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2025.07.027"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-025-06260-z"},{"key":"e_1_2_10_30_1","volume-title":"MAA: Mothers' Absolute Affection, Programme for Promotion of Breastfeeding, Operational Guideline","author":"Ministry of Health and Family Welfare","year":"2016"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/roiw.12240"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2025-071516"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2026.108600"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-023-00602-z"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01044-2"},{"key":"e_1_2_10_36_1","unstructured":"Rutstein S. O.2008. DHS Working Papers. The DHS Wealth Index: Approaches for Rural and Urban Areas. DHS Working Papers No. 60. Calverton MD: Macro International."},{"key":"e_1_2_10_37_1","volume-title":"The DHS Wealth Index. DHS Comparative Reports No. 6","author":"Rutstein S. O.","year":"2004"},{"key":"e_1_2_10_38_1","volume-title":"Making the Demographic and Health Surveys Wealth Index Comparable. DHS Methodological Reports No. 9","author":"Rutstein S. O.","year":"2014"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.2196\/57254"},{"key":"e_1_2_10_40_1","volume-title":"Stata Statistical Software: Release 18","author":"StataCorp","year":"2023"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lansea.2023.100155"},{"key":"e_1_2_10_42_1","doi-asserted-by":"crossref","DOI":"10.18356\/9789210027557","volume-title":"The State of the World's Children 2023: For Every Child, Vaccination","author":"United Nations Children's Fund","year":"2023"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-023-00577-x"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01024-7"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02741-0"},{"key":"e_1_2_10_46_1","volume-title":"Global Nutrition Target 2030: Breast-Feed Brief. Department of Nutrition and Food Safety","author":"World Health Organization","year":"2025"},{"key":"e_1_2_10_47_1","volume-title":"Indicators for Assessing Infant and Young Child Feeding Practices: Definitions and Measurement Methods","author":"World Health Organization (WHO) and The United Nations Children's Fund (UNICEF)","year":"2021"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70258","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/mcn.70258","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70258","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:43:06Z","timestamp":1792053786000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.70258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":47,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/mcn.70258"],"URL":"https:\/\/doi.org\/10.1111\/mcn.70258","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-01-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70258"}}