World Development Report 1984

effectiveness of existing laws, instead increased declines in breastfeeding in the last three decades
institutional and community pressure for later slowed the decline in infant mortality.
marriage. In 1980 the government raised the legal At least 70 percent of women in developing
minimum ages to twenty and twenty-two-less countries initially breastfeed their children,
than the widely and officially propounded mini- although this proportion is falling. How long they
mums of twenty-three and twenty-five. This was continue to do so varies widely, from two months
interpreted as a relaxation of controls on marriage, in metropolitan Malaysia to twenty-nine months in
and it may have contributed to a recent increase in rural Bangladesh. The trend is toward less breastmarriage
and a spurt in the birth rate. feeding: in Thailand, for example, between 1969
With the possible exception of China, efforts to and 1979 mothers reduced the average length of
raise the age at marriage by persuasion and edict breastfeeding from 22.4 to 17.5 months in rural
have not been particularly successful. Legislation, areas and from 12.9 to 8.4 months in the cities. In
however, is a way for governments to encourage Malaysia the percentage of infants initially
social support for later marriage; and governments breastfed dropped from 89 to 74 percent between
can link the idea to specific programs, especially 1960 and 1974, and the percentage breastfed more
schooling for girls, which affect fertility indirectly. than three months dropped from 75 to 53 percent.
In countries where early marriage is common, gov- Some decline in the duration of breastfeeding is
ernments need to go further, giving women more a natural consequence of economic development
rights and encouraging men and women to sup- and may be a reasonable choice-if for example, a
port expanded women's opportunities within the working mother's income more than compensates
household as well as in society at large. in improved health care and nutrition for the family.
Studies show that mothers' employment in
itself does not affect whether mothers initiate
Providing information about breastfeeding breastfeeding, but employment may affect how
long they continue to breastfeed. Malaysian
Full breastfeeding and frequent suckling are good women who had recently been employed off the
guarantees that resumption of menstruation will farm tended to wean their children completely at
be delayed, though protection decreases with each an earlier age. Filipino women in a semiurban setmonth
after childbirth. Failure to menstruate is a ting breastfed if they worked close to home, but
good, but not an absolute, guarantee against preg- started mixed feeding earlier if they worked in a
nancy; about 7 percent of women conceive without different area. In addition, employment may
having resumed menstruation. As a basic form of lengthen periods between sucklings, leading to a
contraception, breastfeeding has a well-estab- briefer amenorrheic period. But especially where
lished reputation in developing countries. In one breastfeeding is being shortened only moderately
study three-quarters of Guatemalan mothers knew from long periods, say, of a year or more, the
that it could postpone conception; in another, 60 mother's and infant's health is unlikely to sufferpercent
of Malaysian women knew it made con- as long as families can afford proper nutrition and
ception more difficult, and 20 percent thought it couples can use contraception to avoid an
made it impossible. Women who breastfeed and unwanted immediate pregnancy.
who want to avoid pregnancy are 10 percent of all But evidence shows that in many cases breastmarried
women in Mexico, 15 percent in Peru, and feeding is being curtailed simply because mothers
16 percent in Honduras. Only ten years ago breast- do not know how to do it; the chief reason given
feeding provided more months of protection for stopping breastfeeding is insufficient milk, yet
against conception in the developing countries that is biologically implausible for all but a few
than did family planning programs. women. Some mothers switch to bottlefeeding
Aside from its effect on fecundity, breastfeeding because they lack guidance and information about
avoids the considerable health risks connected the health benefits of breastfeeding, and they
with bottlefeeding-particularly where the pow- believe bottlefeeding is more "modern." In Malaydered
milk may be improperly prepared, adequate sia women who live with parents, in-laws, or other
sterilization is not possible, and families cannot adult relatives are less likely to abandon breastafford
an adequate supply of powder. Though feeding.
after four to six months mother's milk should be Evidence that behavior will change in the light of
supplemented with other food, continued breast- information comes from the industrialized counfeeding
still benefits a baby's health. In Malaysia tries, where medical opinion did not clearly favor
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