Abstract
ABSTRACTOBJECTIVE To identify factors associated with exclusive breastfeeding in the first six months of life in Brazil.METHODS Systematic review of epidemiological studies conducted in Brazil with exclusive breastfeeding as outcome. Medline and LILACS databases were used. After the selection of articles, a hierarchical theoretical model was proposed according to the proximity of the variable to the outcome.RESULTS Of the 67 articles identified, we selected 20 cross-sectional studies and seven cohort studies, conducted between 1998 and 2010, comprising 77,866 children. We identified 36 factors associated with exclusive breastfeeding, being more often associated the distal factors: place of residence, maternal age and education, and the proximal factors: maternal labor, age of the child, use of a pacifier, and financing of primary health care.CONCLUSIONS The theoretical model developed may contribute to future research, and factors associated with exclusive breastfeeding may subsidize public policies on health and nutrition.
Highlights
Breastfeeding is a crucial issue for public health, for it directly affects the standards of health and mortality of populations.[4,14,20,39,53] The prevalence and duration of partial or exclusive breastfeeding increased in all social strata and regions of Brazil between the decades of 1990 and 2010.35,45,a,b Part of this trend can be attributed to national policies of breastfeeding promotion, protection, and support.[35]Different social and cultural contexts may influence the practice of exclusive breastfeeding and its determinants
The theoretical model developed may contribute to future research, and factors associated with exclusive breastfeeding may subsidize public policies on health and nutrition
A study conducted in cities of three countries noted that higher levels of maternal education were related both with higher prevalence of exclusive breastfeeding in Santos, SP, Southeastern Brazil, and with lower prevalence in Mexico City, Mexico, and in Sula and Tegucigalpa, Honduras.[32]
Summary
Different social and cultural contexts may influence the practice of exclusive breastfeeding and its determinants. A study conducted in cities of three countries noted that higher levels of maternal education were related both with higher prevalence of exclusive breastfeeding in Santos, SP, Southeastern Brazil, and with lower prevalence in Mexico City, Mexico, and in Sula and Tegucigalpa, Honduras.[32]. This review was restricted to the Brazilian context, since the determinants of exclusive breastfeeding may behave differently in diverse cultures.
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