Implementation of the Brazilian Breastfeeding Network and prevalence of exclusive breastfeeding

Passanha, Adriana; Benício, Maria Helena D’Aquino; Venâncio, Sônia Isoyama; Reis, Márcia Cristina Guerreiro dos

doi:10.1590/S0034-8910.2013047004807

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Sumário

Public Health Practice Original Articles • Rev. Saúde Pública 47 (6) • Dec 2013 • https://doi.org/10.1590/S0034-8910.2013047004807 copy

Implementation of the Brazilian Breastfeeding Network and prevalence of exclusive breastfeeding

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE

: To evaluate the association between the level of implementation of the Brazilian Breastfeeding Network and the prevalence of exclusive breastfeeding.

METHODS

: Cross-sectional study of a representative sample of 916 infants < 6 months, in Ribeirao Preto, SP, Southeastern Brazil, in 2011. Data on breastfeeding, place of outpatient care and other characteristics were collected during the National Vaccination Campaign. The factor studied is where outpatient care took place: Private; Non-Network Public; Public with Network Workshop; and Public certified by Network. The individualized effect of the factor studied on the outcome was analyzed using Poisson regression with robust variance.

RESULTS

: The comparison between private (reference category) and other outpatient care showed significant dose-response relationship with a progressive increase in the prevalence of exclusive breastfeeding in public non-Network, public with Network Workshop and public accredited by Network outpatient care (p = 0.047). As regards the Basic Health Units accredited by Network category, the Prevalence Ratio of exclusive breastfeeding was equal to 1.47 (95%CI 1.00;2.17), after adjustment for confounding variables.

CONCLUSIONS

: The prevalence of exclusive breastfeeding for infants < 6 months was higher in places accredited by the Brazilian Breastfeeding Network, which evinces the importance of investing in accreditation of Basic Units of Health by this strategy.

Breast Feeding; Infant Nutrition; Maternal-Child Health Centers; Primary Health Care; Cross-Sectional Studies

Variable	n	EBF (%)	PR	95%CI	p
Age of infant (months)					< 0.001^a
> 1	123	62.2	1
1 ├ 2	135	45.5	0.73	0.58;0.92
2 ├ 3	152	38.1	0.61	0.48;0.79
3 ├ 4	185	28.7	0.46	0.35;0.60
4 ├ 5	161	23.6	0.38	0.28;0.52
5 ├ 6	160	11.5	0.18	0.12;0.29
Sex					0.358
Male	474	31.8	1
Female	442	34.7	1.09	0.91;1.31
Birth weight (g)					0.158
< 2,500	78	26.0	1
2,500 +	817	34.1	1.32	0.90;1.95
Type of delivery					0.992
Cesarean	540	33.2	1
Vaginal	376	33.2	1.00	0.91;1.10
Maternal age group (years)
< 20	103	22.6	1		0.044^a
20 ├ 35	188	37.3	1.65	1.14;2.40
35 +	105	35.3	1.57	1.00;2.44
Births					0.001
First	415	29.6	1
Multiparous	398	40.9	1.38	1.14;1.68
Work status					< 0.001^a
Working outside the home	163	23.5	1
Not working outside the home	415	35.5	1.52	1.12;2.06
On maternity leave	234	42.5	1.81	1.32;2.49
Schooling (years)					0.106^a
≤ 8	189	32.0	1
9 ├ 12	444	34.5	1.08	0.84;1.38
12 +	181	40.2	1.26	0.95;1.66
Outpatient care
Private	379	34.8	1		0.851^a
Public non-Network^b	378	31.5	0.91	0.74;1.11
Public with Network Workshop^b	50	30.6	0.88	0.56;1.37
Public Network certified^b	45	38.6	1.11	0.75;1.65

Variable	PR	95%CI	p^a
Outpatient care			0.047
Private	1
Public non-Network^b	1.07	0.86;1.35
Public with Network Workshop^c	1.32	0.82;2.13
Public Network certified^d	1.47	1.00;2.17

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

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[1] Correspondence
: Adriana Passanha. Departamento de Nutrição. Av. Dr. Arnaldo, 715. 01246-904 São Paulo, SP, Brasil. E-mail: adriana.passanha@gmail.com