Trends in breastfeeding indicators in a city of northeastern Brazil

Vieira, Graciete O.; Reis, Mariana R.; Vieira, Tatiana O.; Oliveira, Nelson F.; Silva, Luciana R.; Giugliani, Elsa R.J.

doi:10.1016/j.jped.2014.08.012

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Original Articles • J. Pediatr. (Rio J.) 91 (3) • May-Jun 2015 • https://doi.org/10.1016/j.jped.2014.08.012 copy

Trends in breastfeeding indicators in a city of northeastern Brazil ^☆ ☆ Please cite this article as: Vieira GO, Reis MR, Vieira TO, Oliveira NF, Silva LR, Giugliani ER. Trends in breastfeeding indicators in a city of northeastern Brazil. J Pediatr (Rio J). 2015;91:270-7.

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To investigate trends in breastfeeding indicators in the city of Feira de Santana, Brazil, and to identify population characteristics that might have influenced this trend.

METHODS:

Three methodologically comparable cross-sectional surveys performed in 1996, 2001, and 2009 were analyzed. These involved 2,159, 2,319, and 1,471 children younger than 1 year of age who were vaccinated in national multivaccination campaigns in the respective years. A standardized questionnaire was used, containing closed questions on consumption of breast milk and other foods on the day before the survey, along with questions regarding the characteristics of the population.

RESULTS:

The annual growth of the breastfeeding indicators was 2.1% for breastfeeding in the first hour of life (from 52.2% to 68.9%); 1.1% for breastfeeding among children aged 9 to 12 months (from 45% to 59.6%); and 0.8% for exclusive breastfeeding among infants younger than 6 months (from 36.9% to 47.4%). The median duration of exclusive breastfeeding increased from 52.3 to 84.3 days, and overall breastfeeding from 278 to 376 days. Some changes in the characteristics of the population were observed, which may have positively influenced the evolution of the breastfeeding indicators (better schooling level among the mothers, less use of dummies/pacifiers, and lower proportions of adolescent mothers), or negatively (greater proportions of primiparous mothers and cesarean deliveries, and lower frequency of births in Baby-Friendly Hospitals).

CONCLUSION:

There were significant advances in breastfeeding indicators, although they are still far from ideal. Changes observed in population characteristics may have positively or negatively influenced this evolution.

Breastfeeding; Nutrition surveys; Child nutrition; Cross-sectional study; Health status indicators

Indicators	Year					Period
	1996	2001	2009	1996-2001 (5 years)		2001-2009 (8 years)				1996-2009 (13 years)
				Difference in period	Annual difference	p	Difference in period	Annual difference	p	Difference in period	Annual difference	p
Prevalence (%) of breastfeeding in the 1st hour of life	^a	52.2	68.9	^a	^a	^a	16.7	2.1	< 0.000	^a	^a	^a
Prevalence (%) of exclusive breastfeeding < 6 months	36.9	39.0	47.4	2.1	0.4	> 0.05	8.4	1.1	< 0.000	10.5	0.8	< 0.000
Prevalence (%) of breastfeeding 9-12 months	45.0	51.8	59.6	6.8	1.4	< 0.05	7.8	1.0	< 0.015	14.6	1.1	< 0.000
Median duration of breastfeeding, in days	278.0	302.4	375.8	24.4	4.9	> 0.05	73.4	9.2	< 0.05	97.8	7.5	< 0.05
Median duration of exclusive breastfeeding in days	52.3	57.0	84.3	4.7	0.9	> 0.05	27.3	3.4	< 0.05	32.0	2.5	< 0.05

Variables	Year of survey				p^c
	2001 (n = 2,319)^a		2009 (n = 1,471)^b
	n	%	n	%
Birth weight	2,153	100.0	1,354	100.0
< 2,500 g	165	7.7	129	9.5	0.058
≥ 2,500 g	1,988	92.3	1,225	90.5
Born in a Baby-Friendly Hospital	2,311	100.0	1,412	100.0
Yes	823	35.6	345	24.4	< 0.000
No	1,488	64.4	1,067	75.6
Gender	2,311	100.0	1,471	100.0
Male	1,154	49.9	715	48.6	0.426
Female	1,157	50.1	756	51.4
Pacifier use	2,318	100.0	1,461	100.0
Yes	1,328	57.3	650	44.5	< 0.000
No	990	42.7	811	55.5
Maternal age	2,319	100.0	1,192	100.0
< 20 years	518	22.3	208	17.4	< 0.000
≥ 20 years	1,801	77.7	984	82.6
Maternal schooling	2,186	100.0	1,169	100.0
≤ eight years	1,319	60.3	382	32.7	0.000
> eight years	867	39.7	787	67.3
Parity	2,318	100.0	1,179	100.0
Primiparous	1,072	46.2	659	55.9	< 0.000
Multiparous	1,246	53.8	520	44.1
Type of delivery	2,123	100.0	1,461	100.0
Normal	1,480	69.7	690	47.2	0.000
Cesarean	643	30.3	771	52.8
Maternal employment outside home	2,315	100.0	1,195	100.0
Yes	539	23.3	259	21.7	0.277
No	1,776	76.7	936	78.3

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E-mail: jped@jped.com.br

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[1] * Corresponding author. E-mail: gracieteovieira@gmail.com (G.O. Vieira).

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Trends in breastfeeding indicators in a city of northeastern Brazil ☆ ☆ Please cite this article as: Vieira GO, Reis MR, Vieira TO, Oliveira NF, Silva LR, Giugliani ER. Trends in breastfeeding indicators in a city of northeastern Brazil. J Pediatr (Rio J). 2015;91:270-7.

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Trends in breastfeeding indicators in a city of northeastern Brazil ^☆ ☆ Please cite this article as: Vieira GO, Reis MR, Vieira TO, Oliveira NF, Silva LR, Giugliani ER. Trends in breastfeeding indicators in a city of northeastern Brazil. J Pediatr (Rio J). 2015;91:270-7.