Retrospective and prospective data collected in Cameroon were used to reassess hypotheses about how infant and early childhood mortality is affected by birth spacing and breast-feeding. These data show that: (a) a short preceding birth interval is detrimental for child survival in the first 4 months of life; (b) full and partial breast-feeding have direct protective effects on child survival in the first 4-6 months of life, with the effects of the former stronger than those of the latter; (c) early (...) subsequent conception significantly increases mortality risks in the first 16 months of life of the index child. These findings are robust to various controls, e.g. study design, data defects, child's health conditions at/around birth, postnatal maternal and child recurrent illnesses, patterns of utilisation of health care services, and immunisation status of the child. (shrink)

SummaryIntense, sustained nursing lengthens inter-birth intervals and is causally linked with low natural fertility. However, in traditional settings, the effects of such nursing on fertility are difficult to disentangle from those of nutrition. Results from an prospective, direct observational study of reproductive function in well-nourished Amele women who nurse intensively and persistently but who also have high fertility are here presented. Endocrine measures show that ovarian activity resumes by median 11·0 months postpartum. Median duration of postpartum amenorrhoea is 11·3 months, (...) time to next conception is 19·0 months, and the inter-birth interval is 28·0 months. Average life time fertility is 6·8. High fertility in Amele women is due both to refractoriness of reproductive function to suckling stimuli, and to maintenance of equivalent age-specific fertility rates across the reproductive life span. (shrink)

SummaryIntense, sustained nursing lengthens inter-birth intervals and is causally linked with low natural fertility. However, in traditional settings, the effects of such nursing on fertility are difficult to disentangle from those of nutrition. Results from an prospective, direct observational study of reproductive function in well-nourished Amele women who nurse intensively and persistently but who also have high fertility are here presented. Endocrine measures show that ovarian activity resumes by median 11·0 months postpartum. Median duration of postpartum amenorrhoea is 11·3 months, (...) time to next conception is 19·0 months, and the inter-birth interval is 28·0 months. Average life time fertility is 6·8. High fertility in Amele women is due both to refractoriness of reproductive function to suckling stimuli, and to maintenance of equivalent age-specific fertility rates across the reproductive life span. (shrink)