title: Association between the Brazilian Breastfeeding Network implementation and breastfeeding indicators.
abstract: OBJECTIVE
  To estimate the association between the implementation of the Brazilian Breastfeeding Network and prevalence of breastfeeding in a medium-size city in southern Brazil.
  
  
  METHODS
  This was a cross-sectional study involving 405 children under 1 year who participated in the second phase of the multivaccination campaign in 2012. Children's consumption of food on the day before the interview was obtained through interviews with mothers or guardians. The manager and one health professional from every health facility that joined the Network were interviewed in order to investigate the process of implementation of this initiative. The association between prevalence of breastfeeding and exclusive breastfeeding and adherence to the Network implementation process was tested using Poisson regression with robust variance.
  
  
  RESULTS
  Multivariate analysis revealed that among the children assisted by health facilities who joined the Network and those attending services that did not adhere to this strategy, the prevalence of breastfeeding (74% and 70.4% among children under 1 year, respectively) and exclusive breastfeeding (43.3% and 38.1% among children under 6 months, respectively) did not differ significantly. Difficulties in implementing the Network, such as high turnover of professionals, not meeting the criteria for accreditation, and insufficient participation of tutors in the process were identified.
  
  
  CONCLUSIONS
  Contrary to the hypothesis of this study, there was no significant association between the implementation of the Brazilian Breastfeeding Network and prevalence of breastfeeding and exclusive breastfeeding in the studied city. It is possible that the difficulties found in implementing the Network in this city have influenced this result.
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Municipal Health Secretariat of Caxias do Sul, Caxias do Sul, RS, Brazil. Electronic address: danusasb@gmail.com.
authors.forename: Danusa S
authors.initials: DS
authors.lastname: Brandão
authors.affiliation: Instituto de Saúde, State Health Secretariat, São Paulo, SP, Brazil.
authors.forename: Sonia I
authors.initials: SI
authors.lastname: Venancio
authors.affiliation: Department of Pediatrics, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Elsa R J
authors.initials: ER
authors.lastname: Giugliani
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D008427:Maternal Health Services; D009035:Mothers; D015999:Multivariate Analysis; D009313:National Health Programs; D015995:Prevalence; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D015397:Program Evaluation; D055815:Young Adult
keywords: Aleitamento materno; Atenção primária à saúde; Avaliação de programas e projetos de saúde; Breastfeeding; Evaluation of health programs and projects; Health promotion; Primary health care; Promoção da saúde