Factors associated with breastfeeding in the first hour of life

被引:41
作者
Boccolini, Cristiano Siqueira [1 ]
de Carvalho, Marcia Lazaro [2 ]
Couto de Oliveira, Maria Ines [3 ]
Godoi Vasconcellos, Ana Gloria [2 ]
机构
[1] Fundacao Oswaldo Cruz Fiocruz, Escola Nacl Saude Publ Sergio Arouca ENSP, Programa Posgrad Epidemiol Saude Publ, Rio De Janeiro, Brazil
[2] Fiocruz MS, ENSP, Dept Metodos Quantitat Saude, BR-21045900 Rio De Janeiro, Brazil
[3] Univ Fed Fluminense, Dept Epidemiol & Bioestat, Inst Saude Comunidade, Niteroi, RJ, Brazil
来源
REVISTA DE SAUDE PUBLICA | 2011年 / 45卷 / 01期
关键词
Breast Feeding; Postpartum Period; Hospitals; Maternity; Maternal-Child Health Services; Cross-Sectional Studies; HOSPITAL PRACTICES; INITIATION; DURATION; BIRTH; CARE;
D O I
10.1590/S0034-89102010005000051
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
OBJECTIVE: To identify factors associated with breastfeeding in the first hour of life (Step 4 of the Baby-Friendly Hospital Initiative). METHODS: A cross-sectional study was conducted with a representative sample of mothers who gave birth in maternity wards in the city of Rio de Janeiro, Southeastern Brazil, between 1999 and 2001. Newborns or mothers with restriction to breastfeeding were excluded, resulting in a sample of 8,397 pairs. A random effect at maternity hospital level Poisson model was employed in a hierarchical approach with three levels: distal, intermediate and proximal for characteristics of the mother, of the newborn, and of prenatal and hospital assistance. RESULTS: Only 16% of the mothers breastfed in the first hour of life. Breastfeeding in this period was less prevalent among neonates with immediate intercurrences after birth (PR = 0.47; CI99% 0.15;0.80); among mothers who did not have contact with their newborns in the delivery room (PR = 0.62; CI99% 0.29;0.95); among mothers submitted to cesarean section delivery (PR = 0.48; CI99% 0.24;0.72); and among mothers who gave birth at private maternity hospitals (PR = 0.06; CI99% 0.01;0.19) or at maternity hospitals contracted out to National Health System (SUS) (PR = 0.16; CI99% 0.01;0.30). The context effect of maternity wards was statistically significant. CONCLUSIONS: At an individual level, breastfeeding within one hour after birth was constrained by inappropriate practices in private or SUS-contracted maternity hospitals. The group effect of maternity hospitals and the absence of individual maternal-related factors that explain the outcome suggest that mothers have little or no autonomy to breastfeed their babies within the first hour of life, and depend on the institutional practices that prevail at the maternity hospitals.
引用
收藏
页码:69 / 78
页数:10
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