Cathy, While the infant mortality rates have dropped significantly since
1989, the rate being  7 deaths per 1000 in the USA.  What we must take note
of is that for black infants in the USA, the infant mortality rate is 14.1
per 1000.   I also ran across an  article that said that in the Washington,
DC area that the black infant mortality rate was 3 times that of white
infant's(I believe this comes from a study in the Lancet). Thus Rogan's
mathmatical model maybe still relevant just not for our white population. [It
is interesting to note that Cuba which is a resource-poor country has an
infant mortality rate of 6.4 per 1000 and in some districts it is lower than
5 per 1000.  Poverty does not seem to be affecting their infant mortality
rate. Although, I do believe that breastfeeding is more prevalent there.]

When we look at breastfeeding intiation and duration rates in the USA and ask
ourselves which populations are the lest likely to breastfeed and the lest
likely to maintain breastfeeding, we are generally looking at black moms,
teenage moms,  premie moms (initiation may be good but maintaining bfing
poor).  These are the groups of moms that are more likely to have an infant
death.  Yes, these groups of moms may have other major risk factors--poverty,
poor nutritional status, prematurity of infants. But one might believe that
there is a correlation.

I agree with you Cathy, that it is difficult to recognize problems associated
with formula feeding.  But it does seem that there there is some relationship
between infant mortality and method of feeding in developed nations.  Valerie
W. McClain, IBCLC

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