Aleitamento materno em maternidades privadas participantes da pesquisa Nascer saudável

Abstract

Introduction: Support to breastfeeding at birth and to exclusive breastfeeding in the first 6 months of life are recommended by the World Health Organization. The Adequate Childbirth Project aimed to improve prenatal and childbirth care in private maternity hospitals and the Healthy Birth Research sought to evaluate this Project. Objectives: The present study aims to estimate the prevalence of breastfeeding in the first hour of life and of exclusive breastfeeding duringmaternity stay in private hospitals and to analyze factors associated with these outcomes. Methods: The Healthy Birth Research was a cross-sectional study conducted in 2017 in 12 private hospitals that participated in the Adequate Childbirth Project. A complex sample was adopted, and information was collected from 400 puerperal women per hospital, through interviews and observation of medical records. Conditions that prevented breastfeeding at birth, such as HIV-positive mothers and newborns with severe malformations were excluded. Multiple logistic regression was used according to a hierarchical theoretical model. Results: Prevalence of breastfeeding in the first hour of life was 57.1%. Lower maternal education (aOR = 0.643), lower socioeconomic status (aOR = 0.687), cesarean section (aOR = 0.649), being late preterm (aOR = 0.660) and not rooming-in (aOR = 0.669) were negatively associated with the outcome. Having received information about the importance of breastfeeding at birth during prenatal care (aOR = 2,585), being target of the Adequate Childbirth care model (aOR = 1,273), skin-to-skin contact at birth (aOR = 2,127), and female newborn (aOR = 1,194) were positively associated with the outcome. The prevalence of exclusive breastfeeding during maternity stay was 65.2%. Multiparity (aOR = 1.519), maternal diseases (aOR = 0.740), late onset of prenatal care (aOR = 0.436), delivery in health operator hospitals (aOR = 0.633), breastfeeding in the first hour of life (aOR = 1,951), low birth weight (aOR = 0.311) and non rooming-in (aOR = 0.441) were associated with exclusive breastfeeding. Conclusions: The prevalence of breastfeeding in the first hour of life was high, according to WHO parameters. Prenatal guidance about breastfeeding at birth, being target of the Adequate Childbirth care model and skin-to-skin contact at birth were protective factors for the outcome. The prevalence of exclusive breastfeeding during maternity stay was high, and breastfeeding at birth contributed to this practice, while non rooming-in showed a negative influence on the outcome.