Abstract
ABSTRACTObjective: To investigate the influence of the first postpartum visit, family income, pacifier habit, number of siblings and birth weight on the maintenance of exclusive breastfeeding in infants aged one week up to six months.Methods: In this cross-sectional study, data were collected through a survey, which included social and demographic characteristics of the families and the breastfeeding practice in children aged one week to six months, who received care at family health units in the municipality of Vitória de Santo Antão, Pernambuco, Northeast Brazil, between December 2014 and February 2015. Prevalence ratio was used to indicate how many times the outcome prevalence was increased by the influence of the studied variables, as well as a binary logistic regression model for the analysis and reliability of the results.Results: The prevalence of exclusive breastfeeding was 41.7%. Family income, pacifier habit, number of siblings and birth weight did not show statistical association with the maintenance of exclusive breastfeeding. However, the absence of postpartum home visits adversely influenced the outcome (p=0.009). The children who received home visits had a higher chance of being exclusively breastfed for six months or more (PR 2.28, 95%CI 1.17-4.42). In the logistic regression, only the visit showed significance to estimate the probability of exclusive breastfeeding.Conclusions: The absence of postpartum home visits negatively influenced the duration of exclusive breastfeeding. This finding fills a gap in the knowledge of determinants of exclusive breastfeeding and may guide the planning of local strategies and actions to promote, protect and support exclusive breastfeeding.
Highlights
It is agreed that breastmilk is the best food for the promotion and protection of children’s health, and has recognized nutritional, immunological, cognitive, economic, social and emotional benefits.[1,2] These benefits are exploited to the fullest when breastfeeding is practiced exclusively up to six months of age, being supplemented by other types of food up to two years of age or more, as recommended by the World Health Organization (WHO).[3]The WHO estimations have shown that if breastfeeding were practiced universally, the deaths of 823,000 children and 20,000 mothers could be prevented each year.[4]
The descriptive analysis was performed with frequency calculations of the results found, and the association between the variables was investigated through the chi-square test, with the outcome variable being exclusive BF and adopting a level of significance lower than 0.05 (p
Most infants had received some type of food — among which the introduction of water and tea in the first six months can be highlighted — and the most frequent justification given by mothers for having weaned or discontinued exclusive BF was insufficient milk
Summary
The WHO estimations have shown that if breastfeeding were practiced universally, the deaths of 823,000 children and 20,000 mothers could be prevented each year.[4] In spite of the benefits of exclusive breastfeeding and of the efforts to promote it, rates in Brazil, with an evident improvement,[5] are below the recommended levels, and its early interruption is an important public health problem.[6] The most recent survey on the prevalence of BF in Brazilian capitals and in the Federal District, published in 2009, revealed a prevalence of 41% of BF. Even though there was a significant increase in the indexes on the fourth month of life in Brazil (from 35.5% in 1999 to 51.2% in 2008), this rate does not reach 10% in the sixth month.[7]
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