Fatores associados ao aleitamento materno exclusivo no primeiro mês de idade

Abstract

Exclusive breastfeeding (EBF) during the first six months of life is essential to promote proper growth and development, and contribute to reducing child mortality. Socioeconomic, demographic, biological, behavioral, psychological among others, interfere with this practice. However, the measurement of some variables has been a challenge due to the subjectivity and limitations of self-report data, both prone to errors. The identification of similar characteristics patterns among nursing mothers and health professionals allows better understanding of the between interrelationship the various factors associated with breastfeeding, and the role of each individual in that process. To this end, theoretical models can be used by Latent Class Analysis (LCA); statistical technique that seeks to identify characteristics of individuals with similar patterns of behavior; and categorize them into their most likely class their responses. The objectives of this study were: a) identify behavior patterns towards EBF among nursing mothers and health professionals; b) evaluates the factors associated with EBF cessation within the first month of life, including variables that were not previously examined in the literature. This is a cohort study with cross-sectional analysis, which used LCA to design a model with four constructs (maternal emotional state, availability to breastfeeding, maternal attitude towards breastfeeding; and health professional’s attitude towards breastfeeding), each with two latent classes, from 15 indicators surveyed in a birth cohort composed 1.309 women interviewed in the first month after delivery. In addition, logistic regression analysis was also performed to investigate the association between EBF interruption at 1 month of life and the latent variables and other covariates. Four constructs were defined using LCA, three related to maternal characteristics: attitude, emotional state and availability to breastfeeding, and on attitude of health professionals on breastfeeding. The frequency of women with unfavorable emotional state was 36.5%; 14.7% had less availability to breastfeed; and 41.5% had a negative attitude towards breastfeeding; and 62.0% of health professionals had negative attitude towards breastfeeding. The classes unfavorable maternal emotional state (OR=1.62; IC95%: 1.28-2.05), unfavorable health professional’s attitude towards breastfeeding (OR=1.31; IC95%: 1.03-1.67) and negative maternal attitude to breastfeeding (OR=2.18; IC95%: 1.73-2.75) were associated with EBF interruption in the 1st month of life. Maternal education up to elementary school (OR=1.47; IC95%: 1.15-1.89) and family income less than one minimum wage (OR=1.41; IC95%: 1.10-1.81) also presented statistical significance for the denouement. The results for education and income were consistent with the literature. The LCA demonstrated behavior patterns of nursing mothers and health professionals on the EBF. The study found new factors associated with interruption of EBF at 1 month of life.