Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States of Ameirca.
PLoS One. 2019 Jul 11;14(7):e0219801. doi: 10.1371/journal.pone.0219801. eCollection 2019.
Early life feeding practices can directly affect the growth, development, and survival of a child. This study aimed to estimate the frequency of and factors associated with exclusive breastfeeding (EBF) in the first month of life among Amazonian infants. We used data of 1,523 mother-child pairs of the MINA-Brazil birth cohort study. Mothers were interviewed soon after delivery at baseline and by telephone at 30-45 days postpartum (n = 962, 63.2% of those eligible). Kaplan-Meier survival analysis and accelerated failure-time (AFT) models were used to estimate the probability of EBF and the factors associated with EBF duration in the first month. At 30 days of age, 36.7% of the studied population (95% confidence interval [CI] 33.6-39.8) were exclusively breastfed, with a median duration of 16 days. Considering all eligible children for follow-up, the probability of EBF in the first month was 43.7% (95% CI 40.4-46.8), and the median duration was 30 days. The duration of EBF (time-ratio, TR) was 28% longer among multiparous mothers (TR 1.28; 95% CI 1.11-1.48). The use of a pacifier and the occurrence of wheezing were associated with a reduced EBF duration by 33% (TR 0.67; 95% CI 0.58-0.77) and 19% (TR 0.80; 95% CI 0.70-0.93), respectively. These results highlight that EBF among children in the Brazilian Amazon is considerably below international recommendations, and indicate the immediate need to plan and implement actions to promote and support breastfeeding early in life.
生命早期的喂养方式会直接影响儿童的生长、发育和生存。本研究旨在估计亚马逊地区婴儿出生后第一个月内纯母乳喂养（EBF）的频率及其相关因素。我们使用了 MINA-Brazil 出生队列研究的 1523 对母婴数据。母亲在基线时分娩后不久接受访谈，并在产后 30-45 天（n = 962，符合条件的母亲的 63.2%）通过电话接受访谈。Kaplan-Meier 生存分析和加速失效时间（AFT）模型用于估计 EBF 的概率和与第一个月 EBF 持续时间相关的因素。在 30 天时，研究人群中有 36.7%（95%置信区间 [CI] 33.6-39.8）的婴儿进行了纯母乳喂养，中位持续时间为 16 天。考虑所有符合随访条件的儿童，第一个月 EBF 的概率为 43.7%（95% CI 40.4-46.8），中位持续时间为 30 天。多产母亲的 EBF 持续时间（时间比，TR）长 28%（TR 1.28；95% CI 1.11-1.48）。使用奶嘴和出现喘息与 EBF 持续时间缩短 33%（TR 0.67；95% CI 0.58-0.77）和 19%（TR 0.80；95% CI 0.70-0.93）相关。这些结果表明，巴西亚马逊地区儿童的 EBF 明显低于国际建议，表明迫切需要规划和实施行动，以促进和支持生命早期的母乳喂养。
