Abstract

PIP: According to a Family Health International study, proper policies regarding breastfeeding and the spacing of births should be made a part of national health policies in developing countries, where they can prevent a myriad of infant and maternal deaths each year and help curb population growth. The practice of breastfeeding however is declining in these countries. As part of the World Fertility Survey, data was analyzed from 150,000 women in 29 countries (5 African nations, 12 Asian and Pacific nations, and 12 nations in Central and South America). In Africa and Asia, breastfeeding prevents 4 births during a woman's reproductive years, meaning she will have 1/3 fewer children than she might have otherwise. In Central and South America, modern contraception has largely replaced breastfeeding as a way to regulate fertility. Calculations showed that if the duration of breastfeeding declined by as much as 1/2, average fertility would increase in Africa by 27%, in Asia by more than 22%, and in Central and South America by almost 9%; major increases in contraceptive usage would be required. Infants born 2 years after a preceding birth are twice as likely to die before age 5 as those born after a longer interval. To achieve proper spacing a combination of breastfeeding and modern forms of contraception are needed. Recent research suggests that breastfeeding behavior responds readily to education, social encouragement, activities of women's self-help groups, and changes in medical attitudes and practices. In situations where women work, legislation protecting a woman's right to breastfeed are important. In Africa and Asia public policies should aim to maintain the current level and duration of breastfeeding, especially in urban areas where patterns are changing most rapidly. In the Americas promotion of breastfeeding should concentrate on its health benefits for infants, since it is not used in most of these nations to regulate births. Other methods of contraception are available to ensure 2-year intervals between births that do not interfere with lactation. If mothers in the 29 nations included in the study spaced their pregnancies by an average of at least 2 years, the current total of 2.6 million deaths of children under 1 year would fall by at least 20%, resulting in a saving of about 500,000 lives each year. Roughly 33,000 infant deaths could be prevented each year in Africa, 80,000 in the Americas, and 390,000 in Asia.