Breastfeeding and early weaning practices in northeast Brazil: A longitudinal study

Objectives. To describe breastfeeding practices from 0 to 12 months of age in 4 small towns that are representative of urban northeast Brazil and to i dentify factors associated with introduction of other milk in the first mon th of life. Methods. From January to August 1998, 364 mothers were interviewed at deliv ery to ascertain antenatal care; delivery room practices; and their intenti ons regarding breastfeeding, pacifiers, and introduction of water, teas, an d other milk. Their perceptions of home support and the advantages of breas tfeeding also were assessed. Thereafter, daily information about feeding pr actices was collected at twice-weekly home visits. When other milk was star ted, a second interview was conducted to ascertain initial and current brea stfeeding problems and use of a pacifier. Reasons for starting other milk w ere investigated using 5-point Likert scales. Results. Mothers were positive toward breastfeeding, and 99% breastfed thei r new infant. Few intended to breastfeed exclusively, and in the first week 80% gave water/tea and 56% used a pacifier. The median duration of exclusi ve breastfeeding was 0 days, and the median age for starting other milk was 24 days. The median duration of breastfeeding was 65 days for mothers who started other milk within 1 month and 165 days for other mothers. After adj ustment for confounding variables, the main factors associated with introdu ction of other milk within 1 month were pacifier use in the first week (odd s ratio [OR], 4.01; 95% confidence interval [CI]: 2.07-7.78), intention to start other milk in the first month (OR, 3.79; 95% CI: 1.74-8.24), giving w ater/tea in the first week (OR, 3.07; 95% CI: 1.56-6.03), and leaving the m aternity ward before breastfeeding was started (OR, 2.59; 95% CI: 1.34-5.04 ). Conclusion. Although breastfeeding is common in this community, it rarely i s exclusive and takes place for a relatively short duration. Identification of risk factors for early introduction of other milk offers potential aven ues for future intervention, including improvement of breastfeeding support in antenatal and maternity services.