Prevalence of exclusive breastfeeding up to six months of age in full-term newborns during the pandemic and factors associated with early weaning

Silva, Mirelly Sabrina Santos; Gomes, Sandra Raquel de Melo; Berbert, Monalise Costa Batista; Furlan, Renata Maria Moreira Moraes

doi:10.1590/1982-0216/20242660624

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ORIGINAL ARTICLES • Rev. CEFAC 26 (6) • 2024 • https://doi.org/10.1590/1982-0216/20242660624 copy

Prevalence of exclusive breastfeeding up to six months of age in full-term newborns during the pandemic and factors associated with early weaning

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose:

to investigate the prevalence of exclusive breastfeeding up to 6 months old in full-term newborns at a public hospital and the main factors associated with early weaning, during the pandemic caused by severe acute respiratory syndrome.

Methods:

an observational, cross-sectional study with 98 mothers of full-term babies, conducted from January to August 2021, during the COVID-19 pandemic. The participants answered two structured questionnaires. One was applied immediately after childbirth, with questions on identification and socioeconomic data, obstetric-gynecological background, and current pregnancy and childbirth. The second questionnaire, applied 6 months after childbirth, had questions about the child's feeding status. Statistical tests were used to associate the prevalence of exclusive breastfeeding up to 6 months old and other variables, at the 5% significance level.

Results:

16.3% of the babies were exclusively breastfeeding until the sixth month, during the COVID-19 pandemic, in the public hospital where the study was carried out. Exclusive breastfeeding up to 6 months old was not associated with the study variables.

Conclusion:

the prevalence of exclusive breastfeeding until the sixth month in full-term babies, in a public hospital, during the COVID-19 pandemic, was 16.3%. None of the variables analyzed was associated with early weaning.

Keywords:
Breast Feeding; Weaning; Rooming-in Care; Infant, Newborn; Maternal and Child Health

Socioeconomic data and obstetric-gynecological history		EBF in the 6^th month		Total	p-value
Socioeconomic data and obstetric-gynecological history		Yes	No	Total	p-value
Color/Race	Black	5	17	22	0.603^**
	East Asian	1	2	3
	White	2	9	11
	Multiracial	8	54	62
	Total	16	82	98
Occupation	Self-employed	3	29	32	0.431^**
	Works in a company	7	29	36
	Works at home	6	24	30
	Total	16	82	98
Family income	Up to 1 minimum wage	6	38	44	0.316^**
	2 to 3 minimum wages	6	35	41
	More than 3 minimum wages	4	9	13
	Total	16	82	98
Number of children	1	11	35	46	0.552^**
	2	3	28	31
	3	2	15	17
	More than 3	0	4	4
	Total	16	82	98
Were the other children on EBF?	Yes	4	41	45	0.102^***
	No	0	7	7
	Total^*	4	44	52
Were there complications in previous breastfeeding?	Yes	2	14	16	0.095^***
	No	2	30	32
	Total^*	4	44	48
Was the breastfeeding experience pleasant?	Yes	4	36	40	0.130^***
	No	0	8	8
	Total^*	4	44	48

Research moment	Variables researched		EBF in the 6th month		Total	Valor de p
Research moment	Variables researched		Yes	No
Pregnancy	Planned pregnancy	Yes	7	27	34	0.410^***
		No	9	55	64
		Total	16	82	98
	Prenatal care	Yes	16	81	97	0.657
		No	0	1	1
		Total	16	82	98
	Prenatal guidance	Yes	3	18	21	0.775^**
		No	13	64	77
		Total	16	82	98
Delivery	Type of delivery	Cesarean	10	34	44	0.122^***
		Vaginal	6	48	54
		Total	16	82	98
	Breastfeeding within the first hour after delivery	Yes	9	58	67	0.255^***
		No	7	24	31
		Total	16	82	98
Immediate postpartum period (at the maternity hospital)	Guidance immediately after childbirth	Yes	15	74	89	0.792^**
		No	1	8	9
		Total	16	81	98
	EBF (at the maternity)	Yes	15	73	88	0.567^**
		No	1	9	10
		Total	16	82	98
	Use of artificial nipples at the maternity	Yes	1	6	7	0.680^**
		No	15	76	91
		Total	16	82	98
	Maternal complaints at the maternity	No complaint	9	50	59	0.089^*
		Sore nipples	4	6	10
		Breastfeeding pain	2	7	9
		Cracked nipples	0	2	2
		Sore nipples and breastfeeding pain	0	16	16
		Breastfeeding pain and cracked nipples	1	1	2
		Total	16	82	98
After hospital discharge	Breastfeeding guidance received in follow-up visits after hospital discharge	Yes	8	23	31	0.084^***
		No	8	59	67
		Total	16	82	98

Variables researched on breastfeeding guidance		Prenatal		Immediate postnatal period
Variables researched on breastfeeding guidance		n	%	n	%
Received breastfeeding guidance	Yes	21	21.4	89	90.8
Received breastfeeding guidance	No	77	78.6	9	9.2
Setting where guidance was provided	Community health center	18	18.4	-	-
Setting where guidance was provided	Private clinic	3	3.1	-	-
Professional who provided guidance	Physician	17	81.0	36	40.4
	Nurse	8	38.1	59	66.3
	Speech-language-hearing pathologist	0	0	5	5.6
	Licensed practical nurse	0	0	14	15.7
	Others	0	0	13	14.6
How guidance was provided	Individual care	18	85.7	73	82.0
	Group care	0	0	1	1.1
	Spontaneous conversation	2	9.5	6	6.7
	Booklets	1	4.8	4	4.5
	Individual care and booklets	0	0	5	5.6
Guidance content	Latching and positioning the baby at the breast	8	38.1	83	93.3
	Use of pacifiers and bottles	0	0	3	3.4
	Benefits of breastfeeding	2	9.5	6	6.7
	Ideal EBF time	0	0	4	4.5
	Breast care	9	42.9	18	20.2
	Other information	5	23.8	12	13.5

Guidance content	EBF in the 6^th month	Prenatal				Postnatal
Guidance content	EBF in the 6^th month	Yes	No	Total	p-value	Yes	No	Total	Valor de p
Latching and positioning the baby at the breast	Yes	2	1	3	0.531⁺⁺	14	1	15	1.000⁺⁺
	No	6	12	18		69	5	74
	Total	8	13	21		83	6	89
Benefits of breastfeeding	Yes	0	3	3	1.000⁺⁺	0	15	15	0.584⁺⁺
	No	2	16	18		6	68	74
	Total	2	19	21		6	83	89
Breast care	Yes	0	3	3	0.229⁺⁺	4	11	15	0.493⁺⁺
	No	9	9	18		14	60	74
	Total	9	12	21		18	71	89
Other information	Yes	1	2	3	1.000⁺⁺	2	13	15	1.000⁺⁺
	No	4	14	18		10	64	74
	Total	5	16	21		12	77	89
Use of pacifiers and bottles	Yes	0	3	3	-	1	14	15	0.429⁺⁺
	No	0	18	18		2	72	74
	Total	0	21	21		3	86	89
Ideal EBF time	Yes	0	3	3	-	1	14	15	0.529⁺⁺
	No	0	18	18		3	71	74
	Total	0	21	21		4	85	89

Variables on the infant's feeding status at 6 months		n	%
EBF	Yes	16	16.3
EBF	No	82	83.7
Type of feeding for babies who were not on EBF	Mixed breastfeeding	31	37.8
	Infant formula	35	42.7
	Baby food	55	67.1
Introducing other foods	Yes	58	59.2
Introducing other foods	No	40	40.8
Age at which baby food was introduced	3 months or earlier	3	5.2
	4 months	14	24.1
	5 months	41	70.7
Age at which mixed breastfeeding began	First 15 days	12	18.8
	First month	8	12.5
	Second month	8	12.5
	Third month	17	26.6
	Fourth month	9	14.1
	Fifth month	10	15.6
Age at which the infant was weaned	First 15 days	3	8.3
	First month	5	13.9
	Second month	4	11.1
	Third month	10	27.8
	Fourth month	11	30.6
	Fifth month	3	8.3
Reason reported by the mother for discontinuing EBF before 6 months	Replaced with industrialized products	0	0
	Little milk production	23	28.4
	The infant did not latch on	1	1.2
	Health issues	0	0
	Mother’s choice	2	2.5
	Return to work	17	21.0
	Belief that her milk was weak	9	11.1
	Sore nipples	3	3.7
	Beliefs, culture, and lifestyle (breast ptosis)	0	0
	Other reasons	28	34.6
Mother’s desire to resume breastfeeding	Yes	4	9.1
Mother’s desire to resume breastfeeding	No	40	90.9

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[1] Corresponding author: Renata Maria Moreira Moraes Furlan, Universidade Federal de Minas Gerais - Faculdade de Medicina - Departamento de Fonoaudiologia, Avenida Alfredo Balena, 190, Santa Efigênia, CEP: 30130-100 - Belo Horizonte, MG, Brazil, E-mail: renatamfurlan@gmail.com