Factors associated with the interruption of exclusive breastfeeding in infants up to 30 days old

Moraes, Bruna Alibio; Gonçalves, Annelise de Carvalho; Strada, Juliana Karine Rodrigues; Gouveia, Helga Geremias

doi:10.1590/1983-1447.2016.esp.2016-0044

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Original Articles • Rev. Gaúcha Enferm. (Online) 37 (spe) • 2016 • https://doi.org/10.1590/1983-1447.2016.esp.2016-0044 copy

Factors associated with the interruption of exclusive breastfeeding in infants up to 30 days old

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To identify factors associated with the interruption of exclusive breastfeeding (EBF) in infants up to 30 days old.

Method

A cross-sectional study conducted at a university hospital in southern Brazil, from December 2014 to September 2015, with 341 infants up to 30 days old and their mothers. A semi-structured questionnaire was applied consisting of variables related to sociodemographic characteristics, obstetric history of the mother, companion’s education, and data of the infant and of breastfeeding. Collected data were subjected to bivariate and multivariate analysis with the estimation of Prevalence Ratios (PR).

Results

The prevalence of EBF was 79.5%. The factors associated with the interruption of EBF were babies ≥ 21 days, who received formula supplementation at the hospital, women with difficulties breastfeeding after hospital discharge, and non-white.

Conclusion

the factors associated with EBF interruption can help health workers create actions for mothers with difficulties and prevent interruption of EBF.

Breastfeeding; Weaning; Prevalence

Variables	n	Interruption of EBF within the 1^st month n (%)	p*
Mother’s age			0.678
< 20	53	12 (22.6)
≥ 20	288	58 (20.1)
Mother’s education			0.710
Finished primary school	101	22 (21.8)
Secondary school or more	240	48 (20.0)
Mother’s skin colour			0.084
White	199	34 (17.1)
Non-white	142	36 (25.4)
Marital status			0.499
With companion	315	66 (21.0)
Without companion	26	4 (15.4)
Paid occupation			0.995
Yes	185	38 (20.5)
No	156	32 (20.5)
Maternity leave			0.644
Yes	151	32 (21.2)
No	34	6 (17.6)
Return to work			0.043
Yes	14	6 (42.9)
No	171	32 (18.7)
Family income			0.725
Up to 2 minimum wages	93	17 (18.3)
2-4 minimum wages	167	37 (22.2)
More than 4 minimum wages	63	12 (19.0)
Infant’s age			0.136
Less than 10 days	31	4 (12.9)
10 - 20 days	264	52 (19.7)
More than 20 days	46	14 (30.4)
Newborn< 2500g			0.520
Yes	15	4 (26.7)
No	326	66 (20.2)
Newborn < 37 weeks			>0,999
Yes	18	3 (16.7)
No	322	67 (20.8)
Companion’s education			0.157
Finished primary school	104	26 (25.0)
Finished secondary school or more	199	36 (18.1)

Variables	n	Interruption of EBF within the 1^st month n (%)	p*
First pregnancy			0.526
Yes	159	35 (22.0)
No	182	35 (19.2)
Prenatal care			0.205
Yes	340	69 (20.3)
No	1	1 (100.0)
Number of prenatal consultations			0.118
<6	31	3 (9.7)
≥ 6	292	63 (21.6)
Prenatal category			0.976
Unified Health System	275	56 (20.4)
Health insurance	41	8 (19.5)
Private	9	2 (22.2)
Unified Health System + Health insurance	8	2 (25.0)
Unified Health System + Private	7	1 (14.3)
Guidance on breastfeeding in prenatal care			0.820
Yes	129	27 (20.9)
No	211	42 (19.9)
Participation in prenatal group			0.182
Yes	34	4 (11.8)
No	307	66 (21.5)
Guidance on breastfeeding in prenatal group			0.559
Yes	28	3 (10.7)
No	6	1 (16.7)
Type of delivery	236	43 (18,2)	0.114
Vaginal	236	43 (18.2)
Caesarean section	105	27 (25.7)
Vaginal with episiotomy			0.588
Yes	111	22 (19.8)
No	123	21 (17.1)
Skin-to-skin contact			0.221
Yes	219	41 (18.7)
No	119	29 (24.4)

Variables	n	Interruption of EBF within the 1^st month n (%)	p*
Breastfeeding of previous children			0.018
Yes	169	28 (16.6)
No	13	6 (46.2)
Breastfeeding in CO			0.047
Yes	293	55 (18.8)
No	48	15 (31.3)
Breastfeeding in the delivery room			0.061
Yes	112	15 (13.4)
No	180	40 (22.2)
Breastfeeding in AC			0.108
Yes	338	68 (20.1)
No	3	2 (66.7)
Difficulty breastfeeding in AC			<0.001
Yes	180	53 (29.4)
No	160	17 (10.6)
Newborn was given dummy/pacifier at hospital			0.029
Yes	13	6 (46.2)
No	327	63 (19.3)
Newborn received supplement at hospital			<0.001
Yes	80	34 (42.5)
No	261	36 (13.8)
How the supplement was received			>0.999
Cup	75	32 (42.7)
Syringe	2	1 (50.0)
Cup + Syringe	3	1 (33.3)
Intention to breastfeed after discharge			0.369
Yes	339	69 (20.4)
No	2	1 (50.0)
Hospital discharge in EBF			<0.001
Yes	324	53 (16.4)
No	17	17 (100.0)
Hospital discharge with guidance:			<0.001
EBF	317	48 (15.1)
Breastfeeding + formula	23	21 (91.3)
Other	1	1 (100.0)
Difficulty in breastfeeding after discharge			<0.001
Yes	151	46 (30.5)
No	187	21 (11.2)
Received help to breastfeed			0.336
Yes	109	31 (28.4)
No	44	16 (36.4)
Encouraged to continue breastfeeding			0.164
Yes	278	59 (21.2)
No	60	8 (13.3)
Newborn was given dummy/pacifier after discharge			0.001
Yes	178	49 (27.5)
No	163	21 (12.9)
Breastfeeding on free demand			0.621
Yes	261	49 (18.8)
No	75	16 (21.3)
Smoking during lactation			0.074
Yes	42	13 (31.0)
No	299	57 (19.1)

Variables	PR (CI95%)	p
Mother’s skin colour (non-white)	2.58 (1.18 – 5.62)	0.018
Infant’s age range
≤ 9 days	1.00
10 - 20 days	1.70 (0.51 – 5.69)	0.391
≥ 21 days	3.97 (1.01 – 15.6)	0.049
Infant received supplement at the hospital	2.04 (1.07 – 3.92)	0.031
Difficulty breastfeeding after discharge	2.64 (1.12 – 6.21)	0.026

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[1] Corresponding author: Bruna Alibio Moraes. E-mail: brunaalibiom@gmail.com