Gabriela Dos Santos Buccini1, Rafael Pérez-Escamilla2, Sonia Isoyama Venancio3. 1. Program of Nutrition in Public Health, School of Public Health, University of São Paulo, São Paulo, Brazil gabibuccini@usp.br. 2. Yale School of Public Health, New Haven, CT, USA. 3. Instituto de Saúde, Secretaria Estadual da Saúde de São Paulo, São Paulo, Brazil.
Abstract
BACKGROUND: Exclusive breastfeeding (EBF) rates for infants younger than 6 months have increased in Brazil, although at the current pace of improvement it would take 6 years to reach an EBF rate of 50%. Thus, it is important to identify relevant modifiable key risk factors for the premature interruption of EBF. OBJECTIVE: This study aimed to find out if pacifier use is an independent risk factor for the interruption of EBF among Brazilian infants. METHODS: We conducted secondary cross-sectional data analyses of 2 waves of infant feeding surveys conducted in 1999 and in 2008 in the Brazilian state capitals and Federal District (N = 42 395 children < 6 months). Multivariate logistic regression was used to test the association between pacifier use and the risk of interruption of EBF in a pooled sample and within each survey wave, adjusting for socioeconomic, demographic, and biomedical confounders. RESULTS: In the pooled sample, a third of the infants were exclusively breastfed (32.7%) and almost 50% had used a pacifier. Whereas EBF prevalence among infants increased from 25.1% in 1999 to 40.3% in 2008, pacifier use prevalence decreased from 58.5% to 41.6% in the same time period. Pacifier use was strongly associated with the risk of interruption of EBF in 1999 (adjusted odds ratio [AOR] = 2.65; 95% confidence interval [CI], 2.38-2.94), in 2008 (AOR = 3.18; 95% CI, 2.81-3.60), and in the pooled sample (AOR = 2.77; 95% CI, 2.63-2.91) after adjusting for key confounders. CONCLUSION: Pacifier use was the strongest risk factor for EBF interruption. Effective strategies to reduce pacifier use among infants younger than 6 months may further improve EBF rates in Brazil.
BACKGROUND: Exclusive breastfeeding (EBF) rates for infants younger than 6 months have increased in Brazil, although at the current pace of improvement it would take 6 years to reach an EBF rate of 50%. Thus, it is important to identify relevant modifiable key risk factors for the premature interruption of EBF. OBJECTIVE: This study aimed to find out if pacifier use is an independent risk factor for the interruption of EBF among Brazilian infants. METHODS: We conducted secondary cross-sectional data analyses of 2 waves of infant feeding surveys conducted in 1999 and in 2008 in the Brazilian state capitals and Federal District (N = 42 395 children < 6 months). Multivariate logistic regression was used to test the association between pacifier use and the risk of interruption of EBF in a pooled sample and within each survey wave, adjusting for socioeconomic, demographic, and biomedical confounders. RESULTS: In the pooled sample, a third of the infants were exclusively breastfed (32.7%) and almost 50% had used a pacifier. Whereas EBF prevalence among infants increased from 25.1% in 1999 to 40.3% in 2008, pacifier use prevalence decreased from 58.5% to 41.6% in the same time period. Pacifier use was strongly associated with the risk of interruption of EBF in 1999 (adjusted odds ratio [AOR] = 2.65; 95% confidence interval [CI], 2.38-2.94), in 2008 (AOR = 3.18; 95% CI, 2.81-3.60), and in the pooled sample (AOR = 2.77; 95% CI, 2.63-2.91) after adjusting for key confounders. CONCLUSION: Pacifier use was the strongest risk factor for EBF interruption. Effective strategies to reduce pacifier use among infants younger than 6 months may further improve EBF rates in Brazil.
Authors: Qianling Zhou; Haoyue Chen; Katherine M Younger; Tanya M Cassidy; John M Kearney Journal: Int Breastfeed J Date: 2020-05-20 Impact factor: 3.461
Authors: Gabriela Buccini; Rafael Pérez-Escamilla; Maria Helena D'Aquino Benicio; Elsa Regina Justo Giugliani; Sonia Isoyama Venancio Journal: PLoS One Date: 2018-12-19 Impact factor: 3.240
Authors: Najmeh Maharlouei; Amirhosein Pourhaghighi; Hadi Raeisi Shahraki; Dariush Zohoori; Kamran B Lankarani Journal: Int J Community Based Nurs Midwifery Date: 2018-07