The importance of breastfeeding in minimizing mortality and morbidity from diarrhoeal diseases: the Bangladesh perspective.

Despite world-wide promotion of breastfeeding, there is a declining trend in breastfeeding practice in many developed as well as developing countries. In these countries, health planners are faced with the difficult task of re-educating women on the value of breastfeeding. In this context, it is useful to review the role of breastfeeding in combating infectious diseases, especially childhood diarrhoea, and in preventing deaths. Studies have shown that the duration of benefits of breastfeeding in diarrhoea can range from a few months to several years. However, breastfeeding is not consistently protective in all types of diarrhoea. For example, there is evidence of increased risk of rotavirus diarrhoea in breastfed children compared to non-breastfed children after certain age. Impairment of child growth is another controversial issue associated with prolonged breastfeeding. Is this growth-faltering, or do breastfed children follow a normal growth pattern which is below the reference growth curve? How long should mothers be advised to continue breastfeeding? This review focuses on answers to these questions and discusses benefits of breastfeeding and its controversial issues. The reasons for choosing the case study in Bangladesh are: (i) the prevalence of breastfeeding in Bangladesh is often cited as one of the highest in the world, (ii) diarrhoeal diseases are hyper endemic in this country; and (iii) issues of breastfeeding in several diarrhoeal diseases have been well documented here.