Phyllis, I think that perhaps you are misinterpreting this...I'll have a go at explaining my interpretation.

"Infant mortality has tended to be highest among populations in which breastfeeding was most common: the poor."
Yes, infant mortality has been highest amongst the poorest populations. However, high breastfeeding rates have assisted in protecting against even worse infant mortality rates in these poor populations (keeping in mind that exclusive breastfeeding rates are also low nearly everywhere).

"The advent of primary health care for a large portion of a population may explain decreased in infant mortality in the face of declines in breastfeeding."
Infant mortality rates in some populations have decreased in some populations. Paradoxically, breastfeeding rates have decreased at the same time. You would think that as breastfeeding rates decreased that mortality rates would increase however, at the same time that breastfeeding rates decreased the availability of primary health care increased which compensated (and then some) for the decrease in breastfeeding rates. Had breastfeeding rates not decreased there would have been an even bigger decrease in infant mortality.

Karleen Gribble
Australia

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