Fatores associados ao tempo de aleitamento materno em coorte dos primeiros anos de vida

Abstract

The aim of this study was to evaluate the association between breastfeeding duration and socioeconomic aspects, living conditions such as sanitation, maternal reproductive history, behavioral habits of the mother as well as mother and child’s biological aspects. Initial sample consisted on 86 children extracted from three Family Health Units from Vitória, Espírito Santo, whose ages ranged from zero to three months Periodical Follow up was carried out through seven home visits, when data on socioeconomic status, feeding practices, maternal reproductive history and mother and child biological characteristics was collected. At these moments, mothers were briefed on the importance of breastfeeding for craniofacial biomechanics during morphogenesis, nutritional transition, mouth hygiene and deleterious effects of nutritious and non-nutritious sucking. From the initial sample, 67 children remained in the study being followed until a medium age of thirty months. Data from questionnaires were processed in two multivariate statistical analysis: a) Logistic Regression had exclusive breastfeeding for three months, breastfeeding for up to six months and breastfeeding for up to twelve months used as dependent variables while other variables that presented a p-value < 0,10 on Chi-square test were used as independent variables. b) Cox Regression had breastfeeding duration as dependent variable and other variables that presented p-value < 0,10 on the survival LogRank test as the independent ones. Logistic regression models showed that pacifier use during the first month of life is a risk factor for the interruption of exclusive breastfeeding for three months (OR = 5,3: IC95% = 1,1 – 27,3), breastfeeding for up to six months (OR = 4,1: IC95% = 1,1 – 15,3) and breastfeeding for up to twelve months (OR = 4,4: IC95% = 1,5 – 12,1). Formula feeding on the first month of life was another predictor of risk for the interruption of breastfeeding up to six months and twelve months (OR = 11,9: IC95% = 3,1 – 45,8) and (OR = 3,4: IC95% = 1,2 – 9,5) respectively. Maternal age equal or superior to 35 years was a protective factor for breastfeeding for up to twelve months (OR = 0,2: IC95% = 0,08 – 0,6). Likewise, Cox regression models presented similar results; the use of pacifier until the sixth month and formula feeding during the first month were the main risk factors for maintenance of breastfeeding (HR = 1,7: IC95% = 1,1 – 2,9) and (HR = 2,0: CI95% = 1,2 – 3,5) respectively. Additionally, family income equal or lower than two 9 minimum wages was a protective factor for the maintenance of breastfeeding (HR = 0,54: IC95% = 0,3 – 0,9). Considering these findings it can be concluded that lower family income and accentuated maternal age, functioning as socioeconomic and maternal intrinsic biological factors, interfere positively on the duration of breastfeeding. Thus, strategies to avoid pacifier use and early introduction of formulas must be implemented to support adequate breastfeeding duration and promotion of children’s health integrally from the first years of life.