A Cross-Sectional Study of the Prevalence and Determinants of Formula-Feeding Practices by Mothers in a Sub-district of Kerala, India

Background There is a scarcity of data on formula-feeding practices in India. Therefore, we conducted this study to determine the prevalence and factors associated with formula-feeding practices among mothers of infants in a sub-district of Kerala, India. Methods This community-based cross-sectional study included 300 mothers of infants aged 0-12 months selected using multistage cluster sampling. Data on formula feeding practices were collected at any point during the infant's life through a pre-tested, structured interview schedule. Log-binomial regression analysis was conducted to identify factors associated with formula feeding. Results The mean age of the mothers was 27.06 years (SD: 3.90). Of the participants, 75% (n=225) were graduates or postgraduates, 67.33% (n=202) were homemakers, and 58% (n=174) were above the poverty line (APL). Early initiation of breastfeeding (within one hour of birth) was reported by 65% (n=195) of the mothers. The prevalence of formula feeding among infants under one year was 53.3% [95% Confidence Interval (CI): 47.5-59.1%]. Infants of mothers who delivered in private hospitals [adjusted prevalence ratio (APR): 3.44, 95% CI: 2.47-4.79; p<0.001] and those with a birth weight below 2.5 kg [APR: 1.20, 95% CI: 1.03-1.39; p=0.015] were more likely to be formula-fed compared to their counterparts. Conclusion Formula feeding was observed in over half of the infants in our study. Targeted interventions are essential to reduce formula-feeding practices, especially among low-birth-weight infants and those born in private hospitals.