In Germany, maternity leave started in 1878 (an employment ban for three weeks after giving birth to a child). In 1883, public health insurance was installed, which included payments for women in childbed as well. We had a major reform starting in 1986 that aimed to ensure social protection for a period of three years for parents (mothers and fathers alike). Parents were protected agains dismissals for 3 years, 24 month of which were paid parental leave. This, however, led to rather long work interruptions of mothers (compared by international standards) which is seen as one reason for the rather high gender wage gap in Germany. The reform of 2007 aims to reduce these work interruptions and to promote active fatherhood. Thus, paid paternity leave was reduced to 14 month, with 2 months to be taken by the father. You can send me an e-mail ([email protected]) and I will give you more information about this reform and Germany's family policy monitoring program.

The New America Foundation has webinars on this kind of topic (workplace support for parents). I would check with someone there: http://newamerica.net/.

Germany undertook a major reform to its (quite generous) parental leave program in 2007. As this reform came largely unexpected to (potential) parents, we do have a natural experiment in this field of social policy that will be evaluated in detail in the near future. Some first results are alredy available:

www.rwi-essen.de/publikationen/ruhr-economic-papers/44/

http://www.econstor.eu/bitstream/10419/26623/1/595172806.PDF

Furthermore, the whole system of family policy (child benefits, allowances, joint filing ect.) is at the moment being evaluated by our Ministry of Family Policy. The indicators used are mainly demographic and labor-market oriented, but they want to measure child well-being as well. If you're interested, i can keep you posted.

Joerg I am very interested in your research. Germany has had paid maternal leave since 1883 right? Do you know the goals of the more recent policy? Have the goals for German maternity leave policies changed or remained the same as policies have changed?

In Germany, maternity leave started in 1878 (an employment ban for three weeks after giving birth to a child). In 1883, public health insurance was installed, which included payments for women in childbed as well. We had a major reform starting in 1986 that aimed to ensure social protection for a period of three years for parents (mothers and fathers alike). Parents were protected agains dismissals for 3 years, 24 month of which were paid parental leave. This, however, led to rather long work interruptions of mothers (compared by international standards) which is seen as one reason for the rather high gender wage gap in Germany. The reform of 2007 aims to reduce these work interruptions and to promote active fatherhood. Thus, paid paternity leave was reduced to 14 month, with 2 months to be taken by the father. You can send me an e-mail ([email protected]) and I will give you more information about this reform and Germany's family policy monitoring program.

Our public health surveillance team that reviews infant/fetal deaths has long suspected that paid maternity leave would decrease the number of infants dying in unsafe sleep environments because moms who return to work shortly after giving birth may be more likely bring their infant into bed with them because they are desperate for sleep and have to get up for work in the morning. This has never been researched, to the best of my knowledge, but probably should be!

Paid maternity leave is essential before and after child birth for the health and well being of mother and child.in india,facilities in the public sector is satisfactory but not so in private sector.it should be monitored by the government.

Faith, from what I have read the majority of people do sleep with their babies. I have also read that increased paid leave decreases infant mortality. I think it is difficult to identify a specific cause for the decrease, but I know that there is a great deal of research on the harmful effects of stress on the mother as well as the fetus or infant.

As an employer and a mother, I can personally speak to both issues. As a mother it is comforting to know I would have a job and I had time to arrange child care. As an employer, I had two key people out at the same time. It was a hardship on the company and the other employees.

I think paid maternal leave has a positive influence on parents as it would

avoid them from worrying that the family budget is reduced, whereas their expenditure is increasing due to the additional member in the family. As such, this support helps the family to focus more on taking care of the baby and the mother to recover from child birth..

Noorsharipah, Thank you for your thoughts. Do you know much about the maternity leave policies in Malaysia? Are families given non-monetary social support? Are all women able to benefit from the policy or is it limited to certain women?

I tried to stress the social value of maternity/paternity/parental leave arrangements in EU 27. Please see the link below:

http://eprints.lse.ac.uk/46298/

I hope it helps

In Brazil maternity leave lasts 4 months what guarantee nursing and bonding between mother and baby. Healthier baby and mother.

VERY INTERESTING, Joerg!! And during the Cold War split, did East Germany retain the old systems? Very interesting!

Hi Emily, thanks for your question. Allow me to give you some info about maternity leave in Malaysia. Mothers get full pay. At one time, maternity leave was for just 6 weeks, then the duration increased to 2 months and recently extended to 3 months. Fathers also get a few days leave. (I'm probably not the best source of info...)

Well, it takes time for healing to take place and for the uterus to contract. I believe paid maternity leave does enhance the well-being of the family :)

High Emily,,

I've not been following the current policies on this in particular. But what I know, in Malaysia the women here are quite lucky as we have been well treated and we have a specific ministry known a Ministry of Women, Family and Community Development. We have been having maternity leave benefit, if I'm not mistaken since 1960's or perhaps since independence (1957). The policy has been improved ever since. In 1970's, 80's and 90's, maternity leave in the government sector was only for 42 days but nowadays it has been increased to 3 months. However, in the private sector this benefit varies between 1, 2 or 3 months depending on the employers' decision. Besides maternity leave the government has also introduced Paternity leave which is 7 days leave for a husband when his wife gives birth, for him to settle the family chores and to support the wife. I hope I have given you some insights on the situation in Malaysia. To get more info, perhaps you should try to search the Ministry of Women' s website.

For those of you interested in maternal leave programs: the German Max Planck Institute for Demographic Research offers a "Comparative Family Policy DataBase" that covers 22 OECD countries and includes information on materity leave as well. Registration is free of charge. The dataset is located here:

http://www.demogr.mpg.de/en/projects_publications/online_databases_1906/default.htm

Best,

Joerg

@Voxi: There is not too much research on East German family policy, at least not to my knowledge. After WWII, family policy in East Germany was designed to boost female labor supply. Therefore, maternity leave was rather short and mothers returned to work after 2 or 3 month, predominantly on a full-time basis. This, however, changed during the mid-1980s, when paid maternity leave covered 12 month after giving birth to a child (18 month for mothers with 2 or more children). As far as I know, one reason for that policy shift was to increase fertility rates (which declined steadily in East Germany in the 1980s), but I'm not an expert on this.

Nordic reports /book on this:

Gíslason, I.V. & Eydal, G.B. (Eds.) (2011). Parental leave, childcare and gender equality in the Nordic countries. Copenhagen: Nordic Council of Ministers. [English translation of the book Föräldraledighet, omsorgspolitik och jämställdhet i Norden published in 2010].

Eydal, G.B. and Gíslason, I.V (Eds.) (2008). Equal rights to earn and care, the case of Iceland. Reykjavík: Félagsvísindastofnun.

Paid maternity leave is the practice in Nigeria. It usually last for 4 months for those in government employ - 1 month prior to expected date of delivery and 3 months afterwards. The importance of the paid leave cannot be over-emphasized in this part of the world where poverty is endemic - most importantly, it ensures optimal mother-child bonding and child nutrition because of the uninterrupted availability of the mother for exclusive breastfeeding and child's care, for at least 3 months.

I am not sure of any study measuring its efficacy in our environment and designing such study won't be easy because of ethical issues

In Sri Lankam Maternity Benefits are leave entitlement with pay by women workers who delivered a child.

* What are leave a women worker could be received for her confinement?

(i) Any women worker who has no child or one child is entitled for twelve weeks maternity leave for her confinement.

(ii) Any women worker who has two or more children, is entitled for six weeks maternity leave for her confinement.

(iii) If the confinement does not result in the issue of live child, such women is entitled for six weeks maternity leave for her confinement.

* What are the maternity leave entitlement for women workers under Shop & Office Employees Act ?

(i) Any women worker who has no child or one child is entitled for 84 days maternity leave for her confinement.

(ii) Any women worker has two or more children is entitled for 42 days maternity leave for her confinement.

(iii) If the confinement does not result in the issue of live child, such women is entitled for 42 days maternity leave for her confinement.

* Who is entitled for feeding intervals ?

Only women workers covered by the Maternity Benefits Ordinance are entitled for feeding intervals. Women workers covered by the Shop and Office Employees Act are not entitled for feeding intervals.

Under Maternity Benefits Ordinance Employers should allow the women worker two feeding intervals not less than hour during the period of nine hours.

If employer provide suitable place for feeding the child the period for feeding is not less than thirty minuts.

Emily, I agree that it's difficult to pinpoint the reasons for higher infant mortality in the absence of paid parental leave and that infant sleep practices are only one factor, influenced by many things. I do want to clarify that, according to PRAMS data, in MI (2008), 63.6% of moms reported never sleeping with their infants. So at least in my state, most parents do not sleep with their babies. Bed-sharing is highly correlated with unexpected infant death. I hope some day there could be research focused on how paid parental leave influences these practices, since infant unsafe sleep is the leading cause of postneonatal mortality nationally and is nearly 100% preventable.

For a great overview of parental leave maternity/paternity leave and consequences for female labour market participation in 8 countries you are welcome to download National reports on socio-economic trends and welfare policies, under rubrik publications at: www.projectquality.org. For the latest discussions on family policy in the EU try COFACE www.coface-eu.org/

Thank you all so much for your insight. I am amazed by the continual change in national policies. It seems that each country is still changing and manipulating the details of the policy. I am also curious if there is any research on what percentage of women actually use the maternity leave?

I know is the US, a study found that a small percentage of women in the US are eligible for the FMLA job protected leave, and of those eligible, as the time is not paid, many women to not take the leave because they cannot afford to go without pay.

Dear Emily,

perhaps mothers' well-being is often also influenced by the behaviour of fathers. That's why many researchers have started to talk of 'parental leave' rather than maternity leave only.

You might be interested in the International Network on Leave Policies and Research covering 33 countries: http://www.leavenetwork.org/lp_and_r_reports/

or also (for Austria with a view on 'paternity leave'):

http://www.eurofound.europa.eu/eiro/2011/01/articles/AT1101011I.htm

Best wishes,

Kai

I am intrigued by the long term outcomes of different motherhood and parenting variables. I would like to examine societal outcomes of different countries and cohorts based on year of birth, and then to examine how the maternity policies for the year of birth influenced long term outcomes for the cohort. I plan to control for country, year of birth, gender, and income. What additional exogenous variables should I consider in my model?

Sounds like an interesting project. You might want to add educational level and marital status. An interesting book that discusses the prospects for birth cohorts, but from a welfare state perspective is Esping-Andersens, G. (2009) The Incomplete Revolution. It could be a good source for interesting ideas.

I come back to your initial question: the impact on "well being". What's "wellbeing" do you adress? mother's or children? life as a whole or working life? in this latter, do you restrict to worklife balance or do you consider more extensive issues such as their impact on subsequent jobs? in the case you adress the working lifes, Eurofound EWCS microdata is an excellent source.

Maternal paid leave is one of the keys to improve maternal health care and achieve MDG 5.

Dear Emily,

here is a link to a presentation that might be of interest for you:

http://www.euro.centre.org/data/1369300770_43579.pdf

Best wishes,

Kai

An interesting Huffpost article refers to two studies showing that 'Short Maternity Leave Increases Moms' Depression' - see the article (with links to the studies) at http://www.huffingtonpost.com/2011/07/21/maternity-leave-matters-says-study_n_905802.html

An insightful CNN article on paternity leave and it's importance in building a parenting foundation at http://www.cnn.com/2013/06/14/living/fathers-day-paternity-leave/index.html.

Thanks Bill Gee for the link. The problem is finding the right balance. Ideally parents should have the right to stay at home with their child with an adequate wage replacement rate long enough to bond with the child and enjoy parenthood but not so long as to risk losing career momentum/depreciation of education/skills, etc. In Sweden this is about one-year. In the USA where parental leave is mostly unpaid I can appreciate parents depressive feelings about returning to work.

Most countries introduce maternity and paternity paid leave. This type of leave is a moral and psychological support for the couple.

If you want to know more about maternal leave, paternal leave and parental leave in Belgium and Denmark -> take a look at https://www.researchgate.net/publication/237081815_Child_leave_and_childcare_systems_and_their_relation_to_gender_equality_in_labour_market_participation._A_comparative_study_of_Belgium_and_Denmark

Thesis Child leave and childcare systems, and their relation to gen...

MATERNITY RULE /LAW IN INDIA

Pregnancy is a special moment for all mothers-to-be. And this is one time when she needs to take best care of herself so that she can give birth to a healthy and robust baby. Most importantly, all this needs to be done under the supervision of a medical expert. It is normally advised that the mothers-to-be stay at home during this entire duration in order to take premium care of them. Yet, many professional women and employees choose to work throughout the first half.

Now for this there is something called the Maternity Leave Law in India that all working mothers-to-be should be aware of. The correct name by which this law is referred is the Maternity Benefit Act, 1961. It was passed by the Central Government in 1961 and pertains to the whole of India. In other words, the Maternity Benefit Act 1961 is applicable to every institution under the government, be it industrial, commercial or agricultural. It is important for all women to know about it because it provides for certain benefits to her during her pregnancy.

The maternity leave right in India stipulates that a woman cannot be dismissed from her job just because she is expecting. Also this policy provides that all working mothers-to-be are entitled to a maternity leave period of 12 weeks from her office. While the first six weeks of maternity leave is to be taken before delivery, the remaining six weeks of leave will be granted immediately after the child is born. A woman can also ask for light work before she goes off on leave.

Moreover, the maternity leave right in India specifies that the employer cannot deduct her salary under such circumstances. At the same time, the maternity benefits permitted under the Maternity Benefit Act 1961 can only be withdrawn if the employee joins some other organization during this time. Generally a lot of women do not stop working soon after coming to know of their pregnancy. Maternity leave law in India is really helpful to those women who cannot risk leaving their jobs in order to support their family.

Very recently, a modification was suggested in the Maternity Benefits Act of 1961. According to this new proposal, the maternity leave will be extended from the present three months to six months. This decision is sure to evoke a mixed reaction from the public. Some women may welcome it and some may feel it will hamper their professional career. This suggestion was given in lieu of the fact that a baby needs to be nursed by the mother for a minimum of six months. Now, one has to wait and watch whether women will take it acceptingly or will it face opposition from corporate world.

I am really interested in the long-term outcomes for the children.

I think in an economic sense it is important, and extended maternity leave post birth supports breastfeeding which is great for mother and baby. I do worry about the consequences where women are not enjoying work, are heavily pregnant and feel they have to carry on for as long as possible (usually because they want more time with baby but can be financial if they dont qualify for full payments). I have met many woemn who reach labour already exhausted and straight into new motherhood!

Working class women in Nigeria are entitled to 16 weeks paid maternity leave. The woman is expected to commence the leave 6 weeks before the estimated time of delivery to ensure she has enough rest and she is in a good state of health to go through the delivery process. Majority of women however, prefer to deliver before commencing the leave because they seem to need more time after delivery than before delivery and they want their babies to be old enough, at least four months, for them to entrust to the care of another. After resuming work, nursing mothers are allowed to close 2 hours earlier than their colleagues for six months to allow them have more time to be with their babies. It is pertinent to note that exclusive breast feeding is encouraged for the first 4 - 6 months, in Nigeria; hence this pattern of maternity leave and reduced number of hours for 6 months support baby care and child health, and reduces the stress of combining work with demands of frequent child clinics and routine immunization on the mother.

" it's difficult to pinpoint the reasons for higher infant mortality in the absence of paid parental leave"

In Victorian England infant mortality was much higher in industrial cities and large towns. A notable exception were the rural fenlands in East Anglia, where women had to go out into the fields to work. This meant that they were unable to breastfeed their infants properly, or their infants were left in the care of older sibs or relatives. Infants were particularly likely to be fed on their backs, predisposing to infections, many of which were fatal. There were also examples of IM falling during strikes. See Newman's book for much other evidence.

" I have also read that increased paid leave decreases infant mortality. I think it is difficult to identify a specific cause for the decrease"

Does anyone know of current data on leave and IM in general in a developed country?

http://www.maternityaction.org.uk/workingparents.html

the above site will give you information in relation to maternity leave in UK

France has a very generous parental leave policy that aims to cover forgone wages, rather than pay for mother's work (so to speak) and some part of it is mandatory. Beyond that, there is government child care available and mothers have more choices.

Your second question, about the longterm effects *on the children* of paid parental leave (PPL), is not simple to answer. This can only be considered in the light of other social policies, including the level of government support for health care, child care, out-of-school-hours care etc. It is also related to social & cultural norms about bringing up children, and to gender equity. Thus there will not be a simple "yes, PPL makes children 15% healthier" answer. This is deeply culturally embedded.

Yes that is all true and significant. Overall, it is the sociopolitical and economic stance of a people, a country. The US and its capitalism has only recently and (reluctantly) instituted parental leave and it is UNPAID, reflecting the (lip-service) to "It takes a village." There is a profound belief that raising children is ONLY/should be at the hands of mother, father, family w/o any help whatsoever from government. It has been and continues to be a struggle for any family/child policy, no matter how meager (in comparison).

In my interviews with breast milk donors, I saw a very different pattern of donation among USA based mothers. Because most of these mothers needed to be back at work within 6-12 weeks of giving birth, many of them were working hard at expressing/pumping extra breast milk for their infant. Basically creating a stockpile of breast milk in their freezer. Consequently they donated the breast milk they stockpiled before it "expired". This is a very different scenario to donors in countries where maternity leave is provided. These women often had fully breastfeeding relationships with their infants, and did not foresee a need to create a stockpile of milk, so often would not use a pump to express an extra store of milk. Rather, they would express milk deliberately for the milk bank, or alternatively express milk in cases of over supply, and donate that. These are, of course, generalisations, but they are intricately tied maternity leave provisions.

In Pakistan, the 'Maternity Leave' is allowed for 90 days; 45 days before childbirth and 45 days after it. If the actual date of delivery is before the Expected Date of Delivery (EDD), the period BEFORE the childbirth is condoned, but if the delivery takes place after the EDD, the period after childbirth is not relaxed to 45 days after childbirth. The 'Maternity Leave' is allowed for 3 childbirths only. The leave is paid (except for some allowances). The mothers after resuming duties are not given any relaxation in nature or duration of the duty.

Provision of Day-Care-Center, though encouraged to be in institutions employing women, is not so obvious. Some mothers do keep their children with them on work for care and breastfeeding but they face a lot of hardship in doing so. Yet some organizations do care for their workers and help them bring-up their children while not compromising their jobs.

The second part of the question is really complex. Children do get mother-care at home during 'Maternity Leave' of their mothers, and it must be beneficial for them. If the babies are are taken to workplaces, they may face exposure to any environmental pollution and accidents. On the other hand, mothers feel more satisfied when they have children with them at the 'Day-Care' in or near their workplace where they can feed the babies and can take care of them for short intervals between work hours.

I think that using breast-feeding to address the question on how paid maternal leave influences well being will yield limited results in the US because this is a limited group of mothers. On the one hand, they tend to be higher income, college-educated women; on the other hand, immigrant young mothers, at least from Latin America tend to be breast feeders, regardless of SES status.

Very interesting project. I am also studying family policies, however not looking at child health outcomes.

In Sweden we have an extended family policy. We do not have maternity leave, but parental leave with 2 months reserved for each parent (this was introduced with one month 1990 and a second month 2000). Fathers (or partner) have 10 days of leave postpartum. Leave is payed with 80 % replacement rate for 360 days and then 90 days of flat rate. If you are unemployed by the time you have a child one will receive the flat rate for all days. If parents share their leave equally the revive extra money from the government. In Sweden we also have child care for which you pay a flat rate, the health care and dental care for children (to 18 years) is free.

Something very important in the Swedish policy is that for both men and women, no mater how long you are home, one is guaranteed to return to the same work position as before.

In Sweden, more and more father stay at home with children. In countries were couples were parental leave is shared more equally, were women return to work and were a replacement rate is payed, paid and unpaid labour is more equally divided. More equally divided labour between spouses result in better health and well being among men and women.

Looking at child health I belie that it is important to also discuss and research the relationship between fathers leave and child health outcomes (also the health of mothers and fathers), not just mother leave.

Thank you Emma,

I agree. Sweden is doing great things for family care leave policy. I look forward to reading your research!

See Ballard's explanation for the very high infant mortality in Bolton (Med Times Gazette 1872;1;630:

"In some cases women have been known to return as early as a fortnight after their infant has been born and very commonly they return to their factory labour within the month. If the woman should chance to have a relative or female friend at home, or a girl sufficiently old to carry the baby, with whom she can leave it, this is the plan usually adopted...Very young babies are fed usually with milk (such as it is!) out of a bottle...It is no matter for surprise that this system of management results in all the evils of mal-nutrition, in attacks of diarrhoea in the summer and pulmonary inflammation in the winter, and very often in the death of the infants..."

Whilst failure of the mother to feed and rear her infant herself does not have such dire consequences today, at least in the developed world, there are still health problems in non-breastfed infants.

In the developing or non-developed countries, there are far too many factors that affect infant mortality. To focus or blame mothers who don't breast-feed or return to work too often ignores economic, individual, and environmental factors that influence "all the evils of malnutrition" (affecting the mother's health to begin with) is, well, outdated and non-scientific.

Thanks for your comment Mary-Helen, the times they are a changing aren't they! While there is a lot to be said for breast-feeding and it is wonderful if it is possible for mothers to do so, as you point out breast-feeding alone is not the single most important answer to infant mortality.

I realise people don't want to hear this, but breastfeeding is important, for morbidity in developed countries today and mortality in days past, eg:

"STATISTICAL COMPARISON OF THE MORTALITY OF BREAST-FED AND BOTTLE-FED INFANTS

WILLIAM H. DAVIS, M.D.

Am J Dis Child. 1913;V(3):234-247.

ABSTRACT The great importance of breast-feeding has long been known, but so far the subject has failed to secure its proper share of attention. Advertisements of infant foods and an abundance of medical literature on scientific feeding of infants have lulled both mothers and physicians into a false sense of security in the practice of artificial feeding. The fearful loss of infant life is so spread out over the entire country that the individual physician does not appreciate his own responsibility, though a conservative estimate ascribes a full third of all infant deaths to unnecessary bottle feeding.

During the siege of Paris, 1870-71, when the milk-supply failed, the Parisian women nursed their children and the infant mortality-rate fell from 330 to 170 per thousand births. A similar fall in the infant mortality-rate was seen during the Lancashire cotton famine, when mothers were not at work in the mills."

***********************************************************************

"To focus or blame mothers who don't breast-feed or return to work too often ignores economic, individual, and environmental factors"

"breast-feeding alone is not the single most important answer to infant mortality".

Seeemingly, it is impossible to discuss breastfeeding without being accused of mother-blame. Fortunately, I am interested in other topics, so I can just move on to less contentious areas, but how will this help the millions of mothers in the developing world who are losing their babies? Could those who disagree with the Davis review please supply another candidate for the single most important cause of high infant mortality in the world today?

1913? Really??

"Single-most important cause" is an outdated concept. Epidemiologists have accepted and adopted the mulch-causality for diseases, as well as for social/sociocultural issues. There is no such thing, because there is always something, one or more factors that will influence the outcome in question. It is quite obvious to see it can never be the "single" most important factor: e.g. a mother breastfeeds, but smoked during pregnancy or drank, used drugs for years before giving birth; a mother breast feeds, but experienced malnutrition or contaminated water and so on and on and on.

Correction: multi-causality

"Epidemiologists have accepted and adopted the multi-causality for diseases, as well as for social/sociocultural issues."

No doubt many complex diseases have multiple and complex causes. But Occam's Razor should always be seriously considered as a first option. Examples of complex processes that turned out to have an unexpected simple explanation include: asteroid impact for KT extinction; a bacterium for ulcers; a digital code for DNA; asbestos for mesothelioma; human agency for crop circles.

"Single-most important cause" is an outdated concept... There is no such thing, because there is always something, one or more factors that will influence the outcome in question. It is quite obvious to see it can never be the "single" most important factor: e.g. a mother breastfeeds, but... experienced malnutrition or contaminated water and so on..."

How does it help mothers in developing countries with dying babies nowadays if we simply dismiss the experience of those having to deal with high infant mortality in developed countries long ago? I have found no data (as opposed to opinion) in the modern literature to contradict this extract from Med Times Gaz 1877;2:269-70.

"Why do our babes die -- and why in such numbers? Many reasons are given, but one seems to be the chief. Improper feeding is the great evil. We may be pretty sure that, had every child who dies before the end of the first year of life had a healthy mother to nurse it, and one, at the same time, willing to do so, the Registrar-General might soon find scope for transferring these mortality tables to a new page in his reports. For it is quite marvellous to observe with how great an amount of hardship these tender babies can even thrive if only they be "properly fed". We can reconstruct a nursery or an orphanage to put it under better sanitary conditions; but even then there will be little success, so far as the preservation of life is concerned, if the chief point -- the feeding of the children -- be not attended to...Yet it is no theory, but my experience, extending over many years, and among a large number of infants, emaciated from their birth, and suffering from every inherited disease, that they thrive and get strong if rightly fed.."

" healthy mother" is the key here, more important than breast-feeding; it is oh so easy to pinpoint mother's feeding in developing countries, so all the other relevant factors can be downplayed or ignored. clean water, goo nutrition, prenatal care, maternal care.

Babies do not die and have never died because mothers didn't breast feed. There is no cause-effect research that numbers this, it's only opinion, using association research as causal

"Babies do not die and have never died because mothers didn't breast feed. There is no cause-effect research that numbers this"

How then to explain these findings?

Lancet. 2010 Jun 5;375(9730):2024-31. doi: 10.1016/S0140-6736(10)60704-0.

Effect of parent's death on child survival in rural Bangladesh: a cohort study.

Ronsmans C1, Chowdhury ME, Dasgupta SK, Ahmed A, Koblinsky M.

BACKGROUND: The effect of a parent's death on the survival of the children has been assessed in only a few studies. We therefore investigated the effect of the death of the mother or father on the survival of the child up to age 10 years in rural Bangladesh.

METHODS: We used data from population surveillance during 1982-2005 in Matlab, Bangladesh. We used Kaplan-Meier and Poisson regression analyses to compute the cumulative probabilities of survival and rates of age-specific death up to age 10 years, according to the survival status of the mother or father during that period.

FINDINGS: There were 144 861 livebirths, and 14 868 children died by 10 years of age. The cumulative probability of survival to age 10 years was 24% in children whose mothers died (n=1385) before their tenth birthday, compared with 89% in those whose mothers remained alive (n=143 473). The greatest effect was noted in children aged 2-5 months whose mothers had died (rate ratio 25.05, 95% CI 18.57-33.81). The effect of the father's death (n=2691) on cumulative probability of survival of the child up to 10 years of age was negligible. Age-specific death rates did not differ in children whose fathers died compared with children whose fathers were alive.

INTERPRETATION: The devastating effects of the mother's death on the survival of the child were most probably due to the abrupt cessation of breastfeeding, but the persistence of the effects up to 10 years of age suggest that the absence of maternal care might be a crucial factor.

****************************************************************************

"it is oh so easy to pinpoint mother's feeding in developing countries, so all the other relevant factors can be downplayed or ignored. clean water, goo nutrition, prenatal care, maternal care."

One factor that can certainly be downplayed, as this study makes clear, is socioeconomic status or poverty and correlates of these such as sanitation, etc. Had these been of any importance, infant mortality would have correlated far more highly with paternal than maternal death.

" healthy mother" is the key here, more important than breast-feeding"

More data indicating the importance of within-family clustering of infant death, the unimportance of social class and general environmental factors like poor sanitation, and implicating breastfeeding practices:

"However, it does seem that some mothers were better than others. Women who had never had any recorded occupation or had been recorded as having no occupation in the population registers were better at keeping their children alive than were other women. The same result was found for women who had been raised in farming or skilled working-class households. It is noteworthy that the husband's social status had no influence on child mortality whatsoever. This does suggest that mothers' social attributes were more relevant for child survival than the social attributes related to the fathers. It could well be that these women carried over into their own families the child-care practices they had learned from their mothers. Perhaps the traditional practice of prolonged breastfeeding, which gave children a much better start in life than the “modern” practice of bottle feeding, played a role here. It may have been the case that women from farming or skilled working-class households and women who had never been active on the paid labor market were more prone to continue traditional child-care practices. Nevertheless, it should be stressed that social factors were not the primary determinants deciding the fates of infants and young children."

Biodemog Soc Biol 2012;58:133.

These are definitely NOT cause/effect studies, just more correctional data and its in the writing: "Probably" and "Perhaps" and "Interpretations" are unscientific conclusion even for correlations, let alone cause/effect.

In developed countries, like US, millions of babies grow to health adults after formula feeding. Breast-feeding may result in babier with fewer illnesses that are not fatal, but not breast-feeding had never led to death in a developed country with modern everything-- medical care, prenatal care, food, water, etc. No research is needed to conclude that the environment is more important for the babies' survival than breast-feeding.

"These are definitely NOT cause/effect studies, just more correctional data"

I assume you mean correlational data. This is the case for the BSB study above, but once social and environmental factors have been excluded, what are you left with other then breastfeeding practices?

As for the Lancet study, why is not the death of the mother (though not the father) an event with consequences? Admittedly, maternal death may not be a totally random event, but what possible artifact or confounder explains a 25-fold increased risk of infant death? And why should this be a surprise since maternal death has been known for centuries to be bad news for the baby in the absence of wet nurses?

"not breast-feeding had never led to death in a developed country with modern everything"

I did not claim it was often fatal in the developed world today, but it was a century ago. Some cases of SIDS may be attributable to lack of efficient breastfeeding. But RG should be concerned with the developing world as well.

In a developing country like India paid maternal leaves are a mandatory process for the working women because women have to manage professional matters as well as family because education of child fully depends on the mother's input in their basic as well higher education along with physical growth by breast-feeding and feeding from other sources etc., if a mother has not been given paid maternity leaves how she will manage their family, this factor directly suffer their family and child basic education, personality and physical growth. In other words if a brain is not satisfied with the physical things of world, how that brain works better. It is suggested that for a healthy world it should be necessary to run a policy for paid maternity leaves for working women and welfare of human being.