A couple of years ago I did a course at the dutch Open University called "the western familiy in historical and antropological perspective". There was a section on infant mortality. A few bits from it: They make a division between endogen mortality and exogen mortality. endogen mortality is due to problems during delivery and birth defects. During the Anciem Regime the endogen mortality was between 40 and 80 promille. This promillage was pretty constant. Exogen mortality could differ from time to time and from regio to regio. I think these are the mortality rates Jack talks about when he says that social environment is very important in this. Eg, in the pre-statistic period (before 1800-1850), total mortality rate was 150 to 250 promille during the first year on the county. In the city it was higher. Between 1 and 5 year the mortality rate was 150 promille. Between 5 and 15 year the mortality rate was 50-75 promille. In other words 30% of the infants died before the age of 5, and 40 % died before 15 years old. during the third quart of the 17th century and the second quart of the 18th century the infant mortality rate was very high. Round 1800 and during the beginning of the 19th century the mortality rates dropped. During 19th century the mortality rates dropped in Western Europe, except in (the current) Holland and Belgium. Here the mortality rates increased. This was caused by the decreasing bf rates. There was a tigth connection between the bf rate, the fertility rate and the infant mortality rate. Eg in Beieren (south Germany), the bf rates were practiaclly zero, the fertility rate maximal, and the mortality rate very high. In Zeeland, with a very high mortality rate, babies from 2 months old were given pap and coffee. In amsterdam the mortality rate among the Jew was much lower bc they breastfed their children. In 1905-106 in Nijmegen, a Dutch city, the mortality rate among breastfed babies was 52 promille, and among artificially fed babies it was 366 promille (note that this is much higher than during the Anciem Regime). another factor was the social one. Among rich families the mortality rates of breastfed children was 2 or 3 times lower than among breastfed babies of poor families. For artificial fed children, the mortality rate of poor children was 15 times higher than of rich children. the mortality rate of woman during childbirth or shortly after it was 7 to 8%. regards, --- Annelies Bon Breastfeeding Resources http://utopia.knoware.nl/users/abon/bfbronnen.html breastfeeding counsellor of the Dutch bf org "Borstvoeding Natuurlijk" mailto:[log in to unmask] living in a new small city, Almere, near Amsterdam, The Netherlands