The statistic from the US Institute on Environmental Health Sciences on
infant mortality is either misstated or an example of innumeracy.  The
infant mortality rate in the US is about 8.4. Does anyone believe that
not breastfeeding is responsible for HALF of those deaths? Remember that
even in industsrial countries where most mothers breastfeed at the
beginnning, the infant mortality rate is 4.4-6.8 per thousand.

In addition to the problems of poverty and inadequate prenatal care,
there are many statistical reasons why the US rate is high relative to
other industrialized countries. These include that in the US, any live
birth (eg babies delivered at 22 weeks), even babies who live for a
minute or two, are almost always reported as live births and included in
the rate. Asian countries and countries where home birth is more
prevelent do not follow this practice and thus their rates miss many of
these early deaths.

Since the vast majority of infant (O-1 year) deaths occur in the
neonatal period (0-27 days)and the presumably the prepondence of those
babies were very sick from the beginning and never breastfed, the risk
to not breastfeeding is artificially inflated.  In other words, it looks
incredibly risking to not breastfeed if all the babies who are so sick
that they are probably going to die no matter what are never breastfed.
We can all advocate that every child be breastfed but we can't delude
ourselves that breastmilk would save the many of there mortally sick
babies. Therefore, we can't claim that these deaths are a result of not
breastfeeding! But that is just what this statistic does--it essentially
says that these babies died from lack of breastmilk, when it fact they
were unfortunatelly denied breastmilk because they were so sick anyway.

We all believe that breastfeeding is vital to infant health.  It
behooves us all to be very careful that the statistics we use to make
our case are accurate and reasonable.

Warmly,
Judith Gelman, IBCLC
Washington, DC
(formally a health economist)