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01-07-2016

Factors Associated with Age at Breastfeeding Cessation in Amazonian Infants: Applying a Proximal–Distal Framework

Authors: Annie D. Kearns, Marcia C. Castro, Bárbara H. Lourenço, Rosângela A. Augusto, Marly A. Cardoso, The ACTION Study Team

Published in: Maternal and Child Health Journal | Issue 7/2016

Abstract

Introduction Breastfeeding is an important determinant of child survival and normal growth and development, but breastfeeding prevalence is generally low in Brazil. Factors associated with infant feeding practices there are not well understood. This paper examines factors associated with breastfeeding cessation in a township in the western Brazilian Amazon. Methods A cross-sectional, population-based study was conducted among children younger than 25 months and collected information on maternal and child characteristics. Survival analysis based on a proximal–distal framework examined the association between breastfeeding duration and socioeconomic and maternal/child biological factors. Results The median breastfeeding duration among 101 children who were no longer breastfeeding was 120 days. Almost two-thirds (63 %) of these children stopped breastfeeding before 6 months of age. In the larger sample of 209 children, 74.6 % had previously been bottle-fed. Considering the full proximal–distal model, a child who had ever been bottle-fed was expected to cease breastfeeding about 88 % sooner than one who was never bottle-fed (p < 0.001). Children in the second-poorest wealth quartile stopped breastfeeding sooner than children in the poorest quartile (p < 0.05). Discussion Breastfeeding cessation in the study area occurred much earlier than the recommended 2 years of age. Factors associated with ending breastfeeding early included ever-use of a bottle, having a single mother, and belonging to the second-poorest wealth quartile. Further research is needed to better understand these factors and other barriers women face to continuing breastfeeding.

Bolton, T. A., Chow, T., Benton, P. A., & Olson, B. H. (2009). Characteristics associated with longer breastfeeding duration: An analysis of a peer counseling support program. Journal of Human Lactation, 25(1), 18–27. doi:10.1177/0890334408325985.CrossRefPubMed

Bueno-Gutierrez, D., & Chantry, C. (2015). Using the socio-ecological framework to determine breastfeeding obstacles in a low-income population in Tijuana, Mexico: healthcare services. Breastfeed Med, 10(2), 124–131.CrossRefPubMed

Byers, T., Graham, S., Rzepka, T., & Marshall, J. (1985). Lactation and breast cancer. Evidence for a negative association in premenopausal women. American Journal of Epidemiology, 121(5), 664–674.CrossRefPubMed

Cardoso, M. A., Scopel, K. K., Muniz, P. T., Villamor, E., & Ferreira, M. U. (2012). Underlying factors associated with anemia in Amazonian children: A population-based, cross-sectional study. PLoS ONE, 7(5), e36341. doi:10.1371/journal.pone.0036341.CrossRefPubMedPubMedCentral

Cobayashi, F., Augusto, R. A., Lourenco, B. H., Muniz, P. T., & Cardoso, M. A. (2013). Factors associated with stunting and overweight in Amazonian children: A population-based, cross-sectional study. Public Health Nutrition. doi:10.1017/s1368980013000190.PubMed

DATASUS. (2011). Taxa de mortalidade infantil em menores de 5 anos from http://tabnet.datasus.gov.br/cgi/idb2011/c16.htm.

Emond, A., Pollock, J., Da Costa, N., Maranhao, T., & Macedo, A. (2002). The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil. Revista Panamericana de Salud Publica, 12(2), 101–110.CrossRefPubMed

Feldens, C. A., Vitolo, M. R., Rauber, F., Cruz, L. N., & Hilgert, J. B. (2012). Risk factors for discontinuing breastfeeding in southern Brazil: A survival analysis. Maternal and Child Health Journal, 16(6), 1257–1265. doi:10.1007/s10995-011-0885-7.CrossRefPubMed

Filmer, D., & Pritchett, L. H. (2001). Estimating wealth effects without expenditure data–or tears: An application to educational enrollments in states of India. Demography, 38(1), 115–132.PubMed

10.

Flacking, R., Wallin, L., & Ewald, U. (2007). Perinatal and socioeconomic determinants of breastfeeding duration in very preterm infants. Acta Paediatrica, 96(8), 1126–1130. doi:10.1111/j.1651-2227.2007.00386.x.CrossRefPubMed

11.

Gillespie, B., d’Arcy, H., Schwartz, K., Bobo, J. K., & Foxman, B. (2006). Recall of age of weaning and other breastfeeding variables. International Breastfeeding Journal, 1, 4. doi:10.1186/1746-4358-1-4.CrossRefPubMedPubMedCentral

12.

Granado, F. S., Augusto, R. A., Muniz, P. T., & Cardoso, M. A. (2013). Anaemia and iron deficiency between 2003 and 2007 in Amazonian children under 2 years of age: Trends and associated factors. Public Health Nutrition, 16(10), 1751–1759. doi:10.1017/s1368980012005617.CrossRefPubMed

13.

Grant, C. C., Emery, D., Milne, T., Coster, G., Forrest, C. B., Wall, C. R., & Robinson, E. M. (2012). Risk factors for community-acquired pneumonia in pre-school-aged children. Journal of Paediatrics and Child Health, 48(5), 402–412. doi:10.1111/j.1440-1754.2011.02244.x.CrossRefPubMed

14.

Greiner, T. (2014). Exclusive breastfeeding: Measurement and indicators. International Breastfeeding Journal, 9, 18. doi:10.1186/1746-4358-9-18.CrossRefPubMedPubMedCentral

15.

Grummer-Strawn, L. M. (1996). The effect of changes in population characteristics on breastfeeding trends in fifteen developing countries. International Journal of Epidemiology, 25(1), 94–102.CrossRefPubMed

16.

Hörnell, A., Hofvander, Y., & Kylberg, E. (2001). Solids and formula: Assocition with pattern and duration of breastfeeding. Pediatrics, 107(3), e38.CrossRefPubMed

17.

Jurberg, C., & Humphreys, G. (2010). Brazil’s march towards universal coverage. Bulletin of the World Health Organization, 88(9), 646–647.CrossRefPubMed

18.

Lamberti, L. M., Fischer Walker, C. L., Noiman, A., Victora, C., & Black, R. E. (2011). Breastfeeding and the risk for diarrhea morbidity and mortality. BMC Public Health, 11(Suppl 3), S15. doi:10.1186/1471-2458-11-s3-s15.CrossRefPubMedPubMedCentral

19.

Lares, B., Rebhun, L., & Souza, M. (1996). The cultural context of breast-feeding: Perspectives on the recent decline in breast-feeding in Northeast and Northcentral Brazil. In G. Rl, S. Ma, & N. Mk (Eds.), At the edge of development: Health crises in a transitional society (pp. 335–362). Durham: Carolina Academic Press.

20.

Lima, T. M. D., & Osório, M. M. (2003). Perfil e fatores asssociados ao aleitamentamento materno em crianças menores de 25 meses da Região Nordeste do Brasil. Revista Brasileira de Saúde Materno Infantil, 3(3), 305–314.CrossRef

21.

da Saúde, Ministério. (2005). Pré-natal e puerpério: Atenção qualificada e humanizada Série A. Ministério da Saúde: Normas e Manuais Técnicos. Série Direitos Sexuais e Direitos Reprodutivos. Brasília.

22.

Ministério da Saúde. (2009). Saúde da criança: Nutrição infantil. Aleitamento materno e alimentação complementar Série A. Normas e Manuais Técnicos Cadernos de Atenção Básica Brasília: Ministério da Saúde.

23.

Moreira, M. A., Cabral, P. C., Ferreira, H. S., & Lira, P. I. (2012). Overweight and associated factors in children from northeastern Brazil. Jornal of Pediatria’s (Rio J), 88(4), 347–352. doi:10.2223/JPED.2203.CrossRef

24.

Muniz, P. T., Castro, T. G., Araujo, T. S., Nunes, N. B., da Silva-Nunes, M., Hoffmann, E. H., & Cardoso, M. A. (2007). Child health and nutrition in the Western Brazilian Amazon: Population-based surveys in two counties in Acre State. Cad Saude Publica, 23(6), 1283–1293.CrossRefPubMed

25.

Neves, A. C. M. D. (2012). Preditores do aleitamento materno exclusivo, Amazônia Legal e Nordeste, Brasil, 2010. (Mestrado), Universidade de Brasília, Brasília. Retrieved from http://repositorio.unb.br/bitstream/10482/12319/3/2012_AliceCristinaMedeirosdeNeves_PARCIAL.pdf.

26.

Parizoto, G. M., Parada, C. M., Venancio, S. I., & Carvalhaes, M. A. (2009). Trends and patterns of exclusive breastfeeding for under-6-month-old children. Jornal of Pediatria’s (Rio J), 85(3), 201–208. doi:10.2223/JPED.1888.

27.

Patel, A., Pusdekar, Y., Badhoniya, N., Borkar, J., Agho, K. E., & Dibley, M. J. (2012). Determinants of inappropriate complementary feeding practices in young children in India: Secondary analysis of National Family Health Survey 2005–2006. Maternal and Child Nutrition, 8(Suppl 1), 28–44. doi:10.1111/j.1740-8709.2011.00385.x.CrossRefPubMed

28.

Rosenblatt, K. A., & Thomas, D. B. (1995). Prolonged lactation and endometrial cancer. WHO Collaborative Study of Neoplasia and Steroid Contraceptives. International Journal of Epidemiology, 24(3), 499–503.CrossRefPubMed

29.

Schwarz, E. B., Ray, R. M., Stuebe, A. M., Allison, M. A., Ness, R. B., Freiberg, M. S., & Cauley, J. A. (2009). Duration of lactation and risk factors for maternal cardiovascular disease. Obstetrics and Gynecology, 113(5), 974–982. doi:10.1097/01.AOG.0000346884.67796.ca.CrossRefPubMedPubMedCentral

30.

Segall-Corrêa, A. M., Marín-León, L., Panigassi, G., Rea, M. F., & Pérez-Escamilla, R. (2009). Amamentação e alimentação infantil. In Ministério da Saúde (Ed.), Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher PNDS 2006: Dimensões do Processo Reprodutivo e da Saúde da Criança (pp. 195–212). Brasília: Ministério da Saúde.

31.

Victora, C. G., Horta, B. L., Loret de Mola, C., Quevedo, L., Pinheiro, R. T., Gigante, D. P., & Barros, F. C. (2015). Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: A prospective birth cohort study from Brazil. Lancet Global Health, 3(4), e199–e205. doi:10.1016/s2214-109x(15)70002-1.CrossRefPubMed

32.

Vogel, A., Hutchison, B. L., & Mitchell, E. A. (1999). Factors associated with the duration of breastfeeding. Acta Paediatrica, 88(12), 1320–1326.CrossRefPubMed

33.

Volpini, C. C. D. A., & Moura, E. C. (2005). Determinantes do desmame precoce no distrito noroeste de Campinas. Revista de Nutrição, 18(3), 311–319.CrossRef

34.

Wayland, C. (2004). Breastfeeding patterns in Rio Branco, Acre, Brazil: A survey of reasons for weaning. Cad Saude Publica, 20(6), 1757–1761. doi:10.1590/S0102-311X2004000600038.CrossRefPubMed

35.

Wenzel, D., Ocana-Riola, R., Maroto-Navarro, G., & de Souza, S. B. (2010). A multilevel model for the study of breastfeeding determinants in Brazil. Maternal and Child Nutrition, 6(4), 318–327. doi:10.1111/j.1740-8709.2009.00206.x.CrossRefPubMed

36.

Whittemore, A. S., Harris, R., & Itnyre, J. (1992). Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white women. Collaborative Ovarian Cancer Group. American Journal of Epidemiology, 136(10), 1184–1203.PubMed

37.

WHO. (2012a). 10 Facts on breastfeeding. Retrieved July, 2012, from http://www.who.int/features/factfiles/breastfeeding/facts/en/index.html.

38.

WHO. (2012b). Nutrition: Infant and young child feeding data by country. Retrieved July, 2012, from http://www.who.int/nutrition/databases/infantfeeding/countries/en/index.html.

39.

Winikoff, B., & Laukaran, V. H. (1989). Breast feeding and bottle feeding controversies in the developing world: Evidence from a study in four countries. Social Science and Medicine, 29(7), 859–868.CrossRefPubMed

Title: Factors Associated with Age at Breastfeeding Cessation in Amazonian Infants: Applying a Proximal–Distal Framework
Authors: Annie D. Kearns
Marcia C. Castro
Bárbara H. Lourenço
Rosângela A. Augusto
Marly A. Cardoso
The ACTION Study Team
Publication date: 01-07-2016
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 7/2016
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-016-1953-9

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Factors Associated with Age at Breastfeeding Cessation in Amazonian Infants: Applying a Proximal–Distal Framework

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