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Individual and contextual determinants of exclusive breast-feeding in São Paulo, Brazil: a multilevel analysis

Sonia Isoyama Venancio1, Carlos Augusto Monteiro

  • 1Departamento de Nutrição da Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil. soniav@isaude.sp.gov.br

Public Health Nutrition
|February 17, 2006
PubMed

Insights

Implementing municipal support measures significantly boosts exclusive breastfeeding (EBF) rates. These initiatives also mitigate risks associated with lower maternal education and birth weight, promoting EBF.

Area of Science:

  • Public Health
  • Maternal and Child Health
  • Epidemiology

Background:

  • Exclusive breastfeeding (EBF) is crucial for infant health and development.
  • Factors influencing EBF practices require identification to inform public health interventions.
  • Understanding both individual and community-level determinants is essential for effective strategies.

Purpose of the Study:

  • To identify individual and contextual factors associated with exclusive breastfeeding (EBF) practices.
  • To analyze the impact of municipal pro-breast-feeding measures on EBF rates.
  • To investigate interactions between individual characteristics and contextual factors in EBF.

Main Methods:

  • A cross-sectional study analyzed data from 34,435 children under six months in São Paulo, Brazil.
  • Data were collected during the 1999 national vaccination campaign, including feeding practices, maternal, and child characteristics.
  • Multilevel models were used to analyze individual and contextual factors, including municipal pro-breast-feeding measures.

Main Results:

  • Higher EBF rates were observed in mothers with tertiary education, aged 25-29, multiparous women, and those with female infants.
  • Infant birth weight >= 3000g, private healthcare follow-up, and the presence of 4-5 pro-breast-feeding measures in municipalities were associated with increased EBF.
  • Pro-breast-feeding measures attenuated risks linked to low maternal schooling and low birth weight, and made public network follow-up protective.

Conclusions:

  • Municipal initiatives supporting, protecting, and promoting breastfeeding positively influence EBF rates.
  • These measures effectively reduce the impact of individual risk factors on breastfeeding cessation.
  • Contextual support is vital for enhancing and sustaining exclusive breastfeeding practices.
Abstract

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