Breastfeeding and Early Weaning Practices in Northeast Brazil: A Longitudinal Study

Abstract

ABSTRACT. Objectives. To describe breastfeeding practices from 0 to 12 months of age in 4 small towns that are representative of urban northeast Brazil and to identify factors associated with introduction of other milk in the first month of life.Methods. From January to August 1998, 364 mothers were interviewed at delivery to ascertain antenatal care; delivery room practices; and their intentions regarding breastfeeding, pacifiers, and introduction of water, teas, and other milk. Their perceptions of home support and the advantages of breastfeeding also were assessed. Thereafter, daily information about feeding practices was collected at twice-weekly home visits. When other milk was started, a second interview was conducted to ascertain initial and current breastfeeding problems and use of a pacifier. Reasons for starting other milk were investigated using 5-point Likert scales.Results. Mothers were positive toward breastfeeding, and 99% breastfed their new infant. Few intended to breastfeed exclusively, and in the first week 80% gave water/tea and 56% used a pacifier. The median duration of exclusive breastfeeding was 0 days, and the median age for starting other milk was 24 days. The median duration of breastfeeding was 65 days for mothers who started other milk within 1 month and 165 days for other mothers. After adjustment for confounding variables, the main factors associated with introduction of other milk within 1 month were pacifier use in the first week (odds ratio [OR], 4.01; 95% confidence interval [CI]: 2.07-7.78), intention to start other milk in the first month (OR, 3.79; 95% CI: 1.74 -8.24), giving water/tea in the first week (OR, 3.07; 95% CI: 1.56 -6.03), and leaving the maternity ward before breastfeeding was started (OR, 2.59; 95% CI: 1.34 -5.04).Conclusion. Although breastfeeding is common in this community, it rarely is exclusive and takes place for a relatively short duration. Identification of risk factors for early introduction of other milk offers potential avenues for future intervention, including improvement of breastfeeding support in antenatal and maternity services. Pediatrics 2001;108(4). URL: http://www. pediatrics.org/cgi/content/full/108/4/e66; pacifiers, breastfeeding, exclusive breastfeeding, risk factors.ABBREVIATIONS. OR, odds ratio; IQR, interquartile range; CI, confidence interval.T he Brazilian national breastfeeding promotion program began in 1981 and was noted for its intensity, coverage, and innovation. 1 Each state organized training for all categories of health professionals and also for traditional healers and others in the nonformal health sector. High-profile mass media campaigns featured national superstars, and legislation was passed on issues such as the advertising of breast milk substitutes and increased maternity leave. 2 Brazil also has been an active participant in the Baby Friendly Hospital Initiative, and in 1998 there were 103 accredited hospitals. 3 Data from national surveys showed an increase in the median duration of breastfeeding from 74 days in 1...

Diagnosis of iron deficiency anemia in children of Northeast Brazil

“…Although 94% of the mothers reported breastfeeding, exclusive breastfeeding during the fi rst six months of life was considered insignifi cant, which corroborates similar fi ndings from other studies conducted in the same region. 13 Stunting was found in 14% of children and overweight in about 11% while the prevalence of weight-for-age defi cit was low (3%). The prevalence of anemia was extremely high (92%), with mean hemoglobin concentration of 95.4 g/L (SD=10.3).…”

“…The same was seen for iron defi ciency, with the highest prevalence found in children aged 6-23 months as early introduction of complementary foods with low iron content predominates with marked reduction of breastfeeding. 12,13,17 Another important factor would be the use of in natura cow milk whose iron has low bioavailability and may interfere with iron absorption from other foods due to its direct effect on the intestinal mucosa, which can cause loss of occult blood in feces. 16 The lower prevalence of anemia with iron defi ciency in children aged 24-30 months could be explained by regular consumption of foods in the family diet, characterized by greater diversifi cation and especially higher consumption of foods of animal origin.…”

Breastfeeding and dummy use have a protective effect on sudden infant death syndrome

“…A negative correlation between the use of a dummy and successful breastfeeding was found in all 14 studies 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47 published between 1999 and 2012 (Table 3). …”

Fatores determinantes do uso de chupeta entre crianças participantes de programa de incentivo ao aleitamento materno

“…Marques et al 18 found that the use of pacifiers at seven days of life was associated with the use of nursing bottles at the end of the first month. These results are confirmed by França et al 19 , who found that nursing bottles were largely used in the first month of life, especially among infants who used pacifiers.…”