Breastfeeding and the Risk of Postneonatal Death in the United States

Abstract

ABSTRACT. Objective. Breastfed infants in the United States have lower rates of morbidity, especially from infectious disease, but there are few contemporary studies in the developed world of the effect of breastfeeding on postneonatal mortality. We evaluated the effect of breastfeeding on postneonatal mortality in United States using 1988 National Maternal and Infant Health Survey (NMIHS) data.Methods. Nationally representative samples of 1204 infants who died between 28 days and 1 year from causes other than congenital anomaly or malignant tumor (cases of postneonatal death) and 7740 children who were still alive at 1 year (controls) were included. We calculated overall and cause-specific odds ratios for ever/never breastfeeding among all children, conducted race and birth weight-specific analyses, and looked for durationresponse effects.Results Conclusions. Breastfeeding is associated with a reduction in risk for postneonatal death. This large data set allowed robust estimates and control of confounding, but the effects of breast milk and breastfeeding cannot be separated completely from other characteristics of the mother and child. Assuming causality, however, promoting breastfeeding has the potential to save or delay ϳ720 postneonatal deaths in the United States each year. Pediatrics 2004;113:e435-e439. URL: http://www.pediatrics. org/cgi/content/full/113/5/e435; breastfeeding, infant mortality, cause of death, risk, logistic models.

Breastfeeding and the Use of Human Milk

“…20 A proportion (21%) of the US infant mortality has been attributed, in part, to the increased rate of SIDS in infants who were never breastfed. 21 That the positive effect of breastfeeding on SIDS rates is independent of sleep position was confirmed in a large case-control study of supine-sleeping infants. 22,23 It has been calculated that more than 900 infant lives per year may be saved in the United States if 90% of mothers exclusively breastfed for 6 months.…”

Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding

“…In many instances there is no other choice for families and, still, even in industrialised western countries without the intense breast feeding and physical monitoring that accompanies co-sleeping, the survival of an infant is threatened. For example, Chen and Rogan 68 found that, even in the USA where infectious diseases do not seriously threaten the lives of infants, approximately 750 American infants die in the first year of life because they were not breast fed. Mothers and infants sleeping side-by-side, cosleeping, continues to be the universal (species-specific) evolved context that best provides maximum night-time breast feeding nutrition for the highly immature and slow developing human infant.…”

Determinants of successful breastfeeding initiation in healthy term singletons: a Swiss university hospital observational study

“…Breastfeeding decreases the risk of sudden infant death [8] , necrotizing enterocolitis, and other neonatal infections [14] , while protecting against cardiovascular disease [27] , atopic disease [33] , and obesity [10] . It may even improve cognitive development [3] .…”