Factors associated with breastfeeding in the first year of life in Cruzeiro do Sul, Acre

All the parturients at a local maternity from July 2015 to June 2016 were invited to participate in a cohort study in Cruzeiro do Sul, Acre. Data on socioeconomic, demographic, obstetric and neonatal of the babies were obtained for the interview. Multiple Poisson regression models with robust variance were used to estimate the prevalence ratio (PR) and 95% confidence intervals (95%CI).

Results:

among the 1551 mothers contacted, 305 lived in the rural area, leaving 1,246 eligible mothers living in urban area. For the 1-year cohort follow-up, 74 non-twin babies were assessed. Most of the mothers reported to have mixed skin color (79%), are over 21 years old (72°%o), more than 10 years of schooling (72%>) and with unpaying job (54%). The children’s age ranged from 10 to 15 months. The frequency of continued breastfeeding was 69,4%> (95%oCI=66.0-72.6). The factors negatively associated with continued breastfeeding were the use of bottle feeding (PR=1.44; CI95%> =1,33-1.56) and pacifier (PR=2.54; CI95%> =1.98-3.27), after adjusting for maternal age and socioeconomic variables.

Conclusion:

the frequency of continued breastfeeding in Cruzeiro do Sul was higher than the national estimates, but below the WHO recommendations for breastfeeding up to two years of age.

Key words:
Breastfeeding; Weaning; Child nutrition; Child health; Birth Cohort

Variables	Total		Breastfeeding		p ^* * Pearson's chi-square test
Variables	n	%	n	%	p ^* * Pearson's chi-square test
Age (years)
<21	215	27.8	139	25.9	0.077
≥21	559	72.2	398	74.1
Self-reported skin color (n=762) ^ Total observations differ due to missing information for some variables.
White	93	12.2	60	11.4	0.556
Black/ Indigenous/ Yellow	69	9.1	49	9.3
Mixed	600	78.7	419	79.4
Schooling (n=744)^ Total observations differ due to missing information for some variables.
0-19 years	209	28.1	152	29.2	0.292
≥ 10 years	535	71.9	368	70.8
Beneficiary of the Bolsa Família Program (n=762)^ Total observations differ due to missing information for some variables.	281	36.9	206	39.0	0.066
Living with a partner (n=762)^ Total observations differ due to missing information for some variables.	600	78.7	430	81.4	0.006
Mother head of household (n=762)^ Total observations differ due to missing information for some variables.	97	12.7	69	13.1	0.674
Had a paying job or activity (n=762)^ Total observations differ due to missing information for some variables.	350	45.9	239	45.3	0.579
Primiparous (n=762)^ Total observations differ due to missing information for some variables.	322	42.3	221	41.9	0.736
Type of delivery:
Normal	402	51.9	276	51.4	0.650
Cesarean	372	48.1	261	48.6
Breastfeeding in the first hour of life
Yes	657	90.0	199	88.8	0.536
Breastfeeding in the first day of life
Yes	743	96.0	227	95.8	0.840

Variables	Total		Breastfeeding		p ^* * Pearson's chi-square test;
Variables	n	%	n	%	p ^* * Pearson's chi-square test;
Baby's sex
Female	402	51.9	288	53.6	0.156
Male	372	48.1	249	46.4
Gestational age (weeks)
≤ 36	60	7.8	41	7.6	0.855
>36	714	92.2	496	92.4
Birth Weight (g) (n=773)^ Total observations differ due to missing information for some variables.
<2,500	49	6.3	33	6.2	0.946
2,500\|-4,000	677	87.6	470	87.7
≥ 4,000	47	6.1	33	6.2
Birth weight according to gestational age (n=773)^ Total observations differ due to missing information for some variables.
< -2 Z score	6	0.8	3	0.6	0.579
-2 \|-\| +2 Z score	736	95.2	511	95.3
> +2 Z score	31	4.0	22	4.1
Characteristics on the first year of life
Stunting	17	2.2	12	2.2	0.917
Overweight	59	7.6	44	8.2	0.372
Bottle use	485	62.7	264	49.2	< 0.001
Pacifier use	170	22.0	46	8.6	< 0.001

Variables	Crude PR (CI95%)	Adjusted PR (CI95%)
Mother's age <21 years at childbirth	0.91 (0.81 - 1.02)	0.94 (0.85 - 1.04)
Beneficiary of Bolsa Família Program	1.10 (1.00 - 1.20)	1.05 (0.97 - 1.14)
Mother living with a partner	1.18 (1.04 - 1.35)	1.09 (0.97 - 1.22)
Bottle use	1.74 (1.59 - 1.89)	1.44 (1.33 - 1.57)
Pacifier use	3.00 (2.34 - 3.86)	2.55 (1.99 - 3.28)

Instituto de Medicina Integral Prof. Fernando Figueira Rua dos Coelhos, 300. Boa Vista, 50070-550 Recife PE Brasil, Tel./Fax: +55 81 2122-4141 - Recife - PR - Brazil
E-mail: revista@imip.org.br

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[1] Authors' contribution

Rodrigues MJ: data analyses and initial manuscript writing. Mazzucchetti L: data analyses. Mosquera PS: data collection and analyses, critical review of the manuscript. Cardoso MA: study design and coordination, data interpretation, and critical review of the manuscript.