Praticas de aleitamento materno em crianças menores de um ano em municipios de Minas Gerais

Abstract

Objective: To assess the prevalence of patterns of breastfeeding in children under one year and study the association of sociodemographic / cultural, healthcare and social indicators with the practice of breastfeeding in the cities of Minas Gerais. Methods: Cross-sectional study based on data from the 15 cities of Minas Gerais participants of the II Survey of Prevalence of Breastfeeding in the Brazilian capitals and Federal District. It was adopted a questionnaire consisting of closed questions, addressing health care characteristics, socioeconomic, cultural, demographic and dietary intake of children younger than one year in the 24 hours before the interview. We conducted a descriptive analysis, were calculated the prevalence of breastfeeding in the first hour of life; exclusive breastfeeding and predominant breastfeeding in children under six months; breastfeeding and complementary breastfeeding in infants under one year, beyond the description of feeding in the first days at home (after discharge from maternity) of children under four months. We applied the chisquare test to estimate the difference between the prevalence of the indicators in the capital and other participating cities. We conducted the analysis of association between the categories of breastfeeding and exclusive breastfeeding with the variables (practices related to breastfeeding, birth conditions and welfare, care related to the child and mother and social indicators). Hierarchical multivariate analysis was performed by Poisson regression (generalized linear model) with robust variance estimation for point and interval of prevalence rates. The initial model was composed of the explanatory variables with P <0.20 in univariate analysis considering as dependent variable the practice of breastfeeding to less than one year and exclusive breastfeeding for those under six months. We adopted a 5% significance level. All tests were performed using SPSS 18.0. Results: There were 7056 children included in the analysis, 70% breastfed within the first hour of life and 72.7% breastfeeding. In children younger than six months (n=3660), it was observed that 39.7% were exclusively breastfed and 16.4% were predominant breastfed. About 56% of children older than six months (N=3396) were complemented breastfed. There were no statistically significant differences between the patterns of feeding between the state capital and other cities. It was identified that children who used pacifiers (PR=1,92, CI95%= 1,75-2,12) and used the bottle (PR=14,28, CI95%=11,1-20,0), whose mothers worked outside the home (PR=1,20, CI95%=1,11-1,29), those born by cesarean section (PR=1,11, CI95%= 1,02-1,20) and those that did monitoring of child care in private health services (PR=1,09, CI95%=1,01-1,19) were more likely of not being breastfed than the others. Compared with exclusive breastfeeding in children under six months, children who used the bottle (PR=3,03, CI95%=2,85-3,33), those not born in the maternity accredited Baby Friendly Hospital Initiative (RP=1,11, CI95%=1,04-1,17), whose mothers were primiparous (PR=1,05, CI95%=1,01-1,11), those whose mothers worked outside the home (PR=1,16, CI95%=1,09- 1,21), which had less than 8 years of schooling (PR=1,11, CI95%=1,05-1,16) and those born in cities with 10 or more infant deaths per thousand live births (PR=1,12; CI95%=1,03-1,21) had higher odds of being breastfed unique than the others. Conclusion: The practice of breastfeeding in the 15 cities of the state in the sample evaluated is still below the recommendations of the World Health Organization and indicates a need for investment on promotion of breastfeeding, especially in vulnerable conditions identified in the maternal conditions (work outside the home, cesarean delivery, primiparous and low education) or environmental (pacifier and bottle use, monitoring of private childcare services, non-accredited hospitals in the Baby Friendly Hospital Initiative and cities with infant mortality rate greater than or equal to 10).