169.07 Impact of modernization on reduced duration of breastfeeding:  Implications on child health status in low income countries

Thursday, April 30, 2009
Charles-Edward Amory Winslow (The Hilton Istanbul Hotel )
Monika Sawhney Tulane University School of Public Health and Tropical Medicine, USA
Collins Opiyo University of Pennsylvania, USA
The association between duration of breastfeeding and child survival is strong and positive, especially in pre-modern societies. Breast milk provides a child with adequate nutrient intake and immunologic defense, as well as helps to regulate birth-spacing. However, forces of modernization necessarily reduce the duration and intensity of breastfeeding, thereby reducing its impact on child survival. While many studies have attempted to explore the breastfeeding-modernization-child survival nexus (Palloni and Millman 1986), cross-country studies, particularly among low income nations, are lacking. An interesting research question, therefore, is: To what extent does modernization reduce the impact of breastfeeding on child survival in low income countries?

The objectives of this study are twofold. The first is to determine the extent to which modernization mediates the impact of breastfeeding on infant and child mortality across low income countries. The second is to recommend some policy actions that would enhance complementarity in the roles of breastfeeding and modernization on one hand and infant and child mortality on the other. The study is based on 24 low-income countries where Demographic and Health Survey data are available for the year 2000 and beyond. A proportional hazards multivariate model - Cox regression - is used in the analysis. Preliminary results show that breastfeeding, as expected, is positively and strongly associated with child survival, and that the longer its duration the greater the impact on childhood mortality. Although modernization reduces its beneficial effect, longer duration of breastfeeding still ensures greater child survival, regardless. Policies at national and regions levels should encourage breastfeeding in adverse/poor conditions – especially where water and sanitation are poor. Government and other agencies should propose and implement policies that encourage prolonged breastfeeding which will reduce exposure of young children to the hazardous environments in less economically developed countries, thereby lowering child morbidly and their risk of death.


Learning Objectives: 1. Recognize the importance of breastfeeding toward improving child survival among low income countries. 2. Consider breastfeeding as an integral part of child survival programs in low income countries. 3. Develop policy ideas that will promote full breastfeeding among low income countries.

Sub-Theme: Social determinants of health and disease
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