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Factors Associated with Low Incidence of Exclusive Breastfeeding for the First 6 Months

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Background: The identification of factors that are associated with early cessation of exclusive breastfeeding is important for defining strategies for the promotion of exclusive breastfeeding. The objective of this study was to identify the determinants of exclusive breastfeeding cessation before 6 months, including variables that generally receive little attention, such as the influence of grandmothers, breastfeeding technique, and sore nipples. Methods: This prospective study follows a cohort of 220 healthy mother-baby pairs from birth to 6 months, living in Porto Alegre, Brazil. Data were collected at the maternity unit, during a home visit at 30 days, and by telephone interview at 60, 120, and 180 days. Breastfeeding technique was assessed and breasts examined at the maternity unit and during home visits. Cox regression was employed to estimate the degree of association between the variables and the outcome. Results: The following factors were associated with cessation of exclusive breastfeeding before 6 months: adolescent mother (hazard ratio [HR] = 1.48, 95% CI 1.01–2.17), fewer than six prenatal visits (HR = 1.60, 95% CI 1.10–2.33), use of a pacifier within the first month (HR = 1.53, 95% CI 1.12–2.11), and poor latch-on (HR = 1.29, 95% CI 1.06–1.58 for each unfavorable parameter). Conclusions: Activities to promote exclusive breastfeeding should be intensified for adolescent mothers and for those whose prenatal care was less than ideal. These activities should reinforce the ill effects of pacifiers and should also include appropriate instruction for these mothers in correct breastfeeding technique. (BIRTH 34:3 September 2007)
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Keywords: epidemiological determinants; exclusive breastfeeding; pacifier

Document Type: Research Article

Affiliations: 1: Luciana Dias de Oliveira is an Assistant Professor in the Nutrition School, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegrel 2: Elsa Regina Justo Giugliani is a Lactation Consultant and an Associate Professor in the Department of Pediatrics, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Publication date: September 1, 2007

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