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N. Binta Mané, MS, Kirsten B. Simondon, MD, PhD, Aldiouma Diallo, MD, Adama M. Marra, MS and François Simondon, MD, PhD

At the time of this study, Binta Mané was with the Institut de Recherche pour le Développement (IRD), Centre IRD de Montpellier, Montpellier, France. Kirsten B. Simondon and François Simondon are with Research Unit 24, Centre IRD de Montpellier. Aldiouma Diallo and Adama M. Marra are with Service Unit 009, Centre IRD de Dakar, Dakar, Senegal.

Correspondence: Requests for reprints should be sent to Kirsten B. Simondon, MD, PhD, Epidemiology and Prevention Research Unit, Centre IRD de Montpellier, BP 64501, 34394 Montpellier cedex 5, France (e-mail: kirsten{at}mpl.ird.fr).

Objectives. We studied reasons for cessation of breastfeeding before the age of 15 months, replacement feeding modes, and child mortality in West Africa.

Methods. Data were gathered for 12208 children born between 1987 and 1997 in a rural area of Senegal. Interviews were conducted with caregivers of early-weaned children, and child mortality risks were assessed.

Results. Fewer than 1% of children had been weaned early. The main reasons for early weaning were maternal death and new pregnancy (in 41% and 27% of cases, respectively). Twenty percent of children had been relactated by a wet nurse, and 16% had received formula. Many early-weaned children died before the age of 2 years (26%), particularly those weaned early as a result of the mother’s death (hazard ratio = 5.1; 95% confidence interval [CI] = 1.74, 15.0). Girls had a lower hazard ratio than boys (0.16; 95% CI=0.05, 0.41).

Conclusions. Our results showed that early cessation of breastfeeding was rare but that associated mortality was high, especially when the mother had died.