Changing impact of breastfeeding on infant and child mortality: A comparative study of Kenya and India

The relationship between breastfeeding and child survival is strong and positive, particularly in pre-modern societies. However, as society modernizes the duration of breastfeeding is often reduced. This portends danger for child survival mainly through reduced nutrient intake, immunologic protection and birth spacing, and increased exposure to pathogenic agents through contaminated food and water. These adverse effects are often mitigated by changes associated with modernization but that are favorable to child survival such adequacy of alternative nutrient sources and child health services, improved water and environmental sanitation, and increased contraception.

The objectives of this study are twofold: (1) examine the extent to which modernization has eroded the beneficial effects of breastfeeding in low income countries; (2) recommend some policy actions that will compensate for the adverse effects of modernization.

The study is based on maternity history data from the Kenyan and Indian Demographic and Health Surveys. It uses the proportional hazards models to examine the relative impact of breastfeeding on childhood mortality when variables associated with high socio-economic status – such as education, income, urbanization, contraception, and piped water - and other background characteristics are controlled.

The results show, inter alia, that full breastfeeding for at least six months has large beneficial effects on child survival regardless of socio-economic status. There is therefore need to promote practices that will ensure full breastfeeding for the first six months of a child's life in low income countries.