title: Backsliding on a key health investment in Latin America and the Caribbean: the case of breastfeeding promotion.
abstract: OBJECTIVE
  We examined trends in breastfeeding promotion investments, breastfeeding promotion activities, and breastfeeding duration in Latin America and the Caribbean from the 1980s to the 2000s.
  
  
  METHODS
  We obtained financial data from the United States Agency for International Development and the International Code Documentation Center, and we obtained breastfeeding promotion data from surveys of breastfeeding coordinators with ministries of health and with the International Baby Food Action Network. We obtained breastfeeding data from nationally representative surveys conducted between 1986 and 2008.
  
  
  RESULTS
  Investment in breastfeeding promotion declined in the 2000s relative to earlier years. For all countries, breastfeeding duration increased between the first and last survey. Of the 12 countries represented in the interval when investment in breastfeeding promotion was high, breastfeeding duration decreased in 1 country. Of the 12 countries represented in the interval when investment was low, breastfeeding duration decreased in 3 countries. Nonetheless, the average annual change in breastfeeding duration for the 2 intervals was positive and similar (0.16 months and 0.21 months).
  
  
  CONCLUSIONS
  Breastfeeding promotion likely resulted in large improvements in breastfeeding. Investments in breastfeeding promotion have declined, but this does not appear to have adversely affected breastfeeding duration.
authors.affiliation: PAHO/WHO, Washington, DC 20037, USA. lutterch@paho.org
authors.forename: Chessa K
authors.initials: CK
authors.lastname: Lutter
authors.forename: Camila M
authors.initials: CM
authors.lastname: Chaparro
authors.forename: Laurence
authors.initials: L
authors.lastname: Grummer-Strawn
authors.forename: Cesar G
authors.initials: CG
authors.lastname: Victora
mesh_terms: D001942:Breast Feeding / Q000706:statistics & numerical data* / Q000639:trends*; D017691:Caribbean Region; D006293:Health Promotion / Q000191:economics* / Q000458:organization & administration; D006801:Humans; D007843:Latin America; D014481:United States; D054702:United States Agency for International Development