Universidade Federal do Rio Grande do Norte. Programa de Pós-Graduação em Saúde Coletiva. Natal, RN, Brasil.
Universidade Federal do Rio Grande do Norte. Hospital Universitário Onofre Lopes. Natal, RN, Brasil.
Rev Saude Publica. 2021 Oct 25;55:63. doi: 10.11606/s1518-8787.2021055003248. eCollection 2021.
OBJECTIVE: To describe feeding practices and the risk factors for the mixed breastfeeding and early weaning in the neonatal period. METHODS: Cohort study, which we collected socioeconomic, demographic, health care and feeding data from 415 mother/child binomials born in four public maternity hospitals in Natal/Brazil. They were followed-up at 48 hours, 7 and 28 days after birth. The association was established using Pearson's Chi-square test and Poisson's regression, after adjusting it to other variables. RESULTS: The prevalence of mixed breastfeeding in the first 2 days was 47,2% and early weaning in 7 and 28 days was 8,4% and 16,2% in that order. The main reasons for mixed breastfeeding and early weaning were: colostrum deficiency (33.8%), difficulty in latching/sucking (23.5%) and "little milk" (70.0%). The use of formula/milk/porridge remained associated with maternal age ≤ 20 years (RR = 0.64; 95%CI: 0.47-0.86), age 20-29 years (RR = 0,70; 95%CI: 0,57-0,87), primiparity (RR = 1.37; 95%CI: 1.11-1.60) and cesarean delivery (RR = 1.20; 95%CI: 1.00-1.45) at 2 days; absence of paternal support (RR = 4.98; 95%CI: 2.54-9.79) and pacifier use (RR = 3.21; 95%CI: 1.63-6.32) at 7 days; and only pacifier use (RR = 2.48; 95%CI: 1.53-4.02) at 28 days. CONCLUSIONS: Early weaning was associated with maternal and health care factors, thus suggesting the need to readjust good practices and educational actions to achieve the exclusive offer to the maternal breast in the neonatal period.
目的:描述新生儿期混合喂养和早期断奶的喂养方式及相关危险因素。
方法:本队列研究收集了巴西纳塔尔州四家公立妇产医院 415 对母婴的社会经济、人口统计学、医疗保健和喂养数据,对其在产后 48 小时、7 天和 28 天进行随访。使用 Pearson's Chi-square 检验和 Poisson 回归来建立关联,并在调整了其他变量后进行分析。
结果:出生后前 2 天混合喂养的比例为 47.2%,7 天和 28 天的早期断奶比例分别为 8.4%和 16.2%。混合喂养和早期断奶的主要原因是初乳不足(33.8%)、含接/吸吮困难(23.5%)和“奶量少”(70.0%)。配方奶/牛奶/粥的使用仍与母亲年龄≤20 岁(RR=0.64;95%CI:0.47-0.86)、20-29 岁(RR=0.70;95%CI:0.57-0.87)、初产妇(RR=1.37;95%CI:1.11-1.60)和剖宫产(RR=1.20;95%CI:1.00-1.45)有关;7 天时缺乏父亲支持(RR=4.98;95%CI:2.54-9.79)和使用安抚奶嘴(RR=3.21;95%CI:1.63-6.32);28 天时仅使用安抚奶嘴(RR=2.48;95%CI:1.53-4.02)。
结论:早期断奶与产妇和医疗保健因素有关,因此需要调整良好的实践和教育措施,以在新生儿期实现母乳喂养的完全供应。
Rev Saude Publica. 2021
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