Breastfeeding patterns in cohort infants at a high-risk fetal, neonatal and child referral center in Brazil: a correspondence analysis
Breastfeeding patterns in cohort infants at a high-risk fetal, neonatal and child referral center in Brazil: a correspondence analysis
Data
2020
Autores
Silva, Maíra Domingues Bernardes
Oliveira, Raquel de Vasconcellos Carvalhaes de
Braga, José Ueleres
Almeida, João Aprígio Guerra de
Melo, Enirtes Caetano Prates
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Pediatrics
Resumo
Background: To investigate the prevalence and patterns of breastfeeding at discharge and in the first six months
of life in a high-risk fetal, neonatal and child referral center.
Methods: Prospective, longitudinal study that included the following three steps: hospital admission, first visit after
hospital discharge and monthly telephone interview until the sixth month of life. The total number of losses was 75
mothers (7.5%). Exposure variables were sorted into four groups: factors related to the newborn, the mother, the
health service and breastfeeding. The dependent variable is breastfeeding as per categories established by the
WHO. All 1200 children born or transferred to the high-risk fetal, neonatal and child referral center, within a seven-
day postpartum period, from March 2017 to April 2018, were considered eligible for the study, and only 1003 were
included. The follow-up period ended in October 2018. For this paper, we performed an exploratory analysis at
hospital discharge in three stages, as follows: (i) frequencies of baseline characteristics, stratified by risk for newborn;
(ii) a multiple correspondence analysis (MCA); and (iii) clusters for variables related to hospital practice and exclusive
breastfeeding (EBF).
Results: The prevalence of EBF at hospital discharge was 65.2% (62.1–68.2) and 20.6% (16.5–25.0) in the six months
of life. Out of all at-risk newborns, 45.7% were in EBF at discharge. The total inertia corresponding to the two
dimensions in the MCA explained for 75.4% of the total data variability, with the identification of four groups,
confirmed by the cluster analysis.
Discussion: Our results suggest that robust breastfeeding hospital policies and practices influence the
establishment and maintenance of breastfeeding in both healthy and at-risk infants. It is advisable to plan and
implement additional strategies to ensure that vulnerable and healthy newborns receive optimal feeding. It is
necessary to devote extra effort particularly to at-risk infants who are more vulnerable to negative outcomes.
Conclusion: At-risk newborns did not exclusively breastfeed to the same extent as healthy newborns at hospital
discharge. A different approach is required for at-risk neonates, who are more physically challenged and more
vulnerable to problems associated with initiation and maintenance of breastfeeding.
Description
Palavras-chave
Longitudinal cohort, Cohort profile, Correspondence analysis, Breastfeeding, High risk.
Citação
Silva MDB, Carvalhaes de Oliveira RV, Braga JU, de Almeida JAG, Melo ECP. Breastfeeding patterns in cohort infants at a high-risk fetal, neonatal and child referral center in Brazil: a correspondence analysis. BMC Pediatr. 2020 Aug 7;20(1):372. doi: 10.1186/s12887- 020-02272-w.