The proportion of infants exclusively breastfed for the first six months has declined from 64% in 2019-21 to about 56% in 2023-24, reversing the rising trend of the decade and even earlier. This fact, revealed by the National Family Health Survey-6, has alarmed public health and nutrition experts, who state that exclusive breastfeeding for at least six months is the most cost-effective nutrition intervention with lifelong benefits for mothers and infants.Breastfeeding rates have declined in almost all states except a few states like Kerala, Gujarat and West Bengal.However, interestingly, the proportion of infants under three years of age who were breastfed within the first hour of birth has increased from about 42% in 2015-16 (NFHS-4) and 2019-21 (NFHS-5) to 50% in the latest survey. While most states have shown significant improvement on this parameter, some states like Punjab and West Bengal have recorded a decline.Some of the states with the highest birth rates have seen steep declines in the proportion of infants exclusively breastfed in the first six months. For example, in Uttar Pradesh the proportion fell from nearly 60% in 2019-21 to only 35% in 2023-24.Over the same period, it fell from 74% to 56% in Madhya Pradesh, from over 70% to 54% in Rajasthan, and from 64% to 54% in Assam. The sharpest decline was seen in Haryana, from about 70% to 41%. Uttarakhand also recorded a decline from about 53% to 41%.In many states where breastfeeding within the first hour of birth was very low, such as Jharkhand, Bihar and Chhattisgarh, this proportion has increased – from 22% to 46.8% in Jharkhand, from 31% to 52% in Bihar and from 32% to almost 52% in Chhattisgarh in 2019-21.In Kerala, the proportion of infants breastfed within the first hour has exceeded 82%, followed by Andhra Pradesh at 67%. The proportion of infants exclusively breastfed for the first six months is highest in Kerala, at about 73%, second only to Chhattisgarh (76%).