ObjectiveThe current study aims to demonstrate independent associations between social, educational and health practice interventions as determinants of exclusive breastfeeding in an urban Ecuadorian population.DesignProspective survival analyses.SettingEcuadorian mother–child dyads in urban settings.ParticipantsWe followed-up 363 mother–baby dyads who attended healthcare centres in Portoviejo, province of Manabi, for a median time (P25–P75) of 125 days (121–130 days).Main outcome measuresWe performed a survival analysis, by setting the time-to-abandonment of exclusive breastfeeding measured in days of life, that is, duration of exclusive breastfeeding, periodically assessed by phone, as the primary outcome. Crude and adjusted mixed-effects Cox proportional hazards model were performed to estimate HRs for each explanatory variable.ResultsThe incidence rate of abandonment of breastfeeding was 8.9 per 1000 person-days in the whole sample. Multivariate analysis indicated the three most significant protective determinants of exclusive breastfeeding were (a) sessions of prenatal breastfeeding education with an HR of 0.7 (95% CI: 0.5 to 0.9) per each extra session, (b) self-perception of milk production, with an HR of 0.4 (95% CI: 0.3 to 0.6) per each increase in the perceived quantity of milk production and (c) receiving early skin-to-skin contact with an HR of 0.1 (95% CI: <0.1 to 0.3) compared with those not receiving such contact, immediately after birth.ConclusionsPrenatal education on breastfeeding, self-perception of sufficient breast-milk production and early skin-to-skin contact appear to be strong protectors of exclusive breastfeeding among urban Ecuadorian mother–baby dyads.

Hablar de pobreza por ingreso y los efectos que ha tenido este indicador a raíz de la presencia del Covid-19 es de gran importancia en la actualidad, debido al fuerte impacto que ha provocado en la vida de las personas, privándolas de satisfacer sus necesidades dignamente. El objetivo de este estudio descriptivo es analizar la evolución del indicador de la pobreza por ingreso en el Ecuador, tomando en cuenta la presencia del Covid-19 y su impacto en los niveles de pobreza hasta el 2020; sustentado en los métodos de revisión bibliográfica, hermenéutico y el análisis de contenido; así como en al análisis de las variables macroeconómicas como el empleo, PIB y coeficiente de Gini. Los resultados obtenidos nos permiten tener una noción de la compleja situación por la que atraviesa el país debido a la pandemia que ha provocado el retroceso de 10 años en el índice de pobreza, una caída del 9% en el crecimiento económico y un suceso alarmante tras presenciarse una mayor tasa de pobreza que de empleo con una diferencia de 1,6%; agudizando la precariedad de la vida económica de las personas más vulnerables.

Objective: The current study aims to demonstrate independent associations between social, educational, and health practice interventions as determinants of exclusive breastfeeding in an urban Ecuadorian population. Design: Prospective survival analyses. Setting: Ecuadorian mother-child dyads in urban settings. Participants: We followed-up 363 mother-baby dyads who were attended in health care centres in Portoviejo, province of Manabi, for up to 150 days. Main outcome measures: We performed a survival analysis, by setting the time-to-abandonment of exclusive breastfeeding measured in days of life, periodically assessed by phone, as the primary outcome. Crude and adjusted mixed-effects Cox proportional hazards model were performed to estimate hazard ratios (HR) for each explanatory variable. Results: The median time of follow-up (P25 to P75) was 125 (121 to 130) days, and the incidence rate of abandonment of breastfeeding was 8.9 per 1000 persons-days in the whole sample. The three more significant protective determinants of exclusive breastfeeding were (i) sessions of prenatal breastfeeding education, with a reduced risk of abandoning the practice of exclusive breastfeeding of 30% (95%CI: 50% to 10%) per each extra session, (ii) self-perception of milk production, with a reduced risk of abandoning the practice of exclusive breastfeeding of 57% (95%CI: 50% to 10%) per each increase in the perceived quantity of milk production; and (iii) receiving early skin-to-skin contact represented a 90% risk reduction of interrupting breastfeeding (95%CI: 94% to 70%) vs. not receiving. Conclusions: Prenatal education on breastfeeding, self-perception of milk production, and early skin-to-skin contact appears to be strong determinants of exclusive breastfeeding in urban Ecuadorian mother-baby dyads; further, educational level of the mother, excreta management conditions are important determinants too.