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  • Title: Breast-feeding, infant health and child survival in the Asia-Pacific context.
    Author: Shah IH, Khanna J.
    Journal: Asia Pac Popul J; 1990 Mar; 5(1):25-44. PubMed ID: 12283346.
    Abstract:
    This article considers the role of breastfeeding (BF) in infant health and child survival, with a special reference to the available information from countries in the Asian and Pacific Region. A simplified framework is proposed for the systematic investigation of the direct influence of BF on infant and child health through its protective effects against infections, especially of the gastrointestinal tract, and the indirect influences on infant mortality through lactational amenorrhea (birth spacing). Despite some methodological constraints, the weight of the available evidence suggests that BF lowers the incidence of infant morbidity and mortality. Increased prevalence and duration of breastfeeding can potentially reduce mortality from diarrhea in developing countries by as much as 25%. For children born to underprivileged couples and in poorer countries, a high prevalence of BF for prolonged durations is critically important in reducing the levels of morbidity and mortality. The framework shows the relationships among many factors. Maternal factors influence a mother's decision to breastfeed and duration of BF. Theses factors also have an independent relationship with infant health and survival. These are the "independent" variables. There are 3 chief intermediate variables: 1) the method of infant feeding; 2) birth spacing; and 3) birth weight. The independent variables affect the mother's choice of the infant feeding methods, which affects the birth interval and birth weight of the next child. The outcome of the relationship between intermediate and independent variables is the infant's health status and its survival probability. Information on key indicators for 25 selected countries and areas in the Pacific and Asian Region are shown in tabular form. Infant mortality rates range from 5/1000 live births in Japan to 171 in Afghanistan. The proportion of infants with a low birth weight also varies a lot. Similar differentials are in effect for other indicators. Countries with better access to health services and lower infant mortality are also the ones which have a lower prevalence of BF. It seems that more hygienic environments seem to affect the sequelae of prevalence and short time of BF. A high prevalence and more time spent at BF helps to reduce the consequences of poor hygienic environment in less economically developed countries.
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