Factors associated with low incidence of exclusive breastfeeding for the first 6 months.
BACKGROUND
The identification of factors that are associated with early cessation of exclusive breastfeeding is important for defining strategies for the promotion of exclusive breastfeeding. The objective of this study was to identify the determinants of exclusive breastfeeding cessation before 6 months, including variables that generally receive little attention, such as the influence of grandmothers, breastfeeding technique, and sore nipples.


METHODS
This prospective study follows a cohort of 220 healthy mother-baby pairs from birth to 6 months, living in Porto Alegre, Brazil. Data were collected at the maternity unit, during a home visit at 30 days, and by telephone interview at 60, 120, and 180 days. Breastfeeding technique was assessed and breasts examined at the maternity unit and during home visits. Cox regression was employed to estimate the degree of association between the variables and the outcome.


RESULTS
The following factors were associated with cessation of exclusive breastfeeding before 6 months: adolescent mother (hazard ratio [HR] = 1.48, 95% CI 1.01-2.17), fewer than six prenatal visits (HR = 1.60, 95% CI 1.10-2.33), use of a pacifier within the first month (HR = 1.53, 95% CI 1.12-2.11), and poor latch-on (HR = 1.29, 95% CI 1.06-1.58 for each unfavorable parameter).


CONCLUSIONS
Activities to promote exclusive breastfeeding should be intensified for adolescent mothers and for those whose prenatal care was less than ideal. These activities should reinforce the ill effects of pacifiers and should also include appropriate instruction for these mothers in correct breastfeeding technique.
Santo
Lilian Cordova do Espírito
LC
Department of Mother and Child Nursing, Nursing School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
de Oliveira
Luciana Dias
LD
Giugliani
Elsa Regina Justo
ER
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001942:Breast Feeding / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D041361:Pacifiers / Q000706:statistics & numerical data; D011295:Prenatal Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D013391:Sucking Behavior