Breastfeeding-Friendly Primary Care Initiative: degree of implementation in a Brazilian metropolis

Sustainability of the Breastfeeding-Friendly Primary Care Initiative: a cross-sectional study

OBJECTIVES

to assess the sustainability of the Breastfeeding-Friendly Primary Care Initiative by analyzing compliance with the Ten Steps in accredited units; and association with maternal satisfaction and exclusive breastfeeding.

METHODS

a cross-sectional study conducted in 2016. An assessment of compliance, conducted by interviews with health professionals, pregnant women, and mothers. An association between compliance and satisfaction, analyzed by Spearman›s correlation test; and association between contextual/individual characteristics and exclusive breastfeeding, by the multilevel Poisson regression.

RESULTS

compliance was 5.4-10 points and satisfaction was 36.8%-100%. Prevalence of exclusive breastfeeding was 56.7%. There was a correlation between compliance and satisfaction. Higher education, prenatal orientation, hospital discharge on exclusive breastfeeding, attendance in mixed units, and female gender of the child were associated with higher prevalence of exclusive breastfeeding; on the other hand, increasing age and pacifier use were associated with lower prevalence.

CONCLUSIONS

the Initiative proved to be sustainable; compliance with the Ten Steps was high and was reflected in maternal satisfaction.

Factors associated with exclusive breastfeeding in the first six months of life in Brazil: a systematic review

OBJECTIVE

To identify factors associated with exclusive breastfeeding in the first six months of life in Brazil.

METHODS

Systematic review of epidemiological studies conducted in Brazil with exclusive breastfeeding as outcome. Medline and LILACS databases were used. After the selection of articles, a hierarchical theoretical model was proposed according to the proximity of the variable to the outcome.

RESULTS

Of the 67 articles identified, we selected 20 cross-sectional studies and seven cohort studies, conducted between 1998 and 2010, comprising 77,866 children. We identified 36 factors associated with exclusive breastfeeding, being more often associated the distal factors: place of residence, maternal age and education, and the proximal factors: maternal labor, age of the child, use of a pacifier, and financing of primary health care.

CONCLUSIONS

The theoretical model developed may contribute to future research, and factors associated with exclusive breastfeeding may subsidize public policies on health and nutrition.