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Optimal breastfeeding practices and infant and child mortality

Author: Mari Jeeva Sankar , Bireshwar Sinha, Ranadip Chowdhury, Nita Bhandari, Sunita Taneja, Jose Martines, Rajiv Bahl
Year: 2015
Resource type: Article

A Systematic Review and Meta-analysis

Breastfeeding is one of the few interventions where the survival benefits span the entire continuum of childhood: newborn, infancy and early childhood. Both the World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) recommend early initiation of breastfeeding, exclusive breastfeeding during the first 6 months of life and continued breastfeeding until 24 months of age. Yet breastfeeding rates globally generally remain low. Only 43% of the world’s newborns are put to the breast within 1 h of birth and 40% of infants aged 6 months or less are exclusively breastfed. A number of reviews have evaluated the impact of breastfeeding on child mortality. The Bellagio Child Survival Series, published in The Lancet in 2003, identified optimal breastfeeding as the key intervention that could prevent up to 13% of under-5 child deaths . Subsequent reviews in the Lancet Neonatal Survival Series and Nutrition series used the Lives Saved Tool (LiST) to model the effect of scaling-up breastfeeding and reaffirmed the importance of breastfeeding in reducing neonatal, infant and child mortality.


Recent estimates suggest that optimal breastfeeding could prevent around 12% deaths in under-5 children every year,amounting to around 800 000 lives in low- and middleincome countries (LMICs) . However, the systematic reviews that formed the evidence base for the estimates were either restricted to a specific age group, such as neonates, or examined the effect of breastfeeding on specific infections such as pneumonia and diarrhoea. Such a focused approach restricts the search of the available literature as well as selection of studies, thereby risking the exclusion of some studies that had reported on other beneficial effects of breastfeeding. Here, we systematically review the available literature and estimate the effects of optimal breastfeeding on (i) all-cause mortality and (ii) infection-related mortality in infants and children aged 0–23 months.

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Mari Jeeva Sankar , Bireshwar Sinha, Ranadip Chowdhury, Nita Bhandari, Sunita Taneja, Jose Martines, Rajiv Bahl (2015). Optimal breastfeeding practices and infant and child mortality. www.ennonline.net/optimalbreastfeedingpracticessankaretal

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