Continued Breastfeeding in a Birth Cohort in the Western Amazon of Brazil: Risk of Interruption and Associated Factors

Déborah de Oliveira Togneri Pastro; Fernanda Andrade Martins; Alanderson Alves Ramalho; Andreia Moreira de Andrade; Simone Perufo Opitz; Rosalina Jorge Koifman; Ilce Ferreira da Silva

doi:10.3390/nu16193408

Continued Breastfeeding in a Birth Cohort in the Western Amazon of Brazil: Risk of Interruption and Associated Factors

Nutrients. 2024 Oct 8;16(19):3408. doi: 10.3390/nu16193408.

Authors

Déborah de Oliveira Togneri Pastro¹, Fernanda Andrade Martins¹, Alanderson Alves Ramalho¹, Andreia Moreira de Andrade¹, Simone Perufo Opitz¹, Rosalina Jorge Koifman^{1

2}, Ilce Ferreira da Silva^{1

2}

Affiliations

¹ Graduate Program of Community Health, Center of Health and Sports Science, Federal University of Acre, Rio Branco 69920-900, AC, Brazil.
² Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sérgio Auroca, Fundação Oswaldo Cruz, Rio de Janeiro 21041-210, RJ, Brazil.

Abstract

Background: Continued breastfeeding reduces infant mortality and provides nutritional, immunological, and developmental benefits for the child.

Objectives: A prospective cohort study conducted in 2015 followed 608 children who were breastfed between 6 and 24 months. The study assessed the risk of breastfeeding interruption at 12, 18, and 24 months, as well as the factors associated with this outcome, in a cohort of newborns in Rio Branco, using the life table method.

Methods: The factors associated with breastfeeding cessation and their 95% confidence intervals (CI95%) were analyzed using both crude and adjusted Cox proportional hazards regression in a hierarchical model. The risks of breastfeeding cessation at 12, 18, and 24 months were 19%, 65%, and 71%, respectively.

Results: Factors positively associated with the risk of breastfeeding cessation include the use of a pacifier before 6 weeks of age (HR = 1.62; CI: 95% 1.24-2.11) and the use of a bottle during the first year of life (HR = 1.41; CI: 95% 1.11-1.78). Maternal return to work after the birth of the baby (HR = 0.78; CI: 95% 0.62-0.97) was found to be negatively associated with the risk of breastfeeding interruption.

Conclusions: Early pacifier use before 6 weeks and the introduction of a bottle in the first year affect continued breastfeeding. Maternal employment was associated with reduced risk of breastfeeding cessation, contrary to most studies.

Keywords: actuarial analysis; associated factors; child nutrition; continued breastfeeding cessation.

MeSH terms

Adult
Birth Cohort
Bottle Feeding / statistics & numerical data
Brazil / epidemiology
Breast Feeding* / statistics & numerical data
Child, Preschool
Cohort Studies
Female
Humans
Infant
Infant, Newborn
Male
Pacifiers* / statistics & numerical data
Proportional Hazards Models
Prospective Studies
Risk Factors
Young Adult

Grants and funding

This work was funded by the Research Program for SUS (PPSUS) and the Foundation for Research Support of the State of Acre (FAPAC) through the PPSUS/FAPAC Calls 2013 (term 007/2013) and 2015 (004/2016), in partnership with the State Health Department of Acre (SES-ACRE); through the National Council for Scientific and Technological Development (CNPq); and through the Department of Science and Technology of the Secretariat of Science, Technology and Strategic Inputs (Decit/SCTIE). This work also received support from CAPES/FAPAC, CAPES/UFAC, and the National Program for Academic Cooperation (Procad), which provided scholarships for the Scientific Initiation Program.