NFHS-6 data on child nutrition carries sobering warnings

Breastfeeding remains one of the most evidence-backed, low-cost public-health interventions available, benefiting both child survival and maternal health. Its decline in states with high malnutrition burdens is a serious policy failure

The headline from NFHS-6 on child health is heartening. Stunting — children who are too short for their age— has declined nationally from 35.5 per cent to 29.3 per cent. That is a substantial improvement and deserves recognition. However, read in full, NFHS-6’s child nutrition story presents a more complicated picture: National gains are uneven, several large states have deteriorated, and key drivers of child nutrition remain deeply concerning.

Severe wasting, the most dangerous form of acute malnutrition, declined from 7.7 per cent to 5.2 per cent. This is a meaningful gain that should translate into fewer child deaths. Yet overall wasting fell only marginally, from 19.3 per cent to 19 per cent, meaning nearly one in five Indian children under five remains acutely malnourished. The proportion of underweight children moved from 32.1 per cent to 31.8 per cent. Nearly one in three Indian children is still underweight.

The state-level data is even more troubling. In Jharkhand, underweight prevalence increased from 39.4 per cent to 41.1 per cent. In UP, wasting rose from 17.3 per cent to 19.2 per cent and underweight from 32.1 per cent to 34.5 per cent. Rajasthan recorded similar deterioration, with wasting rising from 16.8 per cent to 19.8 per cent and underweight from 27.6 per cent to 33.3 per cent. These setbacks in some of India’s largest states are obscured by the national headline.

The stunting figure itself conceals wide disparities. Kerala’s stunting rate is 20.1 per cent, compared with 35.6 per cent in Bihar and 35 per cent in Jharkhand. The gap reflects two very different childhood realities under the same national programmes. Jharkhand’s wasting rate stands at 22.3 per cent, more than double Kerala’s 10.9 per cent, and virtually unchanged from NFHS-5’s 22.4 per cent despite four years of programme implementation.

Only 15.3 per cent of children aged 6-23 months receive an adequate diet, up from 11 per cent. This is progress, but it still means more than eight in 10 children during the most critical developmental period are not receiving what nutrition science recommends. Dietary adequacy is only 8.7 per cent in Rajasthan and 11.9 per cent in Bihar. The decline in stunting has occurred despite this gap, not because it has been resolved.

Perhaps the most worrying finding is breastfeeding. Exclusive breastfeeding among infants under six months has fallen nationally from 63.7 per cent to 55.8 per cent. In UP, it has dropped from 59.7 per cent to 34.6 per cent. Jharkhand and Rajasthan have also seen sharp declines. Kerala, in contrast, improved from 55.5 per cent to 72.7 per cent. This suggests the problem is not institutional delivery but postnatal support after discharge. Breastfeeding remains one of the most evidence-backed, low-cost public-health interventions available, benefiting both child survival and maternal health. Its decline in states with high malnutrition burdens is a serious policy failure.

There are clear successes. Full vaccination coverage increased from 83.8 per cent to 87.1 per cent, while rotavirus vaccine coverage surged from 36.4 per cent to 85.4 per cent, reflecting effective national rollout.

NFHS-6 confirms India can reduce stunting. But wasting, dietary inadequacy and declining breastfeeding remain major risks. Whether the next NFHS shows continued progress on stunting will depend on whether these warning signs are addressed now.

The writer is senior fellow. Pahle India Foundation and former director, office of vice chairperson, NITI Aayog