Martins Fernanda Andrade, Ramalho Alanderson Alves, Andrade Andréia Moreira de, Opitz Simone Perufo, Koifman Rosalina Jorge, Silva Ilce Ferreira da
Universidade Federal do Acre. Centro de Ciências da Saúde e do Desporto. Programa de Pós-Graduação em Saúde Coletiva. Rio Branco, AC, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Auroca. Departamento de Epidemiologia e Métodos Quantitativos em Saúde. Rio de Janeiro, RJ, Brasil.
Rev Saude Publica. 2021 May 17;55:21. doi: 10.11606/s1518-8787.2021055002134. eCollection 2021.
To characterize breastfeeding patterns in the first six months of life and factors associated with early weaning in a birth-cohort in Rio Branco, state of Acre.
This is a prospective study with all babies born between April and June 2015. The mothers were interviewed soon after birth and between 6 and 15 months postpartum. At hospital discharge, breastfeeding was defined as exclusively (EBF), and breastfeeding (BF). In the follow-up, breastfeeding patterns were exclusive breastfeeding (EBF), predominant breastfeeding (PBF), and breastfeeding (BF). The interruption of breastfeeding in the first six months was classified as early weaning. The Kaplan Meier method (log-rank: 95%) was used to estimate the conditional probability of change in breastfeeding pattern, and early weaning risk. Crude and adjusted proportional Cox regression models, and their respective 95% confidence intervals (95%CI), were used to analyze the factors associated with early weaning.
The study included 833 infants in EBF (95.4%) and BF (4.6%) at hospital discharge. During the first six months of life, the infant likely discharged in EBF remaining in EBF, becoming PBF, and BF, were respectively 16.4%, 32.3%, and 56.5%. The weaning likely at six months was statistically higher for infants discharged in BF (47.4%) when compared with those discharged in EBF (26%). Factors associated with early weaning were BF at hospital discharge (HR = 1.82; 95%CI 1.06-3.11), no mother cross-breastfeeding (HR = 2.50; 95%CI 1.59-3.94), pacifier use (HR = 6.23; 95%CI 4.52-8.60), less than six months of breastfeeding intention (HR = 1.93; 95%CI 1.25-2.98), lack of breastfeeding in the first hour of life (HR = 1.45; 95%CI 1.10-1.92), and pregnancy alcohol consumption (HR = 1.88; 95%CI 1.34-2.90).
Compared to infants in EBF, those in BF at hospital discharge were more likely to wean. Public health efforts should prioritize EBF at hospital discharge, promote breastfeeding in the first hour of life, and prevent alcohol consumption risks during pregnancy, cross-breastfeeding and pacifier use.
描述阿克里州里奥布兰科市一个出生队列中婴儿出生后头六个月的母乳喂养模式以及与早期断奶相关的因素。
这是一项针对2015年4月至6月间出生的所有婴儿的前瞻性研究。母亲们在产后不久以及产后6至15个月接受访谈。在医院出院时，母乳喂养被定义为纯母乳喂养（EBF）和母乳喂养（BF）。在随访中，母乳喂养模式分为纯母乳喂养（EBF）、主要母乳喂养（PBF）和母乳喂养（BF）。头六个月母乳喂养的中断被归类为早期断奶。采用Kaplan Meier方法（对数秩检验：95%）来估计母乳喂养模式变化的条件概率以及早期断奶风险。使用粗线性和校正后的比例Cox回归模型及其各自的95%置信区间（95%CI）来分析与早期断奶相关的因素。
该研究纳入了833名婴儿，出院时纯母乳喂养（EBF）的占95.4%，母乳喂养（BF）的占4.6%。在出生后的头六个月里，出院时可能为纯母乳喂养的婴儿继续保持纯母乳喂养、转变为主要母乳喂养以及转变为母乳喂养的比例分别为16.4%、32.3%和56.5%。出院时母乳喂养的婴儿在六个月时断奶的可能性在统计学上高于纯母乳喂养出院的婴儿（47.4%对比26%）。与早期断奶相关的因素包括出院时母乳喂养（HR = 1.82；95%CI 1.06 - 3.11）、母亲无交叉母乳喂养（HR = 2.50；95%CI 1.59 - 3.94）、使用安抚奶嘴（HR = 6.23；95%CI 4.52 - 8.60）、母乳喂养意愿不足六个月（HR = 1.93；95%CI 1.25 - 2.98）、出生后第一小时未进行母乳喂养（HR = 1.45；95%CI 1.10 - 1.92）以及孕期饮酒（HR = 1.88；95%CI 1.34 - 2.90）。
与纯母乳喂养出院的婴儿相比，出院时母乳喂养的婴儿更有可能断奶。公共卫生工作应优先在出院时推广纯母乳喂养，促进出生后第一小时的母乳喂养，并预防孕期饮酒、交叉母乳喂养和使用安抚奶嘴带来的风险。
