Birth weight and the effects of birth spacing and breastfeeding on infant mortality

Analyses previously reported, based on data from the World Fertility Survey (WFS), are replicated here with data from the Malaysian Family Life Survey. Comparison of results, when data limitations inherent in the World Fertility Surveys are reproduced or relaxed, suggests that these limitations cause little distortion, and thus bolsters confidence in the validity of results based on WFS data in which these limitations are inescapable. Generalizations based on the present investigation and on the body of previous work that it tends to validate are presented. Most significantly, these include the greater importance of both breastfeeding and birth spacing under generally unfavorable conditions, the variability of durations to which some benefit of continued breastfeeding persists, and the observation that the great majority of birth-spacing effects operate through some mechanism other than the association of breastfeeding with birth interval lengths.
PIP: Analyses previously reported, based on data from the World Fertility Survey (WFS) are replicated with data from the Malaysian Family Life Survey, based on a stratified probability sample for 1,262 ever-married women 50 years of age in Peninsular Malaysia. Comparison of the results, when data limitations inherent in the WFS are reproduced or relaxed, suggests that these limitations cause little distortion, and thus bolsters confidence in the validity of results based on WFS data in which these limitations are inescapable. Generalizations based on the present investigation and on the body of previous work that it tends to validate are presented. The greater importance of both breastfeeding and birth spacing under generally unfavorable conditions becomes clear. The relationship between breastfeeding and survival for all births, as well as for the last 2 births, emphasized in this model, has a logit coefficint significant at the .01 level for the 1st month of life as well as the period from birth to 1 year. The durations to which some benefit of continued breastfeeding persists, are variable. In countries where the situation generally is more favorable to child survival, as indicated by rates of infant mortality, breastfeeding's positive effects on child survival are less significant. Breastfeeding promotion and continuation should be the goal especially for programs operating among very poor groups. The great majority of birth spacing effects operate through some mechanism other than the association of breastfeeding with birth interval lengths, as indicated by the fact that significant survival advantages are often associated with birth spacing after controlling for breastfeeding