BackgroundBreastfeeding within the first hour of life is a potential mechanism for health promotion. The purpose of this study was to evaluate the prevalence of breastfeeding initiation within the first hour of life in Feira de Santana, Bahia, Brazil, between 2004 and 2005, and investigate the influence of maternal, child and prenatal factors on this practice.MethodsThis is a cross-sectional study extracted from the results of a contemporary cohort conducted in 10 maternity hospitals in the city of Feira de Santana, Bahia, Brazil. A group of 1,309 mother-child pairs was included in the study. Information about mother's and baby's characteristics, pregnancy, birth, and time of breastfeeding initiation was collected in the first 72 hours after delivery, through interview with mothers and hospital records. The data gathered were stored and analyzed using the SPSS 16.0 and R 8.0. The chi-square test and binary logistic regression analysis were used to examine the relationship between breastfeeding within the first hour and different variables.Results47.1% of the mothers initiated breastfeeding within the first hour after birth. Early initiation of breastfeeding was associated with birth at full term pregnancy (adjusted Prevalence Ratio 1.43; 95% confidence interval 1.10 to 2.00), mothers who received prenatal guidance regarding the advantages of breastfeeding (aPR1.23; 95% CI 1.11 to 1.41) and vaginal delivery (aPR 2.78; 95% CI 2.38 to 3.23).ConclusionsIn order to improve the rates of breastfeeding within the first hour of life, health care professionals must promote the factors favoring this practice such as prenatal guidance regarding the advantages of breastfeeding, vaginal delivery and full term birth, and stimulate this practice in vulnerable situations such as mothers with cesarean section and preterm birth.

BackgroundDeterminants of the duration of exclusive breastfeeding (EBF) differ in effect and magnitude across populations. The present study aimed to identify factors associated with discontinuation of EBF in a municipality in northeastern Brazil, including variables that have received little or no attention in previous literature.MethodsThis cohort study involved 1,344 mother-child pairs selected from maternity hospitals in Feira de Santana, Bahia, Brazil. Subjects were followed up for 6 months through monthly home visits, and discontinuation of EBF was recorded. Possible determinants were tested using Cox’s four-level hierarchical survival model, taking into consideration the temporal proximity of the predisposing factors to interruption of EBF. Median duration of EBF was estimated using Kaplan-Meier’s survival curve.ResultsMedian duration of EBF was 89 days. Out of the 19 variables tested, 9 showed an association with EBF cessation; of these, two had never been evaluated in Brazilian studies, namely, mother partner’s appreciation for breastfeeding (hazard ratio [HR] 0.62; 95% confidence interval [95% CI] 0.48-0.79) and limiting the number of nighttime feeds at the breast (HR 1.58; 95% CI 1.11-2.23). Another two variables that had been previously evaluated, but had never been described as determinants of discontinuation of EBF showed association: presence of cracked nipples (HR 2.54; 95% CI 2.06-3.13) and prenatal care provided by public services (HR 1.34; 95% CI 1.17-1.55). Other variables showing associations with the outcome were: guidance on breastfeeding received at the hospital (HR 0.80; 95% CI 0.68-0.92), birth in a Baby-Friendly Hospital (HR 0.85; 95% CI 0.73-0.99), less than or equal to 8 years of maternal schooling (HR 1.34, 95% CI 1.17-1.53), mother working outside the home (HR 1.73; 95% CI 1.53-1.95), and use of a pacifier (HR 1.40; 95% CI 1.14-1.71).ConclusionsThe study confirmed that the factors associated with EBF duration are multiple, variable, and dependent on the population being evaluated. Characteristics that had never been previously evaluated or described, at least in Brazilian studies, behaved as determinants of EBF in the present study, and thus allow to expand the existing list of factors determining this practice.

Objective: To describe the eating habits of breastfed and non-breastfed children through the analysis of food intake by children younger than one year of age in Feira de Santana in 2001.Methods: Cross-sectional study. The mothers of children younger than one year answered a questionnaire during the national vaccination day in 44 (71%) vaccination units selected by simple stratification. 2,319 children were evaluated, representing 24.3% of the estimated population. Prevalence ratio and 95% confidence interval were calculated. Statistical significance was determined using the chi-square test.Results: Non-breastfed children aged four months or younger were 8.2 and 6.7 times more likely to receive the family food (95% CI: 3.23-20.66) or vegetable soup (95% CI: 3.84-11.78), respectively. In the same age group, the prevalence of non-breastfed children receiving water, juice, and fruit was significantly higher in relation to breastfed children (70.7% vs 19.7%, 63.3% vs 26.7%, 33.3% vs 4.9% and 14.4% vs 1.4%, respectively). Conclusion:Breastfed children had healthier habits than non-breastfed children in terms of the introduction of complementary foods.J Pediatr (Rio J). 2004;80(5):411-6: Breast feeding, feed, feeding behavior, mixed feeding.

OBJETIVOS: conhecer a prevalência do aleitamento materno e os fatores associados ao desmame das crianças menores de um ano, em Feira de Santana, no ano 2001. MÉTODOS: estudo transversal com aplicação de questionários às 2319 mães presentes nas 44 (71,1%) unidades de vacinação selecionadas, por estratificação simples. Foi calculada a razão de prevalência e considerado como significante p < 0,05 e intervalo de 95% de confiança. RESULTADOS: a prevalência do aleitamento foi 69,2% nos menores de um ano. A ocorrência da amamentação exclusiva foi maior nas crianças que não usavam chupeta (49,4%) e que mamaram no primeiro dia de vida (40,4%). As variáveis estatisticamente significantes relacionadas com as maiores chances de amamentar foram: amamentação no primeiro dia (p <0,001), mães que não trabalhavam fora do lar (p <0,001), menor renda familiar (p <0,001), multiparidade (p = 0,03) e a não utilização de chupetas (p <0,001). CONCLUSÕES: as atividades assistenciais quanto à prevenção do desmame devem estar voltadas sobretudo para as mães que trabalham fora do lar, aquelas de maior renda familiar e primíparas. Quanto às crianças, para as que não foram aleitadas no peito no primeiro dia de vida e que usam chupetas.

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BackgroundTo evaluate the prevalence and factors associated with cesarean delivery according to whether care was provided in public or private hospitals in Brazil.MethodsThis was a cross-sectional study based on a cohort of live births between April 2004 and March 2005. A total of 1,344 mother-child pairs were followed up during the first month of life. The variables analyzed were the socioeconomic and demographic characteristics of the mother and newborn, as well as the healthcare provided during pregnancy and childbirth. Hierarchical analysis was carried out for both prediction models, i.e. healthcare provision either within the Brazilian National Health System (public service) or within the private network. Prevalence and association measurement calculations were carried out. Values were considered significant when pless than or equal to 5.0 %.ResultsA total of 1,019 (75,8 %) gave birth in public hospital. The prevalences of cesarean delivery were 29.9 % and 86.2 % in the public and private sectors, respectively. Through hierarchical logistic regression, the risk factors for cesarean delivery presented in the public hospital were maternal age greater than or equal to 20 years (p = 0.003), primiparity (p = 0.004), twinning (p = 0.039), prenatal care provided in the private network (p = 0.004), delivery in hospitals providing high complexity medical care (p = 0.000) and prenatal care with greater than or equal to 6 consultations (p = 0.035). In the private sector, no association was observed between the variables studied and cesarean delivery.ConclusionsThe cesarean delivery rates were high in both sectors, although in the private network the rate was almost triple that of the public service. The absence of determinant factors of birth in the private sector drew attention. In planning measures against the growing cesarean rates, it is necessary to take into consideration the environmental determinants as primiparity, twinning and greater maternal age, frequent indications of primary cesarean delivery, as well as to implement actions that might improve the quality of prenatal and delivery care.

This study demonstrated that the HTW phenotype was associated with an atherogenic lipid profile, and this phenotype is suggested as a screening tool to identify adolescents with metabolic alterations.

The anthropometric indicators studied had little utility as screening tools for dyslipidemia, especially in children.