Factors associated with the use of the Child Health Handbook in a large city of the Brazilian Northeast, 2009. / Fatores associados ao uso da Caderneta de Saúde da Criança em uma cidade de grande porte do nordeste brasileiro, 2009.

This study aimed to investigate the factors associated with mothers reading the Child Health Handbook (CHH) and health professionals completing this instrument, in Feira de Santana, Bahia, 2009. This is a cross-sectional study with the application of 727 forms to mothers of children under one year of age. The outcomes studied were mother reading the CHH and health professionals completing weight and height measures. We performed a logistic regression analysis with p ≤ 0.05. The prevalence of reading, weight and height were, respectively, 81.1%, 68.9% and 47.3%. Mothers with a higher level of education had a greater chance of reading the CHH. Recording weight and height was more prevalent in mothers who were under 35 years of age. Performing childcare in areas of the Family Health Program or the Community Health Workers was positively associated with the height's record, despite the low prevalence of records. Child age greater than six months was positively associated with all outcomes. It demonstrated the underutilization of CHH by mothers and health professionals, which indicates the need for training of health professionals and guidance to mothers on the importance and management of this issue.

Fatores associados ao uso da Caderneta de Saúde da Criança em uma cidade de grande porte do nordeste brasileiro, 2009 / Factors associated with the use of the Child Health Handbook in a large city of the Brazilian Northeast, 2009

Resumo O objetivo do estudo foi averiguar os fatores associados à leitura da Caderneta de Saúde da Criança (CSC) pelas mães e a seu preenchimento pelos profissionais de saúde, em Feira de Santana (Bahia), em 2009. Estudo transversal com aplicação de 727 formulários às mães de crianças menores de um ano. Os desfechos estudados foram: leitura materna da caderneta e preenchimento de medidas de peso e comprimento, por profissionais de saúde. Realizou-se análise de regressão logística com valor de p ≤ 5%. A prevalência de leitura, medidas de peso e comprimento foram, respectivamente, 8,1%, 68,9% e 47,3%. Maior escolaridade materna associou-se a maiores chances de leitura. Registros de peso e comprimento foram mais prevalentes em mães com idade < 35 anos. Realizar puericultura em áreas do Programa de Saúde da Família ou dos Agentes Comunitários de Saúde associou-se positivamente com anotações do comprimento, apesar das baixas prevalências dos registros. Idade da criança ≥ 6 meses associou-se a todos os desfechos. Demonstrou-se a subutilização da CSC por mães e profissionais de saúde, indicativos da necessidade de medidas educativas com treinamentos dos profissionais de saúde e orientações às mães sobre a importância e o manejo da mesma.

Abstract This study aimed to investigate the factors associated with mothers reading the Child Health Handbook (CHH) and health professionals completing this instrument, in Feira de Santana, Bahia, 2009. This is a cross-sectional study with the application of 727 forms to mothers of children under one year of age. The outcomes studied were mother reading the CHH and health professionals completing weight and height measures. We performed a logistic regression analysis with p ≤ 0.05. The prevalence of reading, weight and height were, respectively, 81.1%, 68.9% and 47.3%. Mothers with a higher level of education had a greater chance of reading the CHH. Recording weight and height was more prevalent in mothers who were under 35 years of age. Performing childcare in areas of the Family Health Program or the Community Health Workers was positively associated with the height’s record, despite the low prevalence of records. Child age greater than six months was positively associated with all outcomes. It demonstrated the underutilization of CHH by mothers and health professionals, which indicates the need for training of health professionals and guidance to mothers on the importance and management of this issue.

[Maternal intention to breastfeed: a systematic review]. / Intenção materna de amamentar: revisão sistemática.

This study seeks to identify the factors associated with maternal intention to breastfeed (MIB) in pregnant women. A systematic review of articles in the Medical Literature Analysis and Retrieval System Online (PubMed/Medline) and the Latin American and Caribbean Literature in Health Sciences (Lilacs) databases was conducted. Two independent reviewers performed the search, using the "Medical Subject Headings" and "Key words in Science and Health" vocabulary, referring to: breastfeeding, intention, and pregnant women. Research articles in English, Portuguese and Spanish that analyzed MIB as an outcome were selected. The studies were classified by methodological quality, using a scale that considered internal and external validity criteria, with a maximum score of 30 points. Nine articles were selected, with a methodological quality varying from 12 to 21 points. The studies assessed 68 variables; 35 of which were associated with MIB. The characteristics associated with MIB found in two or more studies were: primiparity, higher level of schooling and older maternal age, prior experience with breastfeeding, not smoking, and living with a partner. Knowledge of the characteristics associated with MIB represents a fundamental step in the planning of actions that seek to increase the duration of breastfeeding.

Prevalence and factors associated with cracked nipples in the first month postpartum.

BACKGROUND: To assess the prevalence and factors associated with the occurrence of cracked nipples in the first month postpartum. METHODS: This was a cross-sectional study nested in a cohort of mothers living in Feira de Santana, state of Bahia, northeastern Brazil. Data from 1,243 mother-child dyads assessed both at the maternity ward and 30 days after delivery were analyzed. The association between cracked nipples as reported by mothers and their possible determinants was analyzed using Poisson regression in a model where the variables were hierarchically organized into four levels: distal (individual characteristics), distal intermediate (prenatal characteristics), proximal intermediate (delivery characteristics), and proximal (postnatal characteristics). RESULTS: The prevalence of cracked nipples was 32 % (95 % confidence interval [95 % CI] 29.4-34.7) in the first 30 days postpartum. The following factors showed significant association with the outcome: poor breastfeeding technique (prevalence ratio [PR] = 3.18, 95 % CI 2.72-3.72); breast engorgement (PR = 1.70, 95 % CI 1.46-1.99); birth in a maternity ward not accredited by the Baby-Friendly Hospital Initiative (PR = 1.51, 95 % CI 1.15-1.99); cesarean section (PR = 1.33, 95 % CI 1.13-1.57); use of a feeding bottle (PR = 1.29, 95 % CI 1.06-1.55); and higher maternal education level (PR = 1.23, 95 % CI 1.04-1.47). CONCLUSIONS: The prevalence of cracked nipples was high in our sample. Most of the factors associated with cracked nipples were related to postnatal characteristics, especially poor breastfeeding technique, which could be improved to help prevent the condition.

Intenção materna de amamentar: revisão sistemática / Maternal intention to breastfeed: a systematic review

Resumo O presente estudo tem como objetivo identificar os fatores associados à intenção materna para amamentar (IMA) em gestantes. Foi realizada revisão sistemática de estudos de bases de dados Medical Literature Analysis and Retrieval System Online (PubMed/Medline) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs). Dois revisores independentes buscaram artigos, com os “Medical Subject Headings” e os “Descritores em Ciência e Saúde”, referentes: ao aleitamento materno, à intenção e às gestantes. Foram incluídas pesquisas que apresentavam IMA como desfecho, em inglês, português e espanhol; e classificadas, quanto à qualidade metodológica, de acordo com critérios de validade interna e externa de uma pesquisa, com pontuação máxima de 30 pontos. Selecionou-se nove artigos, com qualificação metodológica entre 12 e 21 pontos, que investigaram 68 variáveis; 35 dessas se associaram à IMA. As características associadas à IMA em gestantes, relatadas em dois ou mais estudos, foram: primeira gestação, maior escolaridade e idade materna, experiência prévia com a amamentação, ausência do hábito de fumar e residir com o companheiro. O conhecimento das características associadas à IMA representa um passo fundamental no delineamento de ações que visem maior duração do aleitamento materno.

Abstract This study seeks to identify the factors associated with maternal intention to breastfeed (MIB) in pregnant women. A systematic review of articles in the Medical Literature Analysis and Retrieval System Online (PubMed/Medline) and the Latin American and Caribbean Literature in Health Sciences (Lilacs) databases was conducted. Two independent reviewers performed the search, using the “Medical Subject Headings” and “Key words in Science and Health” vocabulary, referring to: breastfeeding, intention, and pregnant women. Research articles in English, Portuguese and Spanish that analyzed MIB as an outcome were selected. The studies were classified by methodological quality, using a scale that considered internal and external validity criteria, with a maximum score of 30 points. Nine articles were selected, with a methodological quality varying from 12 to 21 points. The studies assessed 68 variables; 35 of which were associated with MIB. The characteristics associated with MIB found in two or more studies were: primiparity, higher level of schooling and older maternal age, prior experience with breastfeeding, not smoking, and living with a partner. Knowledge of the characteristics associated with MIB represents a fundamental step in the planning of actions that seek to increase the duration of breastfeeding.