We recently had a series of articles about our infant mortality and how we are
worse than any state in the union.  In the article they stressed the large
number of teen moms and showed a picture of one bottle feeding.  I am posting
the answer that one of the pediatricians I work with wrote as I thought it was
very good - and succinct.  I am posting with her permission.

Breastfeeding and essential weapon against infant mortality

I commend the STAR for recent articles on the island's high infant mortality
rate. I also commend the secretary of  health for launching the educational
campaign to decrease infant mortality.  Clearly, emphasis on adequate prentatl
care and avoidance of drugs, alcohol and cigarettes during pregnancy are
important.

However, there is a glaring omission in the article:  the extremely low rates
and durations of breasteeding in Puerto Rico substantially contribute to infant
mortality.  It is widely accepted that formula feeding is associated with
increased infant mortality as well as morbidity (disease), even in developed
countries.  Estimates are that, even in the United States, breastfeeding has the
potential to decrease infant mortality by 4 in every 1,000 live births.

If Puerto Rico could achieve high rates of exclusive breastfeeding for 4 to 6
months as is currecntly recommended, there would be a huge impact on infant
mortality incidence, bringing the 12.7 in 1,000 much closer to average stateside
levesl of 8 in 1,000.

The picture on the May 4 article on teenage pregancy tells the story.  The baby
has a bottle in it's mouth.  This was a missed opportunity to point out the all
to obvious correlation between the problem (dying children) and one of the most
efficient and readily available solutions (mother's milk).

Both the Puerto Rico and the San Juan Health Departments have proclaimed public
policies to promote breastfeeding.  We cannot afford to miss such golden
opportunities as your article to educate people about the benefits of
breastfeeding - and the risks of formula feeding.  More importantly, Feliciano
[Sec. of Health of Puerto Rico] and Varela [ Head of Dept. of Health of San
Juan] MUST include breastfeeding support and promotion in both the "Action
Committee for the Prevention of Infant Mortality" as well as the home visitation
probram for at-risk mothers.

Caroline J. Chantry, MD, FAAP
Centro Pediatrico de Lactancia y Crianza, Inc.
Ashford Hospital, Condado [Puerto Rico]