Association between the use of a baby's bottle and pacifier and the absence of breastfeeding in the second six months of life

Rigotti, Renata Ribeiro; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira

doi:10.1590/1413-81232015204.00782014

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Free Themes • Ciênc. saúde coletiva 20 (4) • Apr 2015 • https://doi.org/10.1590/1413-81232015204.00782014 copy

Association between the use of a baby's bottle and pacifier and the absence of breastfeeding in the second six months of life

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction:

The World Health Organization recommends breastfeeding for two years or more and advises against bottle feeding and pacifier use.

Objective:

Investigate the association between bottle feeding and pacifier use, and breastfeeding in the second half-year of life.

Methods:

Survey in a municipality of Rio de Janeiro state, in 2006, interviewing those responsible for 580 children aged 6-11 months. Bottle feeding and pacifier use, and variables which in the bivariate analysis were associated with the outcome 'absence of breastfeeding' (≥ 0.20), were selected for multiple analysis. Adjusted prevalence ratios were obtained by a Poisson regression model.

Results:

40% of the children 6-11 months were not being breastfed, 47% used a pacifier and 57% used a bottle. Pacifier use (PR = 3.245; CI95%: 2.490-4.228) and bottle feeding (PR = 1.605; CI95%: 1.273-2.023) were shown to be strongly associated with the outcome, and also with: mother's low schooling (PR = 0.826; CI95%: 0.689-0.990); low birth weight (PR = 1.488; CI95%: 1.159-1.910); mother not being the baby carer (PR = 1.324; CI95%: 1.080-1.622); and increasing age of the baby in days (PR = 1.004; CI95%: 1.002-1.006).

Conclusions:

The use of pacifiers and bottles can reduce continued breastfeeding. Stronger discouragement of these artifacts should be adopted in public health policies.

Breastfeeding; Bottle; Pacifiers; Infant nutrition; Epidemiological studies

Variable	n	%

Person accompanying the child
Mother	484	83.4
Other	96	16.6
Mother’s age
< 20 years	72	12.4
20–34	425	73.3
> 34	68	11.7
Level of education
Up to secondary incomplete	341	61.0
Secondary completed or higher	218	39.0
Mother has paid employment
Yes	145	25.1
No	433	74.9
Municipality of residence
Barra Mansa	556	95.9
Other municipality	24	4.1
Area of residence
Urban	548	94.5
Rural	32	5.5
First or later child
First	302	52.1
Second or later	278	47.9
Birth hospital: financing
Private	354	62.2
Public	215	37.8
Type of birth
Normal	199	34.4
Caesarian	380	65.6
Gender of child
Male	296	51.0
Female	284	49.0
Birth weight
< 2500 g	44	7.7
2500g or more	527	92.3
Child’s age
6–8 months	265	45.7
9–11 months	315	54.3
Prior hospitalization
Yes	42	7.3
No	531	92.7
Use of pacifier
Yes	274	47.2
No	306	52.8
Use of feeding bottle
Yes	331	57.3
No	247	42.7

Characteristics	Prevalence	Gros PR	CI 95%	p- value

Use of pacifier
Yes	65.0%	3.68	2.846–4.761	< 0.001
No	17.6%	1
Use of feeding bottle
Yes	51.4%	2.11	1.657–2.698	< 0.001
No	24.3%	1
Person accompanying the child
Mother	36.8%	1
Other	56.3%	1.53	1.238–1.890	< 0.001
Mother’s age
< 20 years	43.1%	1.39	0.894–2.173	0.142
20–34	39.5%	1.28	0.880–1.861	0.196
> 34	30.9%	1
Mother’s level of education
Up to secondary incomplete	34.3%	0.73	0.593–0.890	0.002
Secondary complete or higher	47.2%	1
Mother has paid employment
Yes	55.9%	1.60	1.320–1.944	<0.001
No	34.9%	1
Location of residence
Barra Mansa	40.3%	1
Other municipality	33.3%	0.83	0.466–1.470	0.518
Place of vaccination
Urban area	40.5%	1
Rural area	31.3%	0.77	0.457–1.302	0.331
First or later child
First	43.0%	1.17	0.959–1.435	0.121
Second or later	36.7%	1
Birth hospital
SUS	34.9%	1
Private	42.1%	1.21	0.969–1.503	0.094
Type of birth
Normal	36.7%	1
Caesarian	41.8%	1.14	0.918–1.418	0.236
Gender of child
Female	38.0%	0.91	0.743–1.109	0.343
Male	41.9%	1
Birth weight
< 2500 g	65.9%	1.73	1.361–2.194	< 0.001
2500g or more	38.1%	1
Child’s age
6–8 months	32.8%	1
9–11 months	46.0%	1.25	1.090–1.421	0.001
Prior hospitalization
Yes	50.0%	1.27	0.926–1.759	0.135
No	39.2%	1

Characteristics	Adjusted PR	CI 95%	p-value

Use of pacifier
Yes	3.245	2.490–4.228	< 0.001
No	1
Use of feeding bottle
Yes	1.605	1.273–2.023	< 0.001
No	1
Person accompanying the child
Mother	1
Other	1.324	1.080–1.622	0.007
Mother’s level of education
Up to secondary incomplete	0.825	0.689–0.990	0.039
Secondary complete or higher	1
Birth weight
< 2500 g	1.453	1.162–1.817	0.001
2500g or more	1
Age of child in days	1.004	1.002–1.006	<0.001

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[1] Collaborations RR Rigotti, MIC Oliveira and CS Boccolini participated equally in all the stages of preparation of the article.