Effect of breastfeeding practices on infant and child mortality in Africa: Systematic review and meta-analysis

Abstract

Objective: Lack of exclusive breastfeeding for infants withi the age of 0 and 6 months and no breastfeeding for children aged 6 to 24 months is linked to increased odds of death before the second birthday. Infant mortality in these age groups is due to bot infectious and non-infectious causes. We examine the existing evidence for impact of proper breastfeeding on all-cause mortality in children aged 0 to 24 months in Africa. Methods: We carried out a systematic search of the literature to examine the in_uence of other breastfeeding practices versus EBF on mortality rates in the initial 180 days post birth and the e_ect of no breastfeeding versus any breastfeeding type on mortality rates between 6 and 24 months post birth. We Performed our search in the PubMed and Cochrane Library databases. Data obtained was analyzed used the Generic Inverse Variance Method using the R Software, and heterogeneity was assessed using forest plots. Results: The pooled e_ect size (Odds Ratios) for the di_erence in mortality between infants whowere predominantly breastfed vs those thatwere fed on breast-milk alone was found to be 1.15, 95% CI [1.05; 1.27]. This implies that predominantly breastfed children were 15% more likely to die between the months of 0-6 compared to children who were fed on breast-milk alone. Compared to infants who were fed solely on breast-milk, infants that were not breastfed were 9.64 times more likely to die (OR = 9.64 95% CI [8.01; 11.62], Three studies). Compared to infants between the ages of 6-23 months who got any form of breastfeeding, infants who never received any breast-milk were 3.19 times more likely to die (OR = 3.19 95% CI [1.42; 7.15] Five studies). Conclusion: The _ndings from our study are consistent with previous research on the protective ability of proper breastfeeding habits on infant and child mortality. They support the WHO recommended practices of EBF for the half an year and continued/partial breastfeeding up to the second birthday as key interventions in reducing infant and child deaths in these age groups.