For a new mother, the first six months of a baby’s life are supposed to be guided by one clear piece of advice: breastfeed exclusively. Yet across Telangana, fewer mothers are managing to do so than five years ago and the mothers struggling most aren’t in villages with limited healthcare, but in Hyderabad’s hospitals and homes.
The latest National Family Health Survey (NFHS-6, 2023-24) shows exclusive breastfeeding among children under six months in Telangana has slipped to 64.8 percent, down from 68.2 percent in the previous round (NFHS-5, 2019-21), a fall of roughly 3.4 percentage points.
As World Breastfeeding Week (August 1–7) draws attention back to infant nutrition, new national data reveals a quiet but troubling shift in Telangana and doctors say the reasons have less to do with willingness and more to do with what happens after mothers leave the hospital.
“Almost all mothers want to breastfeed. The problem isn’t willingness, it’s what happens once they’re back home with the door closed and no one else around,” says Dr Rajeev Santhosh, senior consultant neonatologist at Fernandez Hospital. He describes a familiar pattern in clinic: women managing fine at the hospital, then struggling once the structured support disappears.
Meanwhile, Dr Phani Jyotsna, consultant obstetrics and gynaecology at Apollo Hospitals, Financial District, points to the same gap from a different angle. She explains, “The biggest gap is inadequate post-delivery support. Many mothers receive little practical guidance after discharge, while returning to work, family pressures, and aggressive formula marketing further discourage exclusive breastfeeding. Continuous counselling from pregnancy through the first six months is essential.”
It’s a paradox that puzzles many: better hospitals and more doctors per capita in urban Hyderabad, yet lower exclusive breastfeeding rates than in villages. Dr Santhosh doesn’t think Hyderabad-specific data fully explains it yet, but the clinical picture is consistent with the national trend. He explains, “City life just makes it harder. A lot of women are back at their desks within a few months. There’s no grandmother in the next room, no aunt dropping by — nuclear families mean nobody’s around to help while the mother is still healing from delivery, running on no sleep, and trying to figure out a newborn and a household at the same time.”
Both doctors stress that early skin-to-skin contact is a genuine turning point, and one of the survey’s few bright spots. “The first hour after birth is critical. Early skin-to-skin contact stimulates milk production and helps babies latch effectively. While many hospitals follow this practice, emergency deliveries, maternal illness, or delayed protocols can interfere,” highlights Dr Jyotsna. Simple interventions in those first hospital days — rooming-in, early latch assistance, avoiding unnecessary formula top-ups, and hands-on demonstrations — can make what she calls ‘a remarkable difference’ to a mother’s confidence going forward.
Despite different clinical perspectives, both doctors point to the same factor as the biggest driver of early formula use: the fear of insufficient breast milk. “True low milk supply is relatively uncommon. Most concerns arise from anxiety, improper latching, unrealistic expectations, or misconceptions about newborn feeding patterns,” highlights Dr Jyotsna.
Dr Santhosh describes how the fear becomes self-fulfilling. “The baby’s crying after a feed, or wants to feed again barely an hour later, and everyone assumes the milk isn’t enough. So out comes the formula bottle, even when the baby was doing just fine. Once that becomes a habit, the baby’s at the breast less, and supply actually starts to drop — the fear becomes the thing that causes the problem it was afraid of,” he adds.
A newer pressure has entered the picture: the flood of parenting advice available at 2 am on a phone screen. “It’s changed everything about how new mothers look for answers,” Dr Santhosh says. Some of it helps — a mother realising she isn’t alone in her struggles. But much of it is ‘this worked for me’ passed off as fact, including unverified claims about pumping quotas or foods that guarantee more milk. “Every baby’s different, feeding decisions shouldn’t be made off a video,” he says, encouraging mothers to treat social media as background reading and bring real concerns to a lactation consultant or their care team.
Antenatal preparation, both doctors agree, deserves more weight than it currently gets. “Breastfeeding begins with preparation, not after delivery,” points out Dr Jyotsna, who wants expectant mothers taught about latching, positioning, and newborn feeding cues well before the baby arrives.
Dr Santhosh’s closing message is one of early intervention, as he concludes, “Most breastfeeding problems are fixable if caught early. Mothers shouldn’t wait until they’re at their limit, or ready to give up. Reaching out the moment something feels off to a lactation consultant or their doctor is usually what stops a small problem from turning into a big one.”