Breastfeeding in Africa and the Latin American and Caribbean region: the potential role of urbanization.

This paper compares breastfeeding patterns in Africa (AFR) and the Latin American and Caribbean region (LATCAR) based on demographic and health surveys conducted in 23 countries between 1986 and 1990. Results indicate that the proportion of infants who are never breastfed is twice as high in LATCAR than in AFR. The average median breastfeeding duration is 1.64 times higher in AFR (19.3 months) than in LATCAR (11.8 months). The longer breastfeeding duration found in AFR was due to a better lactation performance in both rural and urban areas. In both LATCAR and AFR 71 per cent of the 0-4-month infants were not breastfed exclusively during the first 4 months of life and breastfeeding duration was longer in rural than in urban areas. However, the degree of urbanization had a stronger negative effect on breastfeeding in LATCAR than in AFR. It is concluded that: (a) while LATCAR is in great need of breastfeeding promotion programmes, breastfeeding in AFR should be protected as it becomes more urbanized; (b) the promotion of exclusive breastfeeding remains a priority in both regions; and (c) the magnitude of the inverse association between urbanization and breastfeeding is likely to vary among regions with different socio-economic and cultural backgrounds.