Ecological study of effect of breast feeding on infant mortality in Latin America

Objective: To estimate the effect of exclusive breast feeding and partial breast feeding on infant mortality from diarrhoeal disease and acute respiratory infections in Latin America. Design: Attributable fraction analysis of national data on infant mortality and breast feeding. Setting: Latin America and the Caribbean. Main outcome measures: Mortality from diarrhoeal disease and acute respiratory infections and nationally representative breastfeeding rates. Results: 55% of infant deaths from diarrhoeal disease and acute respiratory infections in Latin America are preventable by exclusive breast feeding among infants aged 0-3 months and partial breast feeding throughout the remainder of infancy. Among infants aged 0-3 months, 66% of deaths from these causes are preventable by exclusive breast feeding; among infants aged 4-11 months, 32% of such deaths are preventable by partial breast feeding. 13.9% of infant deaths from all causes are preventable by these breastfeeding patterns. The annual number of preventable deaths is about 52 000 for the region. Conclusions: Exclusive breastfeeding of infants aged 0-3 months and partial breastfeeding throughout the remainder of infancy could substantially reduce infant mortality in Latin America. Interventions to promote breast feeding should target younger infants.