Pairs seen by lactation consultants and cessation of exclusive breastfeeding in the first month

Gasparin, Vanessa Aparecida; Strada, Juliana Karine Rodrigues; Moraes, Bruna Alibio; Betti, Thaís; Gonçalves, Annelise de Carvalho; Santo, Lilian Cordova do Espírito

doi:10.1590/S1980-220X2018010003422

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Revista da Escola de Enfermagem da USP

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 53 • 2019 • https://doi.org/10.1590/S1980-220X2018010003422 copy

Pairs seen by lactation consultants and cessation of exclusive breastfeeding in the first month^* * Extracted from the dissertation: “Fatores associados à interrupção do aleitamento materno exclusivo no primeiro mês por duplas atendidas pela equipe de consultoria em amamentação”, Programa de Pós-Graduação em Enfermagem, Universidade Federal do Rio Grande do Sul, 2018.

Binomios atendidos por consultores en lactancia y la interrupción de la lactancia materna exclusiva el primer mes

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the survival of exclusive breastfeeding and the factors associated with its cessation in the first month among pairs seen by a lactation consulting team.

Method:

This is a prospective cohort conducted with mother-infant pairs treated at the Hospital de Clínicas of Porto Alegre.

Results:

The sample consisted of 150 pairs. The survival curve indicates that 52.9% of the children remained on exclusive breastfeeding. The hierarchical model was constructed in four levels, and the factors associated with the cessation of exclusive breastfeeding were the milk supplementation during hospitalization, breast problems after hospital discharge and use of pacifiers.

Conclusion:

Awareness of these factors favors the early detection of pairs that may be predisposed to cessation of exclusive breastfeeding, who require greater support, dedication and care.

DESCRIPTORS:
Breast Feeding; Maternal-Child Nursing; Consultants; Risk Factors

Variables		n = 150
Characterization of the mothers
	Age ≥ 20 years	122	(81.3%)
	Years of education ≥ 8 years	121	(80.7%)
	Self-reported white	93	(62.0%)
	Works outside the home	65	(43.3%)
	Has a partner	130	(86.7%)
	Lives with partner	119	(79.3%)
	Lives with maternal grandmother	36	(24.0%)
	Lives with paternal grandmother	16	(12.3%)
	Family income (minimum wages)^#	2.2	(1.3-3.4)*
	Duration of BF in previous child (months)^¶	3	(0-11)*
Current pregnancy
	Had prenatal follow-up	148	(98.7%)
	Number of prenatal consultations ≥ 8^ǂ	110	(73.3%)
	Received orientation about BF on prenatal^ǂ	44	(29.7%)
	Participated in prenatal classes	28	(18.7%)
	Smoked during pregnancy	21	(14.0%)
	Used drugs during pregnancy	3	(2.0%)
Current delivery
	Vaginal birth	88	(58.7%)
	Female infant	72	(48.0%)
	Birth weight	3282g	± 452g^¥

Variables	HR	95% CI	P
Mother’s age	1.03	0.99-1.07	0.057*
Mother’s self-reported skin color	0.85	0.51-1.40	0.526
Presence of a partner	1.40	0.60-3.25	0.432
Cohabitation with partner	0.78	0.31-1.96	0.605
Cohabitation with maternal grandmother	1.15	0.65-2.00	0.622
Cohabitation with paternal grandmother	0.89	0.40-1.96	0.775
Family income	0.91	0.77-1.09	0.332
Mother’s level of education	1.06	0.97-1.17	0.183*
Works outside the home	1.27	0.77-2.08	0.345
Prenatal consultations ≥ 8	0.95	0.50-1.81	0.895
Orientation about BF in prenatal	1.03	0.60-1.79	0.892
Prenatal classes	1.47	0.81-2.67	0.198*
Type of delivery	0.58	0.35-0.96	0.035*
Episiotomy	1.33	0.59-2.96	0.484
Gender of the infant	1.10	0.67-1.81	0.695
Referral: first pregnancy	0.83	0.50-1.37	0.472
Referral: difficulty in the technique	1.04	0.53-2.06	0.891
Referral: LGA	3.85	1.20-12.35	0.023*
Referral: history of no breastfeeding	2.56	1.02-6.41	0.044*
Milk supplementation during hospitalization	2.67	1.59-4.46	0.000*
Use of pacifiers	1.96	1.19-3.22	0.008*
Breast problems after discharge	0.35	0.18-0.70	0.003*

Variables		Cessation of EBF
Variables		HR	95%CI	P
Characteristics of the mothers
	Age	1.03	0.99-1.08	0.160
	Level of education	1.02	0.91-1.14	0.699
Prenatal care
	Prenatal classes	1.43	0.78-2.60	0.244
Hospital care
	Type of vaginal delivery*	0.63	0.38-1.05	0.078
	Referral: LGA	2.52	0.69-9.10	0.158
	Referral: history of no breastfeeding	1.82	0.67-4.92	0.238
	Received milk supplementation during hospitalization*	2.34	1.38-3.96	0.002
Behavior after discharge
	Use of pacifiers	1.86	1.13-3.08	0.015
	Breast problems after discharge	2.38	1.18-4.76	0.015

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Vanessa Aparecida Gasparin Rua Assis Brasil, 1327E, Bairro Presidente Médici CEP 89801-221 - Chapecó, RS, Brazil vane-gasparin@hotmail.com