Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil.
Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus, BA, Brazil.
BMC Pediatr. 2021 Jul 9;21(1):310. doi: 10.1186/s12887-021-02777-y.
Little is known about the factors associated with the World Health Organization (WHO) recommendation of breastfeeding for at least 2 years. The objective of this study was to identify risk factors for and protective factors against breastfeeding interruption before 2 years of age.
In this live birth cohort, mother and infant dyads were followed for 2 years. Data collection was performed at the maternity ward and subsequently at the children's homes, monthly during the first 6 months of life and then at 9, 12, 18, and 24 months. The outcome of interest was breastfeeding interruption before 2 years of age. Median duration of breastfeeding was estimated using Kaplan-Meier's survival analysis, and the associations were tested using Cox's hierarchical multivariate model. Significance was set at 5%.
Data from a total of 1344 dyads were assessed. Median breastfeeding duration was 385 days. The following risk factors for breastfeeding interruption were identified: white skin color (adjusted hazard ratio [HRa]: 1.31; 95% confidence interval [95%CI]: 1.10-1.56), primiparity (HRa: 1.21; 95%CI: 1.05-1.40), working outside the home (HRa: 1.52; 95%CI: 1.30-1.77), child sex male (HRa: 1.18; 95%CI: 1.03-1.35) and use of a pacifier (HRa: 3.46; 95%CI: 2.98-4.01). Conversely, the following protective factors were identified: lower family income (HRa: 0.81; 95%CI: 0.71-0.94), mother-infant bed-sharing (HRa:0.61, 95%CI: 0.52-0.73), on-demand breastfeeding in the first month (HRa: 0.64; 95%CI: 0.47-0.89) and exclusive breastfeeding at 4 months (HRa: 0.58, 95%CI: 0.48-0.70).
The findings allowed to identify both risk factors for and protective factors against breastfeeding interruption before 2 years of age. Knowledge of these factors may help prevent this event and aid in the development of programs that help women maintain breastfeeding for at least 2 years, as recommended by the WHO.
关于世界卫生组织（WHO）建议至少母乳喂养 2 年相关因素的了解甚少。本研究的目的是确定 2 岁前母乳喂养中断的风险因素和保护因素。
在这项活产队列研究中，对母婴对进行了 2 年的随访。数据收集在产科病房进行，随后在儿童之家进行，在生命的头 6 个月每月进行一次，然后在 9、12、18 和 24 个月进行。感兴趣的结果是 2 岁前母乳喂养中断。使用 Kaplan-Meier 生存分析估计中位母乳喂养持续时间，并使用 Cox 分层多变量模型检验关联。设 5%为显著性水平。
共评估了 1344 对母婴对的数据。中位母乳喂养持续时间为 385 天。母乳喂养中断的以下风险因素包括：皮肤白皙（调整后的危险比 [HRa]：1.31；95%置信区间 [95%CI]：1.10-1.56）、初产（HRa：1.21；95%CI：1.05-1.40）、外出工作（HRa：1.52；95%CI：1.30-1.77）、儿童性别为男（HRa：1.18；95%CI：1.03-1.35）和使用奶嘴（HRa：3.46；95%CI：2.98-4.01）。相反，以下保护因素包括：家庭收入较低（HRa：0.81；95%CI：0.71-0.94）、母婴同床（HRa：0.61，95%CI：0.52-0.73）、第一个月按需母乳喂养（HRa：0.64；95%CI：0.47-0.89）和 4 个月时纯母乳喂养（HRa：0.58，95%CI：0.48-0.70）。
这些发现确定了 2 岁前母乳喂养中断的风险因素和保护因素。了解这些因素可能有助于预防这一事件，并有助于制定帮助妇女至少母乳喂养 2 年的计划，这是世卫组织的建议。
