title: Influence of the support offered to breastfeeding by maternity hospitals.
abstract: OBJECTIVE
  To evaluate whether the support offered by maternity hospitals is associated with higher prevalences of exclusive and predominant breastfeeding.
  
  
  METHODS
  This is a cross-sectional study including a representative sample of 916 infants less than six months who were born in maternity hospitals, in Ribeirao Preto, Sao Paulo, Southeastern Brazil, 2011. The maternity hospitals were evaluated in relation to their fulfillment of the Ten Steps to Successful Breastfeeding. Data were collected regarding breastfeeding patterns, the birth hospital and other characteristics. The individualized effect of the study factor on exclusive and predominant breastfeeding was analyzed using Poisson multiple regression with robust variance.
  
  
  RESULTS
  Predominant breastfeeding tended to be more prevalent when the number of fulfilled steps was higher (p of linear trend = 0.057). The step related to not offering artificial teats or pacifiers to breastfed infants and that related to encouraging the establishment of breastfeeding support groups were associated, respectively, to a higher prevalence of exclusive (PR = 1.26; 95%CI 1.04;1.54) and predominant breastfeeding (PR = 1.55; 95%CI 1.01;2.39), after an adjustment was performed for confounding variables.
  
  
  CONCLUSIONS
  We observed a positive association between support offered by maternity hospitals and prevalences of exclusive and predominant breastfeeding. These results can be useful to other locations with similar characteristics (cities with hospitals that fulfill the Ten Steps to Successful Breastfeeding) to provide incentive to breastfeeding, by means of promoting, protecting and supporting breastfeeding in maternity hospitals.
authors.affiliation: Faculdade de Saúde Públic, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Passanha
authors.affiliation: Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Maria Helena D'Aquino
authors.initials: MH
authors.lastname: Benício
authors.affiliation: Instituto de Saúde, Secretaria Estadual da Saúde de São Paulo, São Paulo, SP, Brasil.
authors.forename: Sônia Isoyama
authors.initials: SI
authors.lastname: Venâncio
authors.affiliation: Secretaria Municipal da Saúde de Ribeirão Preto, Ribeirão Preto, SP, Brasil.
authors.forename: Márcia Cristina Guerreiro dos
authors.initials: MC
authors.lastname: Reis
mesh_terms: D000328:Adult; D001938:Brazil; D001942:Breast Feeding / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion; D006771:Hospitals, Maternity; D006801:Humans; D007223:Infant; D008297:Male; D008427:Maternal Health Services; D011247:Pregnancy; D055815:Young Adult