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Exclusive breastfeeding abandonment in adolescent mothers: a cohort study within health primary services* * This article refers to the call “Adolescent health and the role of nurses”. Edited by Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil. Publication of this supplement was supported by the Pan American Health Organization (PAHO/WHO). Articles have undergone the journal’s standard peer-review process for supplements. The views expressed in this supplement are those of the authors alone and do not represent the views of PAHO/WHO. Paper extracted from doctoral dissertation “Exclusive breastfeeding abandonment among adolescent mothers: a cohort study”, presented to Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brazil. Supported by Fondo de Ayuda a la Investigación (FAI iniciación) de la Universidad de Los Andes, Santiago, Chile.

Abstract

Objective:

to analyze the factors associated with the abandonment of exclusive breastfeeding in adolescent mothers during the first 6 months of the infant’s life.

Method:

this is a cohort study of 105 adolescent mothers followed at the child’s 2-, 4- and 6-months of age. The epidemiological approach was adopted, supported by the positivism paradigm. Exposure variables were those directly related to breastfeeding and sociodemographic, family, maternal and child conditions. Data were collected by interview and analyzed by bivariate and multivariate statistics. The Hazard Ratio (HR) was calculated with a 95% confidence interval (95%CI). The tests were performed, admitting an error type I of 5%. The confidentiality of data was ensured.

Results:

the cumulative incidences of exclusive breastfeeding abandonment were 33.3%, 52.2% and 63.8%, at 2, 4 and 6 months, respectively. The variables that remain in the final multivariate model were maternal perception of milk quality (HR=11.6; 95%CI 3.6-37.5), pacifier use (HR=1.9; 95%CI 1.2-3.3), and time of first breastfeeding session (HR=1.4; 95%CI 0.5-12.9).

Conclusion:

the highest abandonment rate occurs before the fourth month. A perception of having poor-quality milk by the adolescent mother and pacifier use are factors that favor the abandonment of exclusive breastfeeding. Determining the factors associated with breastfeeding abandonment may allow their timely management, especially in more vulnerable populations.

Descriptors:
Breast Feeding; Adolescent; Health Promotion; Nursing; Obstetric Nursing; Cohort Studies

Highlights:

(1) The highest abandonment rate of exclusive breastfeeding occurs before the fourth month. (2) A perception of having poor-quality milk may increase the abandonment of exclusive breastfeeding. (3) Pacifier use may increase the abandonment of exclusive breastfeeding. (4) Knowing the factors associated with exclusive breastfeeding may allow for timely management of them. (5) Exclusive breastfeeding promotion strategies must be adopted early, before and after birth.

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E-mail: rlae@eerp.usp.br