Breastfeeding education, early skin-to-skin contact and other strong determinants of exclusive breastfeeding in an urban population: a prospective study.

Autor:	Dueñas-Espín I; Instituto de Salud Pública, Postgrado de Medicina Familiar y Comunitaria, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador igduenase@puce.edu.ec., León Cáceres Á; Instituto de Salud Pública, Postgrado de Medicina Familiar y Comunitaria, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador.; Faculty of Medicine, Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany., Álava A; Distrito 13D02, Centro de Salud San Juan, Ministerio de Salud Pública, Manta, Manabí, Ecuador., Ayala J; Distrito 09d06, Ministerio de Salud Publica, Portoviejo, Manabí, Ecuador., Figueroa K; Zona 4 Manabí - Santo Domingo Distrito de Salud 13D11 Sucre - 'San Vicente', Centro de Salud tipo A 'San Clemente', Ministerio de Salud Publica, San Clemente, Ecuador., Loor V; Distrito 13D01, Centro de salud Palma Juntas y Centro de Salud de San Pablo, Ministerio de Salud Pública, San Pablo, Manabí, Ecuador., Loor W; Distrito de Salud 13d11, Centro de salud tipo A 'San Andrés de Canoa', 'San Vicente', Ministerio de Salud Pública, San Vicente-Sucre, Ecuador., Menéndez M; Zona 4 Manabí - Santo Domingo, Distrito de Salud 13d01 - Centro de Salud El Limón, Ministerio de Salud Pública, El Limón, Ecuador., Menéndez D; Distrito 13D01, Centro de Salud tipo A 'Pimpiguasi', Ministerio de Salud Publica, Portoviejo, Ecuador., Moreira E; Distrito de Salud 13d11, Centro de Salud Tipo A 'Salinas', San Vicente-Sucre, Ministerio de Salud Publica, San Vicente-Sucre, Ecuador., Segovia R; Distrito 13D04, Centro de Salud 'Santa Ana', Ministerio de Salud Pública, Santa Ana, Manabí, Ecuador., Vinces J; Centro de Salud Tipo A Carapungo 1, Ministerio de Salud Publica, Quito, Ecuador.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2021 Mar 18; Vol. 11 (3), pp. e041625. Date of Electronic Publication: 2021 Mar 18.
DOI:	10.1136/bmjopen-2020-041625
Abstrakt:	Objective: The current study aims to demonstrate independent associations between social, educational and health practice interventions as determinants of exclusive breastfeeding in an urban Ecuadorian population. Design: Prospective survival analyses. Setting: Ecuadorian mother-child dyads in urban settings. Participants: We followed-up 363 mother-baby dyads who attended healthcare centres in Portoviejo, province of Manabi, for a median time (P25-P75) of 125 days (121-130 days). Main Outcome Measures: We performed a survival analysis, by setting the time-to-abandonment of exclusive breastfeeding measured in days of life, that is, duration of exclusive breastfeeding, periodically assessed by phone, as the primary outcome. Crude and adjusted mixed-effects Cox proportional hazards model were performed to estimate HRs for each explanatory variable. Results: The incidence rate of abandonment of breastfeeding was 8.9 per 1000 person-days in the whole sample. Multivariate analysis indicated the three most significant protective determinants of exclusive breastfeeding were (a) sessions of prenatal breastfeeding education with an HR of 0.7 (95% CI: 0.5 to 0.9) per each extra session, (b) self-perception of milk production, with an HR of 0.4 (95% CI: 0.3 to 0.6) per each increase in the perceived quantity of milk production and (c) receiving early skin-to-skin contact with an HR of 0.1 (95% CI: <0.1 to 0.3) compared with those not receiving such contact, immediately after birth. Conclusions: Prenatal education on breastfeeding, self-perception of sufficient breast-milk production and early skin-to-skin contact appear to be strong protectors of exclusive breastfeeding among urban Ecuadorian mother-baby dyads. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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