Prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life

Mattiello, Rita; Kotoski, Aline; Ayala, Camila Ospina; Recha, Carine Lucena; Quiroga, Carolina Villanova; Machado, Cátia Regina; Roxo, Cristiano de Oliveira; Varela, Fernanda Hammes; Couto, Giovanna Trevisan; Cassão, Gisele; Lopes, Jéssica Blatt; Gonçalves, João Ismael Budelon; Silva, Juliana Fernandes da; Barh, Mariana Barth de; Rocha, Natalie Duran; Albuquerque, Nathalia Saraiva de; Corte, Ricardo Arlindo Dalla; Bernardes, Rossana; Richter, Samanta Andresa; Rossi, Tainá; Santos, Ina S.

doi:10.1016/j.jped.2021.02.006

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ORIGINAL ARTICLE • J. Pediatr. (Rio J.) 98 (01) • Jan-Feb 2022 • https://doi.org/10.1016/j.jped.2021.02.006 copy

Prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life^☆ ☆ Study conducted at Universidade Católica do Rio Grande do Sul, Programa de Pós-graduação em Pediatria e Saúde da Criança, Disciplina Redação Científica, Porto Alegre, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To investigate the prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life in a sample of women in the first 24 h postpartum during the hospital stay.

Methods:

Cross-sectional study with data from screening phase of a birth cohort. The proportion of mothers who did not intend to breastfeed exclusively for 6 months (primary outcome) derived from a negative response to the question “Would you be willing to try to breastfeed exclusively for the first 6 months?”, in an interview conducted by previously trained interviewers. Crude and adjusted prevalence ratios (PR) with 95% confidence intervals were obtained by Poisson regression with robust variance.

Results:

A total of 2964 postpartum women were interviewed. The overall prevalence of mothers who did not intend to breastfeed exclusively for 6 months was 17.8% (16.4–19.1%). After adjusting for maternal age and type of pregnancy (singleton or multiple), no intention to exclusively breastfeed was higher in mothers with a monthly household income < 3 minimum wages (PR, 1.64; 1.35–1.98) and in those who intended to smoke 4–7 days/week after delivery (PR, 1.42; 1.11–1.83). The presence of significant newborn morbidity (PR, 0.32; 0.19–0.54) and intention to breastfeed up to 12 months (PR, 0.46; 0.38–0.55) had a protective effect against not intending to breastfeed exclusively for 6 months.

Conclusions:

Approximately 1 in every 5 mothers did not intend to breastfeed exclusively for 6 months. Strategies aimed at promoting exclusive breastfeeding should focus attention on mothers from lower economic strata and smokers.

KEYWORDS
Breastfeeding; Exclusive breastfeeding; Postpartum period; Intention

Characteristic		n (%)	Prevalence of no intention to exclusively breastfeed (%)	95% CI^a a 95% CI: 95% confidence interval.	p^b b Heterogeneity test.
Monthly household income (MW)^c c MW: minimum wage in 2014 = 724.00 reais (Brazilian currency).					< 0.001
	< 3	1942 (65.6)	20.6	18.8–22.4
	≥ 3	1020 (34.4)	12.3	10.3–14.4
Living in urban areas of Pelotas					0.789
	Yes	2290 (77.3)	17.9	16.3–19.4
	No	674 (22.7)	17.4	14.5–20.3
Maternal age (years)					0.003^d d Linear trend test.
	< 20	407 (13.7)	24.4	20.2–28.6
	20–29	1345 (45.4)	17.2	15.2–19.3
	30–34	710 (24.0)	16.5	13.7–19.2
	≥35	502 (16.9)	15.6	12.4–18.7
Smoking during pregnancy (days/week)					<0.001
	0–3	2616 (88.3)	16.7	15.3–18.1
	4–7	346 (11.7)	25.7	21.1–30.3
Type of pregnancy					0.070
	Singleton	2919 (98.6)	17.9	16.5–19.3
	Multiple	42 (1.4)	7.1	0.7–15.0
Gestational age (weeks)^e e Variable with 345 missings.					0.062
	≥ 37	2177 (83.1)	17.7	16.1–19.3
	< 37	442 (16.9)	14.1	10.8–17.3
Newborn morbidity					<0.001
	No	2725 (92.0)	18.8	17.3–20.2
	Yes	238 (8.0)	5.5	2.6–8.4
Intention to smoke postpartum (days/week)					<0.001
	0–3	2799 (94.4)	17.1	15.7–18.4
	4–7	165 (5.6)	29.7	22.7–36.7
Intention to breastfeed up to 12 months					<0.001
	No	292 (9.9)	34.6	29.1–40.0
	Yes	2670 (90.1)	15.9	14.5–17.3
Total	–	2964	17.8	16.4–19.1	–

Characteristic		Crude PR	95% CI	p
Monthly household income (MW)^a a MW: minimum wage in 2014 = 724.00 Reais (Brazilian currency).				<0.001
	<3	1.66	1.38–2.00
	≥3	1.00
Living in urban areas of Pelotas
	Yes	1.02	0.85–1.24	0.789
	No	1.00
Maternal age (years)				0.004
	<20	1.57	1.20–2.04
	20–29	1.11	0.88–1.40
	30–34	1.06	0.81–1.38
	≥35	1.00
Smoking during pregnancy (days/week)				<0.001
	0–3	1.00
	4–7	1.54	1.26–1.88
Type of pregnancy				0.100
	Multiple	1.00
	Singleton	2.50	0.84–7.47
Gestational age (weeks)				0.067
	≥37	1.26	0.98–1.62
	<37	1.00
Newborn morbidity				<0.001
	No	1.00
	Yes	0.29	0.17–0.50
Intention to smoke postpartum (days/week)				<0.001
	0–3	1.00
	4–7	1.74	1.36–2.23
Intention to breastfeed up to 12 months				<0.001
	No	1.00
	Yes	0.46	0.34–0.55

Characteristic		Adjusted PR^a a Adjusted for maternal age and type of pregnancy.	95% CI	p
Monthly household income (MW)^b b MW: minimum wage in 2014 = 724.00 Reais (Brazilian currency).				< 0.001
	< 3	1.64	1.35–1.98
	≥3	1.00
Newborn morbidity				< 0.001
	No	1.00
	Yes	0.32	0.19–0.54
Intention to smoke postpartum (days/week)				0.006
	0–3	1.00
	4–7	1.42	1.11–1.83
Intention to breastfeed up to 12 months				< 0.001
	No	1.00
	Yes	0.46	0.38–0.55

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E-mail: jped@jped.com.br

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[1] ☆
Study conducted at Universidade Católica do Rio Grande do Sul, Programa de Pós-graduação em Pediatria e Saúde da Criança, Disciplina Redação Científica, Porto Alegre, RS, Brazil.