Dear all:

I want to point out that infant mortality is about breastfeeding.  I have not had a chance to read 
the original article and skipped a few days of postings on Lactnet, but I think I will send yet 
another polite note to the Gates foundation about this particular topic.  

First, there is nothing more frustrating to me than the general ignorance about infant mortality 
being related to birth control.  This whole premise has been shown to be flawed time and time 
again.  It is basic to Demography 101.  In most countries of the world it has been shown that high 
birth rates do not decline until the infant mortality rates drop.  When you routinely see one in five 
children die right before your very eyes and have your own children die, why wouldn't you want to 
have more to soften the sorrow of your losses or that of your friends and neighbors?  

The most useless waste of money I ever saw (apart from five field workers who had a huge grant 
to look at human rights in Cambodia and spent a year sitting in a little village only to conclude 
what anyone with half a brain could have told them in five minutes ---- that the right to food was 
fundamental) was for population control in Niger.  More money was spent n population control 
than any other program.  The infant mortality rates are right up there with Afghanastan.  Had they 
put even a little more money into other programs to increase food availability, they might have 
seen the birth rates drop.

So, here's the connection to infant mortality rates.  Central and West Africa now have the lowest 
rates of breastfeeding among infants under six months old.  Rather than focusing on 
breastfeeding the Global Fund focuses on products:  immunizations, supplements, bed nets.  All 
of these really do reduce the mortality rates and in these settings are a crucial adjunct to the 
public health programs, but which intervention was shown in the Lancet article to have far more 
impact on mortality?  Breastfeeding.  Why the most fundamental of all interventions (which really 
shouldn't be an intervention because it just should never have been disrupted in the first place) is 
not even on the Global Health list is totally irrational.  

I did receive a nice note from the Gates foundation when I wrote them the first time.  So, I'm going 
to write them again and again and again.  To my knowledge I only heard a rumor of one small 
program funded by the Gates Foundation, run by Save the Children that did anything about 
breastfeeding.

So, if infant mortality is high in the United States, and if we have a peer-reviewed article that 
looked pretty solid to me that shows an increase in mortality of 26.6% from formula feeding 
(thank you Karleen for correcting our math on the odds ratios), then it seems to me that correcting 
this problem should be the first on the list of all public health programs in the US.

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