Feeding practices and early weaning in the neonatal period: a cohort study
DOI:
https://doi.org/10.11606/s1518-8787.2021055003248Keywords:
Breast Feeding, Weaning, Mixed Feeding, Infant Formula, Infant Nutrition, Cohort StudiesAbstract
OBJECTIVE To describe feeding practices and the risk factors for the mixed breastfeeding and early weaning in the neonatal period. METHODS Cohort study, which we collected socioeconomic, demographic, health care and feeding data from 415 mother/child binomials born in four public maternity hospitals in Natal/Brazil. They were followed-up at 48 hours, 7 and 28 days after birth. The association was established using Pearson’s Chi-square test and Poisson’s regression, after adjusting it to other variables. RESULTS The prevalence of mixed breastfeeding in the first 2 days was 47,2% and early weaning in 7 and 28 days was 8,4% and 16,2% in that order. The main reasons for mixed breastfeeding and early weaning were: colostrum deficiency (33.8%), difficulty in latching/sucking (23.5%) and “little milk” (70.0%). The use of formula/milk/porridge remained associated with maternal age ≤ 20 years (RR = 0.64; 95%CI: 0.47–0.86), age 20–29 years (RR = 0,70; 95%CI: 0,57–0,87), primiparity (RR = 1.37; 95%CI: 1.11–1.60) and cesarean delivery (RR = 1.20; 95%CI: 1.00–1.45) at 2 days; absence of paternal support (RR = 4.98; 95%CI: 2.54–9.79) and pacifier use (RR = 3.21; 95%CI: 1.63–6.32) at 7 days; and only pacifier use (RR = 2.48; 95%CI: 1.53–4.02) at 28 days. CONCLUSIONS Early weaning was associated with maternal and health care factors, thus suggesting the need to readjust good practices and educational actions to achieve the exclusive offer to the maternal breast in the neonatal period.
References
World Health Organization. Guideline: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services. Geneva (CH): WHO; 2017. [ Links ]
Ministério da Saúde (BR), Secretaria de Atenção Primária à Saúde. Departamento de Promoção à Saúde. Guia alimentar para crianças brasileiras menores de dois anos. Brasília, DF; 2019. [ Links ]
Nações Unidas Brasil. UNICEF: apenas 40% das crianças no mundo recebem amamentação exclusiva no início da vida. Brasília, DF; 2019 [cited 2020 May 22]. Available from: https://brasil.un.org/pt-br/83869-unicef-apenas-40-das-criancas-no-mundo-recebem amamentacao-exclusiva-no-inicio-da-vida [ Links ]
Boccolini CS, Boccolini PMM, Monteiro FR, Venâncio SI, Giugliani ERJ. Breastfeeding indicators trends in Brazil for three decades. Rev Saude Publica. 2017;51:108. https://doi.org/10.11606/S1518-8787.2017051000029 [ Links ]
Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 2016;387(10017):475-90. https://doi.org/10.1016/S0140-6736(15)01024-7 [ Links ]
Universidade Federal do Rio de Janeiro. Estudo Nacional de Alimentação e Nutrição Infantil ENANI-2019: resultados preliminares: indicadores de aleitamento materno no Brasil. Rio de Janeiro, RJ: UFRJ; 2020 [cited 2020 Set 10]. Available from: https://enani.nutricao.ufrj.br/wp-content/uploads/2020/08/Relatorio-preliminar-AM-Site.pdf [ Links ]
Gasparin VA, Strada JKR, Moraes BA, Betti T, Gonçalves AC, Espírito Santo LC. Pairs seen by lactation consultants and cessation of exclusive breastfeeding in the first month. Rev Esc Enferm USP. 2019;53:e03422. https://doi.org/10.1590/s1980-220x2018010003422 [ Links ]
World Health Organization; UNICEF. Baby-friendly Hospital Initiative: ten steps to successful breastfeeding. Geneva: WHO; UNICEF; 2018 [cited 2020 May 10]. Available from: https://www.who.int/activities/promoting-baby-friendly-hospitals/ten-steps-to-successful-breastfeeding [ Links ]
Ministério da Saúde (BR), Secretaria de Atenção à Saúde. Estratégia Nacional para Promoção do Aleitamento Materno e Alimentação Complementar Saudável no Sistema Único de Saúde: manual de implementação. Brasília, DF; 2015. [ Links ]
Brasil. Lei Nº 11265, de 3 de janeiro de 2006. Regulamenta a comercialização de alimentos para lactentes e crianças de primeira infância e também a de produtos de puericultura correlatos. Diário Oficial da União. 4 jan 2006; Seção 1:1-3. [ Links ]
Chantry CJ, Dewey KG, Peerson JM, Wagner EA, Nommsen-Rivers LA. In-hospital formula use increases early breastfeeding cessation among first-time mothers intending to exclusively breastfeed. J Pediatr. 2014;164(6):1339-45.e45. https://doi.org/10.1016/j.jpeds.2013.12.035 [ Links ]
Kelly E, DunnGalvin G, Murphy BP, Hourihane JO. Formula supplementation remains a risk for cow’s milk allergy in breast-fed infants. Pediatr Allergy Immunol. 2019;30(8):810-6. https://doi.org/10.1111/pai.13108 [ Links ]
Ministério da Saúde (BR), Secretaria de Ciência, Tecnologia e Insumos Estratégicos, Departamento de Ciência e Tecnologia. Avaliação da atenção ao pré-natal, ao parto e aos menores de um ano na Amazônia Legal e Nordeste, Brasil, 2010 Brasília, DF: MS; 2013 [cited 2020 Dec 7]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/livro_avaliacao_da_atencao_ao_pre-natal_web.pdf [ Links ]
Batista CLC, Ribeiro VS, Nascimento MDSB. Influência do uso de chupetas e mamadeiras na prática do aleitamento materno. J Heath Biol Sci. 2017;5(2):184-91. https://doi.org/10.12662/2317-3076jhbs.v5i2.1153.p184-191.2017 [ Links ]
Carreiro JA, Francisco AA, Abrão ACFV, Marcacine KO, Abuchaim ESV, Coca KP. Dificuldades relacionadas ao aleitamento materno: análise de um serviço especializado em amamentação. Acta Paul Enferm. 2018;31(4):430-8. https://doi.org/10.1590/1982-0194201800060 [ Links ]
Wagner LPB, Mazza VA, Souza SRRK, Chiesa A, Lacerda MR, Soares L. Strengthening and weakening factors for breastfeeding from the perspective of the nursing mother and her family. Rev Esc Enferm USP. 2020;54:e03563. https://doi.org/10.1590/s1980-220x2018034303564 [ Links ]
Bentley JP, Nassar N, Porter M, Vroome M, Yip E, Ampt AJ. Formula supplementation in hospital and subsequent feeding at discharge among women who intended to exclusively breastfeed: an administrative data retrospective cohort study. Birth. 2017;44(4):352-62. https://doi:10.1111/birt.12300 [ Links ]
Andrade HS, Pessoa RA, Donizete LCV. Fatores relacionados ao desmame precoce do aleitamento materno. Rev Bras Med Fam Comunidade. 2018;13(40):1-11. https://doi.org/10.5712/rbmfc13(40)1698 [ Links ]
Garrison MP, Maisano P. Systematic review of factors influencing non-medically indicated formula supplementation of newborns in the hospital setting. Nurs Womens Health. 2019;23(4):340-50. https://doi:10.1016/j.nwh.2019.06.003 [ Links ]
Rocha BO. Hipogalactia inicial, fatores de risco para o desmame precoce e promoção do aleitamento materno em primíparas atendidas em um Hospital Amigo da Criança no Brasil [dissertação]. Belo Horizonte, MG: Universidade Federal de Minas Gerais; 2018. [ Links ]
Pinheiro JMF, Menêzes TB, Brito KMF, Melo ANL, Queiroz DJM, Sureira TM. Prevalência e fatores associados à prescrição/solicitação de suplementação alimentar em recém-nascidos. Rev Nutr. 2016; 29(3):367-75. https://doi.org/10.1590/1678-98652016000300007 [ Links ]
World Health Organization; UNICEF. Acceptable medical reasons for use of breast-milk substitutes. Geneva (CH): WHO; UNICEF; 2009. [ Links ]
Tsopmo A. Phytochemicals in human milk and their potential antioxidative protection antioxidants. Antioxidants (Basel). 2018;7(2):32. https://doi.org/10.3390/antiox7020032 [ Links ]
Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2016;11(11):CD003519. https://doi.org/10.1002/14651858.CD003519.pub4 [ Links ]
Ministério da Saúde (BR, Secretaria de Atenção à Saúde, Departamento de Ações Programáticas e Estratégicas. Política Nacional de Atenção Integral à Saúde da Criança: orientações para implementação. Brasília, DF; 2018. [ Links ]
Organización Mundial de la Salud; Fondo de las Naciones Unidas para la Infancia. Visitas domiciliarias al recién nacido: una estratégia para aumentar la supervivencia: declaración conjunta OMS/UNICEF. Ginebra (CH): OMS; 2009. [ Links ]
Cheng LY, Wang X, Mo KP. The effect of home-based intervention with professional support on promoting breastfeeding: a systematic review. Int J Public Health. 2019;64(7):999‐1014. https://doi.org/10.1007/s00038-019-01266-5 [ Links ]
Oliveira AKP, Melo RA, Maciel LP, Tavares AK, Amando AR, Sena CRS. Práticas e crenças populares associadas ao desmame precoce. Rev Enferm. 2017;35(3):303-12. https://doi.org/10.15446/av.enferm.v35n3.62542 [ Links ]
Muelbert M, Giugliani ERJ. Factors associated with the maintenance of breastfeeding for 6, 12, and 24 months in adolescent mothers. BMC Public Health. 2018;18(1):675. https://doi.org/10.1186/s12889-018-5585-4 [ Links ]
Sociedade Brasileira de Pediatria, Departamento Científico de Aleitamento Materno. Guia Prático de Atualização. Uso de Chupeta em crianças amamentadas: prós e contras. Rio de Janeiro: SBP; 2017; 3:1-16. [cited 2020 May10]. Available from: https://www.sbp.com.br/fileadmin/user_upload/Aleitamento-Chupeta_em_Criancas_Amamentadas.pdf [ Links ]
Published
Issue
Section
License
Copyright (c) 2021 Josilene Maria Ferreira Pinheiro, Taiana Brito Menêzes Flor, Mayara Gabrielly Germano de Araújo, Ana Márcia Soares Fernandes Xavier, Amanda Michelly Braga da Mata, Vanessa Cristina da Costa Pires, Luana Isabelly Carneiro de Oliveira, Fábia Barbosa de Andrade
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
Funding data
-
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Grant numbers Finance Code 001
