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Breastfeeding protection against infant mortality in Mexico, adjusting for reverse causality
Author(s) -
Cosío Teresita González,
Escobar Leticia,
González Luz Dinorah,
Gatell Hugo López,
Hernández Mauricio
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.850.6
Subject(s) - breastfeeding , medicine , poisson regression , infant mortality , demography , infant formula , pediatrics , causality (physics) , neonatal mortality , breast milk , environmental health , population , physics , quantum mechanics , sociology , biochemistry , chemistry
The effect of breastfeeding (BFing) on the decline of infant (<1yr) mortality (IM) may be overestimated if early neonatal deaths, in infants who cannot breastfeed, are included. Mexican 2012 National Health and Nutrition Survey (NHNS‐2012) data were used. Infant deaths in the last five years were identified by maternal recall (n=1,458 infant mothers, representing, 2,042,011 women). Infants ≥ 1month were considered breastfed (BFed) if mother reported to have BFed her/him for at least 1 month before the survey; infants < 1 month were considered BFed if they received breastmilk for a minimum of 15 days. Mortality was calculated for BFed and not BFed infants in two scenarios: (1) including all infant deaths and (2) excluding 27 (representing 38,289) infants who died and were too sick to breastfeed, to account for reverse causality. Mortality rate ratio (MRR) comparing infants exposed versus unexposed to any BFing, were estimated with Poisson regression. MRR for scenario 1 was 3.01 (CI 95 =2.73, 3.29) and was reduced to 1.32 (CI 95 =1.21–1.44) for scenario 2, which accounts for reverse causality. Non‐breastfed infants had 32% higher mortality than breastfed infants, after controlling for reverse causality. Lactation in Mexico is largely unprotected and breastfeeding rates are decreasing, according to NHNS‐2012, though current policy is addressing this decline. These IM data point to the magnitude of the potential benefit neglected due to non‐breastfeeding. Funding for the National Health and Nutrition Survey was obtained from the Mexican Secretariat of Health.