Abstract
OBJETIVO: Avaliar os fatores de risco associados à ausência de aleitamento materno exclusivo (AME) em crianças <6 meses de vida na cidade de São Paulo, em 2008. MÉTODOS: Aplicou-se o questionário do Projeto Amamentação e Municípios-1998 (AMAMUNIC) a pais/responsáveis de crianças <6 meses de idade durante a Campanha Nacional de Vacinação contra Poliomielite. Cálculo da amostra por conglomerados com sorteio em dois estágios. Os fatores analisados foram idade e educação materna, peso de nascimento, sexo, tipo de parto, nascer em Hospital Amigo da Criança, presença de aleitamento materno precoce, uso de chupeta nas últimas 24 horas e mãe trabalhando fora de casa. Análise estatística por regressão logística binária com SPSS, versão 15.0, sendo significante p<0,05. RESULTADOS: Foram realizadas 724 entrevistas, das quais 275 referiram (39,1%) aleitamento materno exclusivo (Grupo I - GI) e 429 (60,9%) sem aleitamento materno exclusivo (Grupo II - GII). Houve diferenças entre os grupos quanto ao uso da chupeta nas últimas 24 horas (GI 32,3 versus GII 59,8%; p<0.001), mães trabalhando fora (GI 12,4 versus GII 24,8%; p<0.001) e idade da criança (GI 74,1±45,3 versus GII 105,8±49,5 dias; p<0,0001).Na análise multivariada, houve associação entre ausência de aleitamento materno exclusivo e uso de chupeta (OR 3,02; IC95% 2,10-4,36), mãe trabalhando fora (OR 2,11; IC95% 1,24-3,57) e idade da criança (OR 1,01; IC95% 1,01-1,02). CONCLUSÕES: O uso da chupeta nas últimas 24 horas associou-se à ausência de AME em crianças menores do que seis meses, seguido pelo trabalho materno fora de casa e pela idade da criança, que são importantes fatores a serem controlados em programas de promoção do aleitamento materno.
Highlights
The World Health Organization recommends that breastmilk should be the only source of nutrition for the first 6 months of a child’s life and this position is supported by growing recognition of the suitability of breastmilk for the nutritional requirements of newborn infants and older infants, its contribution to harmonious growth and development, its probable role in future quality of life and the incidence of conditions such as cardiovascular diseases, type 2 Diabetes mellitus, arterial hypertension, allergies and nutritional disorders, such as overweight and obesity[1].All of these findings mean that maintenance of breastfeeding is recognized as an indispensable element of programs to promote child health
The final number of complete interviews was 704, and the results were allocated to the two study groups as follows: GI – 275 (39.1%) and GII – 429 (60.9%)
Analysis of factors associated with absence of exclusive breastfeeding (EB) in the first 6 months showed that pacifier use in the previous 24 hours was the most significant risk factor, followed by mothers going out to work and the infant’s age, while heavier birth weight was associated with protection of EB continuation
Summary
The World Health Organization recommends that breastmilk should be the only source of nutrition for the first 6 months of a child’s life and this position is supported by growing recognition of the suitability of breastmilk for the nutritional requirements of newborn infants and older infants, its contribution to harmonious growth and development, its probable role in future quality of life and the incidence of conditions such as cardiovascular diseases, type 2 Diabetes mellitus, arterial hypertension, allergies and nutritional disorders, such as overweight and obesity[1] All of these findings mean that maintenance of breastfeeding is recognized as an indispensable element of programs to promote child health. These investigations have led to the identification of other effects of pacifier use, some of which are even positive in specific situations, such as the possibility of a protective effect against infant sudden death during the first months of life[8,9,10,11,12]
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