Prevalence and factors associated with breast milk donation in banks that receive human milk in primary health care units☆, ☆☆

Meneses, Tatiana Mota Xavier de; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira

doi:10.1016/j.jped.2016.09.004

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Original articles • J. Pediatr. (Rio J.) 93 (4) • Jul-Aug 2017 • https://doi.org/10.1016/j.jped.2016.09.004 copy

Prevalence and factors associated with breast milk donation in banks that receive human milk in primary health care units^☆ ☆ Please cite this article as: Meneses TM, Oliveira MI, Boccolini CS. Prevalence and factors associated with breast milk donation in banks that receive human milk in primary health care units. J Pediatr (Rio J). 2017;93:382-8. , ^☆☆ ☆☆ Study carried out at Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To estimate the prevalence and to analyze factors associated with breast milk donation at primary health care units in order to increase the human milk bank reserves.

Methods:

Cross-sectional study carried out in 2013 in Rio de Janeiro, Brazil. A representative sample of 695 mothers of children younger than 1 year attended to at the nine primary health care units with human milk donation services were interviewed. A hierarchical approach was used to obtain adjusted prevalence ratios (APR) by Poisson regression with robust variance. The final model included the variables associated with breast milk donation (p ≤ 0.05).

Results:

7.3% of the mothers had donated breast milk. Having been encouraged to donate breast milk by healthcare professionals, relatives, or friends (APR = 7.06), receiving information on breast milk expression by the primary health care unit (APR = 3.65), and receiving help from the unit professionals to breastfeed (APR = 2.24) were associated with a higher prevalence of donation. Admission of the newborn to the neonatal unit was associated with a lower prevalence of donation (APR = 0.09).

Conclusions:

Encouragement to breast milk donation, and information and help provided by primary health care unit professionals to breastfeeding were shown to be important for the practice of human milk donation.

KEYWORDS
Human milk; Milk banks; Cross-sectional studies; Primary health care; Donation; Epidemiology

Characteristics	n	%	% donation	CPR	95% CI	p-value
Maternal
Mother's age
13-19 years	158	22.7	8.2	1.163	0.635-2.128	0.625
20-45 years	537	77.3	7.1	1
Ethnicity
Non-White	510	73.5	7.5	1.055	0.575-1.935	0.864
White	184	26.5	7.1	1
Level of schooling
Up to 7 full years	156	22.4	4.5	0.550	0.253-1.196	0.131
8 full years or more	539	77.6	8.2	1
Maternal income
<1 minimum wage	487	70.7	7.4	1.005	0.563-1.793	0.988
1 minimum wage or more	202	29.3	7.4	1
Parity
Primiparous	328	47.2	8.8	1.475	0.865-2.515	0.154
Multiparous	367	52.8	6.0	1

Contextual
Number of residents
5-11 residents	258	37.1	5.4	0.641	0.353-1.162	0.143
Up to 4 residents	437	62.9	8.5	1
Place of residence
Community	443	63.7	6.5	0.750	0.440-1.277	0.289
Neighborhood	252	36.3	8.7	1
Lives with partner
No	148	21.3	6.8	0.901	0.463-1.756	0.760
Yes	547	78.7	7.5	1

Characteristics	n	%	% donation	CPR	95% CI	p-value
Prenatal
Place where it was performed
In other units	231	33.5	4.8	0.545	0.285-1.043	0.067
In this unit	458	66.5	8.7	1
No. of consultations
0-5 consultations	80	11.5	5.0	0.653	0.242-1.765	0.401
6 or more consultations	614	88.5	7.7	1
Information on breastfeeding
Yes	547	78.7	7.9	1.454	0.699-3.025	0.316
No	142	21.3	5.4	1

Of the delivery
Delivery at a baby-friendly hospital
Yes	200	29.0	5.5	0.674	0.353-1.286	0.231
No	490	71.0	8.2	1
Type of delivery
C-section	290	41.7	9.0	1.452	0.857-2.462	0.166
Vaginal	405	58.3	6.2	1

Of the baby at birth
Gestational age
Preterm	71	10.2	8.5	1.172	0.518-2.649	0.703
Full-term	624	89.8	7.2	1
Birth weight
<2500 g	43	6.2	4.7	0.619	0.156-2.460	0.496
2500 g or more	652	93.8	7.5	1
Admission at neonatal unit
Yes	113	16.3	0.9	0.103	0.014-0.738	0.024
No	582	83.7	8.6	1
Type of breastfeeding at discharge
Non-exclusive	146	21.0	6.2	0.806	0.402-1.617	0.543
Exclusive breastfeeding	549	79.0	7.7	1

Characteristics	n	%	% donation	CPR	95% CI	p-value
Of the care and maternal practices
Information on breast milk expression
Yes	416	59.9	11.1	7.408	2.980-18.417	<0.001
No	279	40.1	1.8	1
Help at the unit to breastfeed
Yes	360	51.8	11.1	3.384	1.766-6.485	<0.001
No or unsatisfactory	335	48.2	3.3	1
Self-perception of health
Poor or unsatisfactory	121	17.4	5.8	0.755	0.348-1.635	0.476
Good	574	82.6	7.7	1
Was encouraged to donate breast milk
Yes	327	47.1	13.8	8.417	3.639-19.472	<0.001
No	367	52.9	1.6	1
Was informed about donation by the media
No	95	13.7	7.4	1.005	0.466-2.165	0.990
Yes	600	86.3	7.3	1
Doubts or difficulty in relation to donation
Yes	146	21.1	2.1	0.234	0.074-0.741	0.014
No	547	78.9	8.8	1
Smoker
Yes	78	11.2	2.6	0.323	0.080-1.302	0.112
No	617	88.8	7.9	1
Alcohol consumption
Yes	81	11.7	4.9	0.645	0.239-1.743	0.388
No	614	88.3	7.7	1
Paid job
Yes, but on leave	102	14.7	11.8	2.000	0.875-4.574	0.101
Does not work	439	63.3	6.8	1.162	0.564-2.393	0.684
Yes, but not on leave	153	22.0	5.9	1

Of the baby and care
Age of baby
0-5 months	429	61.7	8.6	1.639	0.903-2.973	0.104
6-12 months	266	38.3	5.3	1
Gender
Male	372	53.5	7.8	1.145	0.671-1.952	0.620
Female	323	46.5	6.8	1
Use of pacifier
Yes	310	44.7	5.5	0.619	0.353-1.087	0.095
No	384	55.3	8.9	1
Bottle-feeding
Yes	400	57.6	5.8	0.606	0.356-1.030	0.064
No	295	42.4	9.5	1

Variables	APR	95% CI	p-value
Admission at neonatal unit
Yes	0.094	0.013-0.656	0.017
No	1

Information on breast milk expression
Yes	3.647	1.482-8.973	0.005
No	1

Help at the unit to breastfeed
Yes	2.238	1.199-4.178	0.011
No	1

Was encouraged to donate breast milk
Yes	7.057	3.037-16.400	<0.001
No	1

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[1] * Corresponding author. E-mail:marinesco@superig.com.br (M.I. Oliveira).