Breast milk is key weapon in fight to lower Africa's child mortality rate

The lives of a million babies could be saved every year by the simplest and most natural remedy of them all - breast-feeding.

Field workers running a research project in remote Ghanaian villages have discovered that the surest way to keep a baby alive is for the mother to start breastfeeding within an hour of the baby being born. If the first feed from the mother's breast is delayed for even one day, they found the risk of the child dying within a month more than doubles. Early introduction to animal milk or any other substitute for mother's milk pushed the child's chance of living for a month down to barely one in 10.

In the developing world, four million babies die every year before they have reached the age of one month. The research, funded by the British Government, suggested that nearly a quarter of them, or a million babies a year, could be saved if they were breastfed from the first hour of life.

Researchers studied the history of almost 11,000 babies born within the same period of 12 months in 2003-04 in Brong Ahafo, the forest savannah region of central Ghana. Nearly 8,000 were breast-fed from the first day, and all but 70 lived through their first month. Those who were given breast milk within the first hour were found to have a less than one in 150 risk of dying. But of the other 3,000, who started breastfeeding later or not at all, 74 - nearly one in 40 - died before they were a month old.

The death rate was particularly high among new- born babies fed on other fluids or solids, who were found to be about four times as likely to die in the first month as babies who drank nothing but breast milk. Colostrum, the first milk produced after childbirth, is rich in a variety of components that help the gut to grow and build resistance to infection. Any substitute, like animal milk, can disrupt the normal function of the gut. In remote villages, the substitute is likely to be a home-made feed, possibly made with unclean water, comprised of cereals, animal milk and herbal concoctions or other liquids low in nutrients, which can damage the digestion or expose the baby to disease. A mother holding a child to her breast is also keeping it warm, reducing the risk of hypothermia.

The results of the survey are seen as particularly significant for Africa, where infant mortality rates are high and there are no cultural bars to early breastfeeding - unlike parts of India and Bangladesh, where many people believe that colostrum should not be used.

But the major bar to breast-feeding in Africa is HIV. In Ghana, where the research was carried out, only about 4 per cent of the population have HIV, but South Africa is thought to have 5.5 million sufferers out of a population of 47 million. The World Health Organisation has urged mothers who know they have HIV to use artificial milk.

The Department for International Development, which funded the study, said yesterday that it was the first of its kind into the effects of early breast-feeding on survival rates. The field work was done by the Kintampo Health Research Centre in Ghana, and the London School of Hygiene and Tropical Medicine.

Hilary Benn, the International Development Secretary, said: "This groundbreaking research could help save one million children's lives every year. What's so exciting about it is that the solution doesn't need costly medicines. We just need to get across the simple message to women that, unless they have HIV, breast-feeding from the time they give birth is not only best - it will increase the chances of their baby surviving."

He added: "We need to support ministries of health, Unicef, the World Health Organisation and others to tackle the underlying reasons why, in some cultures, breast-feeding in the first few days is discouraged."