This study investigates the effect of both total and unsupplemented breast-feeding in conjunction with birth interval on early childhood mortality, using longitudinal data from Matlab, Bangladesh. A discrete hazard model approach shows that it is not the duration of total breast-feeding but the duration of unsupplemented breast-feeding which increases child survival. Unsupplemented breast-feeding appears as such as crucial determinant of early childhood mortality that its effect could not be substantially attenuated even when important demographic and socioeconomic factors were controlled. Each of the covariates--supplementation, previous birth interval and onset of a subsequent conception--has an independent influence on early childhood mortality.
PIP: An analysis of longitudinal data on 2990 women, 13-49 years old, delivering in 1980 in the Matlab, Bangladesh, was conducted to examine the effect of total and unsupplemented breast feeding in conjunction with birth interval on early childhood mortality. Mean length of previous and subsequent birth intervals were 35.4 and 33.3 months, respectively (range, 9-61 months and 10-59 months, respectively). The mothers breast fed on average 29.77 months (0-59 months). They practiced exclusive breast feeding for 5.82 months (0-31 months). A child who received supplementary feedings early was 2.1 times more likely to face early childhood mortality than the child who did not receive supplementary feeding (p .001). When the researcher controlled for parity, sex of child, maternal education, and preceding and subsequent birth intervals, the effect of total months of breast feeding to improve child survival almost disappeared (exponent fell from .809 to .099), while the effect of unsupplemented breast feeding became even stronger (exponent increased from .590 to .696; p .001). A child who received early supplementation, and whose mother conceived within the first year after the index child's birth, was 8.86 times more likely to face early childhood mortality than a child who did not receive early supplementation, and whose mother did not conceive within the first year after the index child's birth. Supplementation, previous birth interval, and onset of subsequent conception all had an independent effect on early childhood mortality. These findings suggested that mothers should carefully consider the timing of weaning and selection of weaning food to narrow the interval between breast feeding and supplementary feeding, so they can significantly reduce the risk of infant mortality and mortality among young children.