The trend of breast‐feeding in a primary child care program

Abstract

The tendency toward the practice of breastfeeding during 1969-81 was evaluated in the Brazilian population served by the Primary Child Health Care Program developed by the Communitary Social Medical Center of Vila Lobato (CSMCVL). The purpose was to evaluate the influence of several measures taken to encourage the breastfeeding practice in the assisted population whether these be internal administrative measures of the CSMCVL or part of the official federal or state policies. The study of children matriculated in 1977 permits the evaluation of 2 additional supporting measures added to the original program: 1) the provision of a nutritional supplement called Gestal to the mothers consisting of a mixture of soya beans and dehydrated cow milk; and 2) the provision of integral dehydrated cow milk as powder during 18 months as a reward for the children who were fed exclusively with breast milk and who had not missed any routine followup appointment in the 1st 6 months of life. In 1980 there was a massive campaign through the social communication systems about the advantages of breastfeeding. The population assisted by CSMCVL is a low income population with low maternal educational level. Overall there was great increase in lactation frequencies over the 1st months. The greatest increase occurred after 1977 when Gestal was supplied to the nursing mothers as a reward. The official campaigns also helped to raise the frequency of breastfeeding in the 1st 6 months of life. Hypogalactia weak milk or little milk were the most frequent reasons cited for early weaning. Orientation and followup of the nursing mothers are important to avoid situations that may lead to premature weaning. The main objective of the program to increase breastfeeding was reached. Maintenance of the increased level of breastfeeding should be supported by incorporating the practice into the cultural values of the population. Legal and social protection of nursing mothers is also needed without the authoritarian and paternalistic measures used as incentives.