Use of Artificial Nipples Among Brazilian Infants and Associated Factors

Transversal study conducted in a Human Milk Bank to evaluate the factors associated with the use of artificial nipples (pacifier and/or nursing bottle) among Brazilian infants. Analyses were performed using the χ2 test and logistic regression analysis. A total of 6017 nursing mothers were evaluated and the use of artificial nipples was reported by 31.3%. The chance of using artificial nipples was higher among infants whose mothers attended antenatal care in private hospitals [odds ratio (OR): 1.61, 95% confidence interval (CI) 1.21-2.14], born in maternities without the Baby-Friendly Hospital Initiative (BFHI) (OR: 18.38, 95% CI 13.50-25.04) and those with adequate birth weight (OR: 2.83, 95% CI 1.99-4.03). A lower chance of using artificial nipples was observed among infants whose mothers had previous breastfeeding experience (OR: 0.76, 95% CI 0.61-0.95), received guidance on breastfeeding during antenatal care (OR: 0.80, 95% CI 0.65-0.98), practiced exclusive breastfeeding (OR: 0.36, 95% CI 0.28-0.45), breastfeeding on demand (OR: 0.66, 95% CI 0.52-0.85) and residents of inland cities/towns (OR: 0.38, 95% CI 0.20-0.72). The findings highlight the importance of breastfeeding guidance during antenatal care and the role of BFHI in clarifying risks associated with artificial nipple use.