Exclusive Breastfeeding and Under-Five Mortality, 2006-2014: A Cross-National Analysis of 57 Low- and-Middle Income Countries

Abstract

Background:Few studies have examined the long-term, cross-national, and population-level impacts of exclusive breastfeeding on major global child health indicators. We investigated the overall and independent associations between exclusive breastfeeding and under-five mortality in 57 low- and-middle-income countries.Methods:Data were obtained from the latest World Health Organization, United Nations, and United Nations Children’s Fund databases for 57 low- and middle-income countries covering the periods 2006-2014. Multivariate linear regression was used to estimate the effects of exclusive breastfeeding on under-five mortality after adjusting for differences in socioeconomic, demographic, and health-related factors.Results:In multivariate models, exclusive breastfeeding was independently associated with under-five mortality after adjusting for sociodemographic and health systems-related factors. A 10 percentage-points increase in exclusive breastfeeding was associated with a reduction of 5 child deaths per 1,000 live births. A one-unit increase in Human Development Index was associated with a decrease of 231 under-five child deaths per 1,000 live births. A $100 increase in per capita health care expenditure was associated with a decrease of 2 child deaths per 1,000 live births. One unit increase in physician density was associated with 2.8 units decrease in the under-five mortality rate.Conclusions and Global Health Implications:Population-level health system and socioeconomic factors exert considerable effect on the association between exclusive breastfeeding and under-five mortality. Given that the health policy and socioeconomic indicators shown to influence exclusive breastfeeding and under-five mortality are modifiable, policy makers could potentially target specific policies and programs to address national-level deficiencies in these sectors to reduce under-five mortality in their countries.

Prevalence and Determinants of Exclusive Breastfeeding Practice among Mothers of Children Aged 6–24 Months in Hail, Saudi Arabia

“…Infants who are breastfed have reduced risks of asthma, obesity, Type 1 diabetes, severe lower respiratory disease, acute otitis media, sudden infant death syndrome, gastrointestinal infections, and necrotizing enterocolitis for preterm infants [ 1 , 2 ]. Studies have shown also an inverse relationship between exclusive breastfeeding (EBF) and infant mortality rates in developing countries [ 3 ], so that WHO described EBF as the single most effective intervention to improve the survival of children [ 4 ]. Women who breastfeed also have a reduced risk of high blood pressure, Type 2 diabetes, ovarian cancer, and breast cancer [ 1 , 2 ].…”

Breastfeeding Knowledge and Practices among Mothers of Children under 2 Years of Age Living in a Military Barrack in Southwest Nigeria

“…[8] Studies have shown an inverse relationship between exclusive breastfeeding and infant mortality rates in developing countries. [11,12] Appropriate infant feeding practices are required if Nigeria is to achieve this goal. [8]…”

Nutritional Anaemia and Obesity in the Eastern Mediterranean Region: The Protective Role of Breastfeeding for Two Years

“…EBF for six months has been shown to have short and long-term outcomes on the health, growth and development of children and young adults (34,35) . There is also growing evidence that CBF for two years may also have long term protective effects on the health of mothers and breastfed children as adults…”

“…There were no significant correlations between TFS, EBF and anaemia. These indicators are important as they reduce serious infectious diseases (34,35) and thereby reduce NA. Whereas early introduction of cow's milk-based foods may increase NA by inducing cow's milk allergy (18) .…”