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Abstract
A review of the biochemical composition of mother's milk, together with evidence from historical demography, leads to the conjecture that breast-feeding might currently be associated with reduced mortality where environmental conditions are poor. Studies in contemporary Third World countries provide equivocal evidence for the protective effect of breast-feeding there: much research has been flawed by lack of proper controls, by methodological shortcomings, or by extremely small samples. This dissertation presents an attempt to control confounding variables and to estimate the relative risks of mortality experienced at different periods early in life, associated with various durations of breast-feeding.
A relatively large sample of Malaysian infants was used. Data on mortality, breast-feeding, and social variables were obtained from a retrospective survey carried out by the Rand Corporation, the Malaysian Department of Statistics, and Survey Research Malaysia. The data were checked for quality and consistency. Using LOGLIN to calculate hazards models--essentially multidimensional life-tables--it was found that breast-feeding had an effect on mortality independent of socio-economic variables and birth cohort. A positive relation was observed between infant survival and longer histories of breast-feeding in four age categories. Breast-feeding was a statistically significant predictor of infant mortality up to age six months. Despite many methodological differences, the results are generally similar to the findings of the Rand Corporation study of the same data. The results imply that where environmental conditions are poor, breast-feeding for longer rather than shorter durations should be encouraged.
