In the current Journal of Human Lactation, Laurie Nommsen-Rivers IBCLC
reviews the Chen & Rogan article which has been quoted in the media for its
suggestion a 21% reduction in U.S. infant mortality for any breastfeeding,
which converts to a 27% increase in deaths for formula-fed. More amazing,
the Chen Rogan paper suggests a 1/.62= a 61% increase in infant mortality
for no breastfeeding in the first 3 months of life.

Nommsen-Rivers discusses the efforts made in the Chen/Rogan to compensate
for confounding factors and the calculations involved, as well as many
reasons why the Chen/Rogan paper may be actually underestimating the full
life savings of breastfeeding: such as their exclusion of the numbers for
the first month, where the most deaths occur, and of course the non-
recognition of exclusive breastfeeding versus supplemented.

Nommsen-Rivers goes on to discuss ways in which the paper could be
overestimating the impact. "Death from injuries" is quite reduced in babies
ever breastfed in the Chen/Rogan sample, which is a bit counter-intuitive
to the actual qualities of breastmilk itself and may more reflect the
attendant parenting practices such as differences in daycare use. I
personally question the SIDS effect here, as some crib/bed deaths are
classified simply as SIDS and some as suffocation or other "accidental"
causes -- factors which are lumped into "accidental deaths" -- while it is
becoming accepted science that breastfeeding reduces SIDS deaths.

These papers lead certainly to even more-controlled studies in the future.

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