Aim: To analyse factors associated with the duration of breastfeeding in a representative cohort of mothers and children, including socio‐demographic and cultural characteristics, breastfeeding antecedents, perinatal factors and perinatal healthcare practices. Methods: The study was conducted in the city of Cordoba, between 1993 and 1998. Mother‐child binomials from all public and private hospitals were asked to participate. Follow‐up consisted of home visits at 30 d, 6, 12, 24, 36, 48 and 50 mo. Information was obtained on 650 healthy newborns. Cessation of breastfeeding during the first 24 mo of life was analysed using the Kaplan‐Meier method, and factors associated with weaning were studied using Cox's proportional risk regression. Results. The median duration of breastfeeding was 4 mo. Factors associated with weaning were: the introduction of artificial formulas within 30 d postpartum [relative risk (RR) = 2.27; 95% confidence interval (CI) = 1.82–2.82]; breastfeeding of a previous child for less than 6 mo (RR=1.64; 95% CI = 1.32–2.02); delay in the first mother‐child contact for over 90 min (RR=1.50; 95% CI = 1.17–1.93); mother's having completed primary or partially completed secondary education (RR= 1.40; 95% CI = 1.01–1.92) or completed secondary education or higher (RR= 1.59; 95% CI = 1.14–2.22); primiparous mother (RR= 1.39; 95% CI = 1.12–1.74) and; the mother recalling having been breastfed for less than 6 mo (RR = 1.27; 95% CI = 1.01–1.61). Conclusions. The purpose of strategies to promote breastfeeding should be to eliminate inappropriate care practices, such as delay in the first mother‐child contact, as well as reducing the impact of other factors leading to the introduction of artificial milk. Moreover, mothers need more and better support from professionals and peers.

DescriptoresLactancia materna. Atención posnatal. Atención perinatal. Cuidado del lactante. Recién nacido. Factores socioeconomicos. Analisis multivariado. Resumen ObjetivoDescribir la modalidad de alimentación de los recién nacidos en instituciones públicas y privadas; y estudiar su relación con prácticas sanitarias de atención del parto y el puerperio y con caraterísticas sociodemográficas. Métodos Se estudiaron 347 binomios madre -hijo representativos de los nacimientos en maternidades públicas y privadas de la ciudad de Córdoba, Argentina. Las madres fueron entrevistadas entre las 24 y 48h posteriores al parto. Mediante análisis de regresión logística se estudió la asociación de las prácticas sanitarias con la modalidad de alimentación en la institución, controlando el efecto de factores sociodemográficos y perinatales, en instituciones públicas y privadas. Se realizó análisis de regresión logistica expressada en "odds ratio", con intervalo de confianza de un 95%. Resultados Recibieron lactancia materna exclusiva el 60,4% de los nacidos en instituciones públicas y el 2,9% de los nacidos en instituciones privadas. El riesgo de no tener lactancia materna completa en las instituciones públicas durante el postparto inmediato fue significativamente mayor cuando los niños recibieron un primer alimento diferente de leche materna [odds ratio (OR):149; Intervalo de confianza (IC) 95%: 16,7-1332)], el primer contacto se retrasó más de 45 minutos (OR:4,43; IC 95%: 1,02-19,20) y la intención de la madre fue amamantar menos de 6 meses (OR:5,80; IC95%: 1,32-25,52); y, en las privadas, cuando los niños recibieron un primer alimento diferente de leche materna (OR:9,88; IC 95%: 1,07-91,15). Conclusiones La atención del parto y el puerperio no es acorde a las recomendaciones actuales e influye en la modalidad de alimentación del recién nacido independientemente de otros factores estudiados. Abstract ObjectiveTo describe the type of newborn feeding in public and private institutions and to investigate its relationship with health practices during delivery and in the puerperium and sociodemographic characteristics.

The objective of this study was to develop a model to predict premature cessation of breastfeeding of newborns, in order to detect at‐risk groups that would benefit from special assistance programmes. The model was constructed using 700 children with a birthweight of 2000 g or more, in 2 representative cohorts in 1993 and 1995 (CLACYD I sample) in Córdoba, Argentina. Data were analysed from 632 of the cases. Mothers were selected during hospital admittance for childbirth and interviewed in their homes at 1 mo and 6 mo. To evaluate the model, an additional sample with similar characteristics was drawn during 1998 (CLACYD II sample). A questionnaire was administered to 347 mothers during the first 24–48 h after birth and a follow‐up was completed at 6 mo, with weaning information on 291 cases. Premature cessation of breastfeeding was considered when it occurred prior to 6 mo. A logistic regression model was fitted to predict premature end of breastfeeding, and was applied to the CLACYD II sample. The calibration (Hosmer‐Lemeshow C statistic) and the discrimination [area under the receiver operating characteristics (ROC) curve] of the model were evaluated. The predictive factors of premature end of breastfeeding were: mother breastfed for less than 6 mo [odds ratio (OR) = 1.84,95% confidence interval (CI) 1.26–2.70], breastfeeding of previous child for less than 6 mo (OR = 4.01, 95% CI 2.58–6.20), the condition of the firstborn child (OR = 2.75, 95% CI 1.79–4.21), the first mother‐child contact occurring after 90min of life (OR =1.88; 95% CI 1.22–2.91) and having an unplanned pregnancy (OR = 1.50, 95% CI 1.05–2.15). The calibration of the model was acceptable in the CLACYD I sample (p= 0.54), as well as in the CLACYD II sample (p= 0.18). The areas under the ROC curve were 0.72 and 0.68, respectively. Conclusion: A model has been suggested that provides some insight onto background factors for the premature end of breastfeeding. Although some limitations prevent its general use at a population level, it may be a useful tool in the identification of women with a high probability of early weaning.

A model has been suggested that provides some insight onto background factors for the premature end of breastfeeding. Although some limitations prevent its general use at a population level, it may be a useful tool in the identification of women with a high probability of early weaning.

Proponemos describir las características sociodemográficas de un grupo de madres menores de 20 años y las características conductuales de sus niños a la edad de 4 años y compararlas con un grupo de niños de la misma edad hijos de madres mayores de 20 años. La muestra es aleatoria, estadísticamente representativa de niños de la ciudad de Córdoba-Argentina estratificados socialmente (N=215) y sus familias. El estrato social muy bajo presenta el mayor número de madres adolescentes. Sólo un escaso número de conductas se presenta en forma significativamente mayor en el grupo de hijos de madres adolescentes. Se discuten algunas explicaciones para este hecho y posibles aplicaciones del estudio.