Article
Breastfeeding in the first hour of life in Brazilian private hospitals participating in a quality-of-care improvement project
Aleitamento materno na primeira hora de vida em maternidades privadas brasileiras participantes de um projeto de melhoria da qualidade da assistência
Registro en:
Alves, Rachael de Vasconcelos et al. Breastfeeding in the first hour of life in Brazilian private hospitals participating in a quality-of-care improvement project. Reproductive health, v. 20, Suppl 2, p. 1-10, Jan. 2023.
1742-4755
10.1186/s12978-022-01538-z
1742-4755
Autor
Alves, Rachael de Vasconcelos
Oliveira, Maria Inês Couto de
Domingues, Rosa Maria Soares Madeira
Pereira, Ana Paula Esteves
Leal, Maria do Carmo
Resumen
RVA was the main responsible for data analysis, interpretation and discussion of the results and writing of the manuscript and approved the fnal draft of the manuscript; MICO contributed to data analysis, interpretation and discussion of the results and writing of the manuscript and approved the fnal draft of the manuscript; RMSMD contributed to the review and approval of the fnal draft of the manuscript; APEP contributed to data analysis, review, and approval of the fnal draft of the manuscript; MCL was the main responsible for study design, contributed to the review and approval of the fnal draft of the manuscript. All authors read and approved the fnal manuscript. The ethics committee of the Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation (CEP/ENSP) approved the Healthy Birth Study under the research protocol CAAE: 1.761. 027 (approval date: January 16th, 2017). Prior to the interview, the interviewer read aloud the Free and Informed Consent Form and received written consent from the interviewee. The participant then received a copy of the Consent Form containing details of the research. All precautions were taken to maintain the confdentiality of the information. This work was supported by the Centro Nacional de Desenvolvimento Científco e Tecnológico (CNPq) and by the Bill & Melinda Gates Foundation, Edital MCTI/CNPq/MS/SCTIE/Decit/Fundação Bill e Melinda Gates No. 47/2014. The funders had no infuence in the identifcation, design, conduct, nor reporting of the analysis. Background: The Baby-Friendly Hospital Initiative's Step 4 recommends: "support mothers to start breastfeeding as soon as possible after birth", thus contributing to the reduction of neonatal mortality. The objective of this study is to estimate the prevalence of breastfeeding in the first hour of life in private maternity hospitals participating in the "Adequate Childbirth Project", a quality-of-care improvement project, and to analyze determinants of this outcome. Methods: Secondary analysis of data collected by the cross-sectional evaluative "Healthy Birth Study", conducted in 2017 in 12 maternity hospitals participating in the Adequate Childbirth Project, where 4800 mothers were interviewed, and hospital records were observed. Conditions that prevented breastfeeding at birth, such as maternal HIV-infection and newborns' severe malformations, were excluded. Multiple logistic regression was performed according to a hierarchical theoretical model. Results: The prevalence of breastfeeding in the first hour of life was 58% (CI 95% 56.6-59.5%). Lower maternal education (aOR 0.643; CI 95% 0.528-0.782), lower economic status (aOR 0.687; CI 95% 0.504-0.935), cesarean section delivery (ORa 0.649; CI 95% 0.529-0.797), preterm birth (aOR 0.660; CI 95% 0.460-0.948) and non-rooming-in at birth (aOR 0.669; CI 95% 0.559-0.800) were negatively associated with the outcome. Receiving information during prenatal care about the importance of breastfeeding at birth (aOR 2.585; CI 95% 2.102-3.179), being target of the quality-of-care improvement project (aOR 1.273; CI 95% 1.065-1.522), skin-to-skin contact at birth (aOR 2.127; CI 95% 1.791-2.525) and female newborn (aOR 1.194; CI 95% 1.008-1.415) were factors positively associated with the outcome. Conclusions: The private maternities participating in the Healthy Birth Study showed a good prevalence of breastfeeding in the first hour of life, according to WHO parameters. Prenatal guidance on breastfeeding at birth, being target of the quality-of-care improvement project and skin-to-skin contact at birth contributed to breastfeeding in the first hour of life.