Continued Breastfeeding in a Birth Cohort in the Western Amazon of Brazil: Risk of Interruption and Associated
Déborah de Oliveira Togneri Pastro1, Fernanda Andrade Martins1, Alanderson Alves Ramalho1
1Graduate Program of Community Health, Center of Health and Sports Science, Federal University of Acre, Rio Branco 69920-900, AC, Brazil.
Background:
Continued breastfeeding reduces infant mortality and provides nutritional, immunological, and developmental benefits for the child.
Objectives:
A prospective cohort study conducted in 2015 followed 608 children who were breastfed between 6 and 24 months. The study assessed the risk of breastfeeding interruption at 12, 18, and 24 months, as well as the factors associated with this outcome, in a cohort of newborns in Rio Branco, using the life table method.
Methods:
The factors associated with breastfeeding cessation and their 95% confidence intervals (CI95%) were analyzed using both crude and adjusted Cox proportional hazards regression in a hierarchical model. The risks of breastfeeding cessation at 12, 18, and 24 months were 19%, 65%, and 71%, respectively.
Results:
Factors positively associated with the risk of breastfeeding cessation include the use of a pacifier before 6 weeks of age (HR = 1.62; CI: 95% 1.24-2.11) and the use of a bottle during the first year of life (HR = 1.41; CI: 95% 1.11-1.78). Maternal return to work after the birth of the baby (HR = 0.78; CI: 95% 0.62-0.97) was found to be negatively associated with the risk of breastfeeding interruption.
Conclusions:
Early pacifier use before 6 weeks and the introduction of a bottle in the first year affect continued breastfeeding. Maternal employment was associated with reduced risk of breastfeeding cessation, contrary to most studies.
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