EFFECT OF NOT BREAST-FEEDING ON THE RISK OF DIARRHEAL AND RESPIRATORYMORTALITY IN CHILDREN UNDER 2 YEARS OF AGE IN METRO-CEBU, THE PHILIPPINES

The effects of not breastfeeding on mortality due to diarrhea and acut e lower respiratory infection (ALRI) in children under 2 years of age were examined using data from a 1988-1991 longitudinal study of 9,942 children in Metro Cebu, The Philippines. Cox regression-methods were u sed to study the magnitude of the risks, possible interactions with bi rth weight and nutritional status, and the effect of additional confou nding factors, Not breast feeding had a greater effect on diarrheal mo rtality than on ALRI mortality. ln the first 6 months of life, failing to initiate breastfeeding or ceasing to breastfeed resulted in an 8- to 10-fold increase in the rate of diarrheal mortality. The rate of mo rtality associated with both ALRI and diarrhea was increased nearly si x times by not breastfeeding, but the rate of ALRI mortality alone was not increased, The data also suggested that the risk of mortality ass ociated with not breastfeeding was greater for low birth weight infant s and infants whose mothers had little formal education, After age 6 m onths, the protective effects of breastfeeding dropped dramatically, T hese findings underscore the importance of promoting breastfeeding, es pecially during the first; 6 months of life, and of targeting high ris k groups such as low birth weight babies and those of low socioeconomi c status.