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  • Title: [Breast feeding influence on child mortality in the Dominican Republic].
    Author: Caceres F.
    Journal: Poblac Desarro; 1992; (2):129-48. PubMed ID: 12178309.
    Abstract:
    Data from the 1986 Demographic and Health Survey were used to assess the status of breast feeding in the Dominican Republic and to analyze its possible relationship to infant mortality in various population subgroups. The analysis was based on a model that explained infant mortality in the Dominican Republic as a function of eight variables. Care was taken to control for the influence of confounding variables, such as the possible exposure of bottle fed infants to impure water in formula and the possibly shorter birth intervals of women who do not breast feed. Respondents to the Demographic and Health Survey were asked how long their infants born in the previous five years were breast fed. Those infants who were 1 year to five years old at the survey date (and therefore exposed to risk of mortality for at least one year) were included in the study. The statistical technique known as proportional hazard models was selected because of its applicability to lactation, a complex determinant of infant survival because of its dependence on the child's age. Four age ranges were studied: under one month, one to two months, three to six months, and seven to eleven months. Child survival and breast feeding status were established for each age range. The risk of death associated with breast feeding status was thus considered as a function of age. The eight control variables were urban or rural residence, family economic status, maternal education and level of information, source of household water, previous birth interval. Prenatal care, and type of attendance at delivery. The results of the study demonstrated that, when the effects of infants' ages were controlled, breast feeding was an important determinant of infant mortality in the Dominican Republic in the first half of the 1980s. The effect of breast feeding on infant mortality is direct and is not a reflection of any of the other factors. Significant interactions were found between breast feeding and age, and between breast feeding and the household source of water. The risk of death was less for breast fed infants at all ages. The magnitude of the coefficients showed that breast feeding could be crucial during the first month of life. The influence of breast feeding decreased with age, and by 6 months the difference in the risk of death of breast fed and nonbreast fed infants was small. There was no true differential between mortality of breast fed infants who had or did not have potable water in the household. Nonbreast fed infants had a higher risk of death whether or not they lived in households with potable water, but those without potable water were at higher risk. A policy to increase infant survival in the Dominican Republic should promote breast feeding and should work to provide potable water.
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