Situation of breastfeeding and complementary feeding in a medium-sized
               municipality in the Ribeira Valley, São Paulo

Tamasia, Gislene dos Anjos; Venâncio, Sonia Isoyama; Saldiva, Silvia Regina Dias Medici

doi:10.1590/1415-52732015000200003

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Artigos Originais • Rev. Nutr. 28 (2) • Mar-Apr 2015 • https://doi.org/10.1590/1415-52732015000200003 copy

Situation of breastfeeding and complementary feeding in a medium-sized municipality in the Ribeira Valley, São Paulo

Situação da amamentação e alimentação complementar em um município de médio porte do Vale do Ribeira, São Paulo

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To analyze the situation of breastfeeding and complementary feeding in the city of Registro, São Paulo.

METHODS:

This cross-sectional study collected sociodemographic and feeding information of infants aged less than one year who participated in the 2011 multiple vaccine campaign. Breastfeeding and complementary feeding were analyzed by indicators proposed by the World Health Organization. The association between outcomes (exclusive breastfeeding and introduction to complementary feeding) and the explanatory variables (maternal and child characteristics) was investigated by the Poisson model with a robust error variance.

RESULTS:

We analyzed 713 children. The prevalence of exclusive breastfeeding was 50.0%. Children who were breastfed exclusively on the first day at home (PR=2.40; 95%CI=1.42-4.06) and not given pacifiers (PR=1.95; 95%CI=1.153.30) were more likely to be exclusively breastfed. The complementary feeding indicators showed that 62.1% of the children aged 6 to 8.9 months consumed fruit plus savory mashes. None of the explanatory variables was significantly associated with this outcome.

CONCLUSION:

The study identified inappropriate infant feeding practices. Such studies can contribute to the proposal of policies, which is particularly important in an unfavorable social development context characterized by the study city.

Breast feeding; Indicators; Supplementary feeding

Variables	n	%

Child’s gender
Male	365	51.2
Female	348	48.8
Low birth weight
Yes	46	6.9
No	620	93.1
Type of delivery
Vaginal	389	56.2
Caesarian	303	43.8
Use of artificial teats
Bottle	362	52.3
Pacifier	279	40.4
Exclusively breastfed on the first day at home
Yes	185	81.9
No	41	18.1
Follow-up
Unified Health Care System	463	77.0
Private Network	138	23.0
Mother’s age
<20 years	92	12.7
20-35 years	436	60.3
>35 years	76	10.5
Parity
Primiparous	276	46.2
Multiparous	322	53.8
Employment status
Works	113	18.8
Does not work	487	81.2
Maternal years of formal education
Up to 8 years	116	19.7
8 to 11 years	373	63.4
>11 years	99	16.8

Variables	n	%

Breastfed in the first hour of life
Yes	546	81.1
No	127	18.9
Exclusively breastfed <6 months
Yes	205	49.9
No	206	50.1
Breastfed from 9-12 months
Yes	76	59.8
No	51	40.2
Children aged 6 to 8.9 months given fruits and savory meals
Yes	90	62.1
No	55	37.9
Children aged 6 to 6.9 months given 1 savory meal
Yes	13	35.1
No	24	64.9
Children aged 7 to 11.9 months given 2 savory meals
Yes	123	66.5
No	62	33.6
Children aged 8 to 11.9 months given foods prepared for the family
Yes	59	39.6
No	90	60.4
Children aged 6 to 11.9 months given high-iron foods
Yes	222	93.7
No	15	6.3
Children aged 6 to 11.9 months given at least 1 unhealthy food
Yes	204	75.6
No	66	24.4

Variables	EBF children^*				Crude PR				Adjusted PR
Variables	n	%		PR	95%CI	p		PR	95%CI	p
	n	%		PR	95%CI	p		PR	95%CI	p

Gender
Male	213	46.0	1
Female	198	53.5	1.2		0.9 - 1.5	0.28
Low birth weight
Yes	29	31.0	1				1
No	360	51.9	1.1		0.9 - 1.3	0.12	1.1		0.8 - 1.6	0.55
Delivery
Caesarian	173	50.2	1
Vaginal	233	50.3	1.0		0.8 - 1.3	0.99
Breastfed in the first hour of life
No	78	41.0	1
Yes	317	51.7	1.2		0.9 - 1.7	0.23
EBF ^* on first day at home
No	39	25.6	1				1
Yes	173	73.4	2.8		1.8 - 4.4	0.00	2.4		1.4 - 4.1	0.01
Pacifier
Yes	160	33.8	1				1
No	245	60.4	1.7		1.3 - 2.2	0.00	1.9		1.1 - 3.3	0.01
Follow-up
Unified Health Care System	280	52.1	1
Private network	67	47.8	0.9		0.6 - 1.3	0.64
Maternal age										0.49^**
=20 years	64	40.6	1				1
20-35 years	264	54.5	1.3		0.9 - 2.0		1.2		0.6 - 2.2	0.62
≥35 years	39	56.4	1.4		0.8 - 2.4		1.2		0.5 - 2.9	0.67
Parity
Primiparous	165	49.7	1
Multiparous	199	54.3	1.1		0.8 - 1.5	0.53
Employment status
Does not work	325	54.8	1
Works	42	35.7	0.9		0.8 - 1.1	0.27
Education level
Up to 8 years	74	51.4	1
8 to 11 years	230	52.6	1.0		0.7 - 1.5
>11 years	53	52.8	1.0		0.6 - 1.7

Variables		CF^*			Crude PR					Adjusted PR
Variables	n	%		PR	95%CI		p		PR	95%CI	p
	n	%		PR	95%CI		p		PR	95%CI	p

Gender
Male	71	63.4	1.0
Female	74	60.8	0.9		0.6	- 1.4	0.84
Low weight
Yes	9	55.6	1.0
No	128	64.1	1.1		0.5	- 2.8	0.76
Bottle
No	39	51.2	1.0
Yes	103	66.9	1.3		0.8	- 2.1	0.29
Pacifier
Yes	67	70.1	1.0
No	76	56.6	1.2		0.8	- 1.9	0.31
Follow-up
Private	37	83.8	1.0					1.0
Unified Health Care System	91	56.0	0.7		0.4	- 1.0	0.08	0.8		0.4 - 1.5	0.42^**
Maternal age											0.89^**
=20 years	15	53.3	1.0
20-35 years	87	64.4	1.2		0.6	- 2.5	0.62
≥35 years	14	85.7	1.6		0.7	- 3.9	0.29
Parity
Primiparous	57	70.2	1.0
Multiparous	57	61.4	0.9		0.55	- 1.38	0.564
Work situation
Does not work	40	85.0	1.0					1.0
Works	76	55.2	0.6		0.4	- 1.0	0.06	0.7		0.4 - 1.2	0.24^**
Education level											0.07^**
Up to 8 years	18	44.4	1.0					1.0
8-11 years	66	63.6	1.4		0.7	- 3.0	0.35	1.4		0.6 - 2.9	0.40^**
>11 years	27	88.9	1.9		0.9	- 4.4	0.09	1.4		0.5 - 3.7	0.47^**

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[1] COLLABORATORS GA TAMASIA and SI VENANCIO helped to design the study, collect data, analyze, and discuss the results of the dissertation on which this article is based. SRDM SALDIVA helped to analyze the data and write the article.