Abstract
ABSTRACTObjective:To characterize the situation of breastfeeding and the adequacy of prescription of infant formulas to infants assisted by a secondary care program of the Public Health System.Methods:This is a cross-sectional study with analysis of medical records of 350 infants from zero to 6 months, followed up between February to April 2019.Results:The possibility of breastfeeding was present in 97.0% of mothers and no infant presented an acceptable medical condition for proscription of breastfeeding. Despite this, only 47.2% of cases were on exclusive breastfeeding before being referred to the program. Regarding the reasons for the introduction of infant formulas, complementation to breast milk was the most present (75.8%), followed by mothers returning to the job market (20.1%). The general rates of inadequacy of those prescribed were 65% before arriving at the program, increasing to 69% (standard formulas) and 80% (formulas for special purposes) during follow-up.Conclusion:The low rate of exclusive breastfeeding and the indiscriminate prescription of infant formulas are a concern for damage to maternal-child healthcare and sound finances of the Public Health System.
Highlights
Breast milk is undoubtedly the best food for newborns and should be maintained exclusively until 6 months of life.[1]
10.9% of neonates who arrived at the Centro Estadual de Atenção Especializada (CEAE) using complementary infant formula were initiated on exclusive breastfeeding (EBF); 41.1% remained with the complementary use of infant formula, and 48.0% began to use infant formula exclusively
It was found that 92% (n=149) of patients used infant formula before referral to the CEAE, and continued to use it after follow-up at the center, while 54% (n=94) of those who did not use before the beginning of follow-up continued without this prescription
Summary
Breast milk is undoubtedly the best food for newborns and should be maintained exclusively until 6 months of life.[1]. Infant formulas are developed to resemble breast milk and can be prescribed for very specific medical and/or nutritional conditions, most often for a limited period.[6] the composition of infant formulas does not match the physiological and nutritional properties of human milk, and negatively impacts the success and duration of breastfeeding.[5] The Ministry of Health highlights as “absolutely condemnable the large-scale distribution of these products, especially in health services”.(5) Excluding cases in which there are acceptable medical reasons for the use of infant milks or formulas, the prescription of these products for infants who do not need these foods should be considered inappropriate.[7]. Given the considerable number of prescriptions for infant formulas without well-established indications, it has become urgent to establish criteria to rationalize access and propose a feasible, equitable, and equal flow for their dispensing, optimizing public resources spent on the purchase of infant formulas.[5]
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