Breastfeeding

17. Breastfeeding has so many anti-ineffective qualities, it should be viewed as a form of immunization. This was one of a number of useful insights by Mary Ann Anderson, Public Health Advisor to USAID, at her October 23 Nutrition Seminar. She reported that an estimated 7 million lives are saved annually by the protective effects of breastfeeding (9 million children a year already die, so without breastfeeding we are talking of 16 million deaths), mostly by reducing diarrheal disease but also acute respiratory infections. This could be increased by another 1.3 million, if exclusive breastfeeding were practiced --i.e., without giving water or other liquids and foods during the first 4-6 months of life. She cautioned that current data, because it does not distinguish between partial and exclusive breastfeeding, in many cases gives the wrong impression that no programmatic efforts to improve breastfeeding practices are necessary. She noted that exclusive breastfeeding in the presence of amenorrhea provides 98 percent protection of pregnancy in the first six months of life.

18. Up to 41 percent of Egyptian pregnancies occur because women stop breastfeeding -- 52 percent among women who do not use contraceptives, according to a recent PRE Working Paper (WPS 478) on "Interrelations Among Child Mortality, Breastfeeding, and Fertility in Egypt, 1975-80." Johns Marcotte and Casterline also report that early weaning is responsible for up to 29 percent of Egyptian children's deaths. Almost a fifth of pregnancies are undertaken in response to these deaths. But it is not actual mortality but perceptions of a child's chances for survival that drive fertility, according to the authors. The analysis involved regression models for the risk of three events occurring after a live birth: another pregnancy, weaning, or the death of the child.

19. An analysis of breastfeeding in Maghreb countries ("The Demographic Challenge to Sustainable Economic Development"), also highlights the contraceptive effect of breastfeeding. In the 1960s breastfeeding kept fertility in Morocco 40 percent below its potential maximum level. Although in the 1980s this dropped to 28 percent, the contraceptive effect of breastfeeding is still more important than all other contraceptives -- which reduce fertility by only 22 percent. The report notes that further reductions in breastfeeding in Morocco would contribute to increased fertility, requiring an expansion of family planning services.

20. Along similar lines, data presented at the UNICEF/WHO breastfeeding meeting in July showed that if breastfeeding stopped there would be a need to increase contraceptive use in Bangladesh by 52 percent, in Mexico by 41 percent, and in Kenya by 56 percent --just to maintain the current fertility rates.

21. Food Outlook. A record 1990 cereal crop is being harvested, reflecting sharp increases in North America and the USSR, but also bumper crops in India and China. Availabilities of wheat and rice are projected to rise 8 percent and 2 percent, respectively. Still, while cereal stocks are expected to rise for the first time in four years, global carryover stocks will remain close to the minimum level considered necessary to safeguard world food security.... Poor prospects for harvests in Ethiopia and Sudan give cause for concern, and the food supply situations in Liberia, Angola and Mozambique continue to deteriorate.... Food aid is expected to increase, by about 4 percent over last year, but still much lower than in the mid-1980s.