[The impact of a breastfeeding promotion program at a health center]

To determine the impact on breastfeeding sustained beyond two months of the "Seventeen Steps" breastfeeding maintenance program consisting of seventeen strategies used to promote, support and protect breastfeeding and implemented for ten months at a medical center.

Nonrandomized clinical trial, involving 147 children born between 01/01/99 and 31/12/2001, who had attended their first medical appointment before two months; 67 children who had passed through the traditional program were studied retrospectively and 80 that had the "17 steps" applied to them were studied prospectively. Maximum follow up period was ten months. The program's impact on breastfeeding was evaluated through survival analysis techniques. The survival curves were described by the Kaplan Meier method and compared with the log-rank test. The Cox regression model was used for covariate adjustment. The initial group comparison was done through the t, Kruskal-Wallis and Chi-squared tests. The significance level adopted was 5%.

Adjusting for mother-child covariates, a significant difference was observed in breastfeeding duration between the two groups (p = 0.047). The relative risk of interrupting breastfeeding for the "17 steps" group was RR = 0.54 (95CI = 0.30-0.99), indicating that there was an 85% greater risk that children on the traditional program would be weaned before completing a year than there was that children on the "17 steps" program would be.

The program had a positive impact on the duration of breastfeeding from two to twelve months of age.