Determinants of early initiation and exclusive breastfeeding of the Bhumij community of India: a community-based cross-sectional study

ABSTRACT Background Breastfeeding practices vary across populations and are influenced by a range of social-cultural, and healthcare-related factors. Evidence on early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) among indigenous communities in India remains limited. This study aimed to identify factors associated with EIBF and EBF among Bhumij mothers in eastern India. Method A community-based cross-sectional study of 306 Bhumij mother-child pairs was conducted in Purulia, West Bengal, India (2023-2024). Socio-demographic and breastfeeding-related data were collected through structured interviews and analysed using bivariate and multivariable logistic regression. Results Almost all children (99.3%) had been breastfed; 72.9% initiated breastfeeding within one hour of birth, and 65.2% were exclusively breastfed during the first six months. In multivariable analyses, mode of delivery, pre-lacteal feeding, and colostrum discarding were significantly associated with EIBF. Maternal knowledge of EBF was positively associated with EBF practice (adjusted OR: 6.14; 95% CI: 2.80-13.46). Maternal perception of milk production was also associated with EBF, with higher odds observed among mothers reporting adequate (adjusted OR: 6.12; 95% CI: 3.00-12.48) or profuse (adjusted OR: 7.71; 95% CI: 2.56-23.25) milk production compared with those reporting insufficient milk production. Conclusion This study provides evidence on breastfeeding practices among Bhumij mothers and identifies healthcare-related, maternal, and caregiving factors associated with EIBF and EBF. The findings contribute to the limited literature on infant feeding practices among indigenous populations in India and may inform breastfeeding promotion and nation-wide maternal-child health programmes in similar settings.