Assessment of factors that interfere on breastfeeding
					within the first hour of life

Pereira, Célia Regina Vianna Rossi; Fonseca, Vânia de Matos; Oliveira, Maria Inês Couto de; Souza, Ivis Emilia de Oliveira; Mello, Rosane Reis de

doi:10.1590/S1415-790X2013000200026

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Revista Brasileira de Epidemiologia

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• Rev. bras. epidemiol. 16 (2) • June 2013 • https://doi.org/10.1590/S1415-790X2013000200026 copy

Assessment of factors that interfere on breastfeeding within the first hour of life

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

To investigate how the 4^thStep of the Baby-Friendly Hospital Initiative was applied, assess the prevalence of breastfeeding (BF) within the first hour after birth and analyze factors associated with non-BF in this period of life.

Methods:

Cross-sectional study conducted in a high-risk maternity-hospital in Rio de Janeiro City, Brazil, with interview to a sample of 403 rooming-in mothers. The prevalence ratio with its respective 95% confidence interval was estimated by the use of SPSS 15® from a model with complementary log log link function.

Results:

The prevalence of BF in the first hour of life was 43.9%. Multivariate analysis showed that were protected against non-BF in the first hour after birth non-black women (PR = 0.62, 95% CI: 0.42-0.90), multiparous women (PR = 0.66, 95% CI: 0.47-0.93), prenatal care (PR = 0.23, 95% CI: 0.08-0.67), vaginal delivery (PR =0 .41, 95% CI: 0.28-0.60), newborn with birthweight ≥ 2,500g (PR = 0.31, 95% CI: 0.11-0.86) and women who received help from the health team to BF in the delivery room (PR = 0.51, 95% CI: 0.36-0.72).

Conclusion:

Help provided by the health team to breastfeeding at birth, Step 4 of the Baby-Friendly Hospital Initiative, as well as non black women, multiparous women, receiving pre-natal care, vaginal delivery and appropriate birthweight contributed to breastfeeding in the first hour of life.

Breastfeeding; Birth; Evaluation; Cross-sectional studies; Newborn; Hospital.

Associação Brasileira de Saúde Coletiva Av. Dr. Arnaldo, 715 - 2º andar - sl. 3 - Cerqueira César, 01246-904 São Paulo SP Brasil , Tel./FAX: +55 11 3085-5411 - São Paulo - SP - Brazil
E-mail: revbrepi@usp.br

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[1] Corresponding author: Vânia de Matos Fonseca. Av. Rui Barbosa 716. Flamengo CEP 22250-020. Rio de Janeiro, RJ. E-mail: vaniamf36@hotmail.com

	Frequency		Non-breastfeeding in the first hour of life
	n	%	%	PR	95%CI
Age (n=403)
Adolescent	98	24.3	60.2	1
Adult	305	75.7	54.7	0.91	0.75-1.1
Education (n=401)
0 to 7 years of study	181	45.1	56.4	1
8 to 14 years of study	220	54.9	55.9	0.99	0.83-1.18
Mother´s skin color (n=402)*
Black	108	26.7	65.7	1
Non-Black	294	72.9	52.7	0.80	0.67-0.95
Working mothers (n=403)
No	194	48.1	57.2	1
Yes	209	51.9	55.0	0.97	0.82-1.15
Number of assets (n=43)
1 to 4 assets	108	26.8	59.2	1
5 or more assets	295	73.2	54.9	0.93	0.77-1.12
Has a partner (n=403)
No	47	11.7	63.8	1
Yes	356	88.3	55.1	0.86	0.68-1.09
Parity (n=403)*
Primiparous mother	134	33.3	61.9	1
Multiparous (two or more children)	269	66.7	53.1	0.86	0.72-1.02
Pregnancy planned (n=403)
No	282	70.0	56.3	1
Yes	121	30.0	55.3	0.98	0.81-1.19

	Frequency		Non-breastfeeding in the first hour of life
	n	%	%	PR	95%CI
Underwent prenatal care (n=403)*
No	28	6.9	85.7	1
Yes	375	93.1	53.9	0.63	0.53 - 0.75
Number of prenatal appointments (n=403)
From 0 to 5 appointments	198	49.2	55.6	1
From 6 to 12 appointments	205	50.8	56.6	1.02	0.83 -1.25
Quarter of prenatal beginning (n=375)**
Third quarter	12	3.2	58.3	1
Second quarter	152	40.5	56.6	0.99	0.69 - 1.41
First quarter	211	56.3	51.7	0.96	0.67 - 1.36
Mentioned breastfeeding in prenatal (n=375)**
No	166	44.3	54.8	1
Yes	209	55.7	53.1	0.99	0.88-1.12
Type of guidance to breastfeeding (n=403)
No guidance	194	48.1	59.3	1
In group *	119	29.5	47.1	0.79	0.63-0.99
In the appointment	90	22.3	61.1	1.05	0.86 - 1.29
Bottle should not be given (n=374)
No	162	43.3	53.0	1
Yes	212	56.7	54.7	1.03	0.85 -1.25

	Frequency	Non-breastfeeding in the first hour of life
	n	%	%	PR	95%CI
Type of delivery (n=403)*
C-section	140	34.7	72.1	1
Normal	263	65.3	47.5	0.66	0.56-0.78
Baby weight at birth (n=403)*
Less than 2500g (1850-2499)	22	5.5	81.8	1
More or equal to 2500g (2500 - 4900)	381	94.5	54.5	0.67	0.54-0.83
At delivery, staff offered help to breastfeeding (n=403)*
No	298	73.9	62.7	1
Yes	105	26.1	37.1	0.59	0.45-0.77
Type of help (n=105)**
Skin to skin contact	54	51.4	53.7	1
Baby´s mouth to breast	51	48.6	19.6	0.37	0.20-0.67
Mother knew she could breastfeed in delivery room? (n=403)
No	228	56.6	57.4	1
Yes	175	43.4	54.2	0.94	0.79-1.13
Anyone asked if mother wanted to put baby on her breast? (n=403)**
No	343	85.1	59.4	1
Yes	60	14.9	36.6	0.62	0.44-0.87
Did they listen what you said about breastfeeding? (n=403)
No	48	11.9	62.5	1
Yes/more or less	355	88.1	55.2	0.88	0.70-1.12
Satisfaction with the service (n=403)
No	44	10.9	52.2	1
Yes	359	89.1	56.5	1.08	0.80-1.46

	Adjusted PR	95%CI
Mother´s skin color*
Black	1
Non-black	0.62	0.42 - 0.90
Parity*
Primiparous mother	1
Multiparous mother	0.66	0.47 - 0.93
Underwent prenatal care*
No	1
Yes	0.23	0.08 - 0.67
Type of delivery*
C-section	1
Normal	0.41	0.28 - 0.60
Baby weight at birth*
Less than 2500g	1
More or equal to 2500g	0.31	0.11 - 0.86
At delivery, staff offered help to breastfeeding*
No	1
Yes	0.51	0.36 - 0.72