Passanha Adriana, Benício Maria Helena D'Aquino, Venâncio Sônia Isoyama, Reis Márcia Cristina Guerreiro dos
Rev Saude Publica. 2013 Dec;47(6):1141-7; discussion 1148. doi: 10.1590/s0034-8910.2013047004807.
To evaluate the association between the level of implementation of the Brazilian Breastfeeding Network and the prevalence of exclusive breastfeeding.
Cross-sectional study of a representative sample of 916 infants < 6 months, in Ribeirao Preto, SP, Southeastern Brazil, in 2011. Data on breastfeeding, place of outpatient care and other characteristics were collected during the National Vaccination Campaign. The factor studied is where outpatient care took place: Private; Non-Network Public; Public with Network Workshop; and Public certified by Network. The individualized effect of the factor studied on the outcome was analyzed using Poisson regression with robust variance.
The comparison between private (reference category) and other outpatient care showed significant dose-response relationship with a progressive increase in the prevalence of exclusive breastfeeding in public non-Network, public with Network Workshop and public accredited by Network outpatient care (p = 0.047). As regards the Basic Health Units accredited by Network category, the Prevalence Ratio of exclusive breastfeeding was equal to 1.47 (95%CI 1.00;2.17), after adjustment for confounding variables.
The prevalence of exclusive breastfeeding for infants < 6 months was higher in places accredited by the Brazilian Breastfeeding Network, which evinces the importance of investing in accreditation of Basic Units of Health by this strategy.
评估巴西母乳喂养网络的实施水平与纯母乳喂养率之间的关联。
2011年在巴西东南部圣保罗州里贝朗普雷图对916名6个月以下婴儿的代表性样本进行横断面研究。在全国疫苗接种活动期间收集了母乳喂养、门诊护理地点及其他特征的数据。研究因素为门诊护理地点：私立；非网络公立；设有网络工作坊的公立；以及获得网络认证的公立。使用具有稳健方差的泊松回归分析研究因素对结果的个体效应。
私立（参照类别）与其他门诊护理之间的比较显示出显著的剂量反应关系，在非网络公立、设有网络工作坊的公立及获得网络认证的公立门诊护理中，纯母乳喂养率呈逐步上升趋势（p = 0.047）。对于获得网络认证类别的基层卫生单位，在对混杂变量进行调整后，纯母乳喂养的患病率比值等于1.47（95%可信区间1.00；2.17）。
在获得巴西母乳喂养网络认证的地方，6个月以下婴儿的纯母乳喂养率较高，这表明通过该策略对基层卫生单位进行认证投资具有重要意义。
