[Evolution of breastfeeding pattern]. / Evolução do padrão de aleitamento materno.

OBJECTIVE: To follow the evolution of the breastfeeding practice among women in a childbirth clinic and evaluate the actions for its promotion. METHODS: Two cohorts of children born in an school hospital of Porto Alegre, Brazil, in different periods of time were compared regarding the prevalence of breastfeeding during the first six months of life, and the percentage of early cessation of breastfeeding. Both were prospective studies, including 202 children in the cohort of 1987, and 187 children in the cohort of 1994. All participants were healthy children, with birth weight of 2500g or more, were being breastfed and their parents were living in the same house. The 1987 study children were followed up through mail, and the 1994 study ones by home visits. RESULTS: Survival analysis showed similar frequencies of breastfeeding in the two cohorts. The prevalence of exclusive breastfeeding, although for a short period in both groups, was higher in the population studied in 1994, especially among children whose mothers were better educated. There was no rate difference of early cessation of breastfeeding between the two cohorts (36% for the 1987 cohort and 39% for the 1994 cohort). CONCLUSIONS: The results revealed a certain degree of apathy in regard of the promotion of breastfeeding during the studied period, giving support to actions to promote breastfeeding, especially among poor families.

Does parental breastfeeding knowledge increase breastfeeding rates?

OBJECTIVE: Although improving mothers' knowledge about breastfeeding can increase rates and duration of breastfeeding, little is known about the influence of fathers' knowledge. The purpose of this study was to assess the knowledge of mothers and fathers about breastfeeding before and after receiving postpartum advice and its relationship to the frequency of breastfeeding. METHODS: A clinical trial was performed with mothers and fathers of normal children born at the Hospital de Clínicas de Porto Alegre, Brazil, between July 1994 and March 1995. The study intervention consisted of postpartum advice supplied by means of a video film discussing basic topics of breastfeeding, an explanatory leaflet, and open discussion after viewing the video. The first 208 couples comprised the control group, the next 197 comprised experimental group 1, and the remaining 196 comprised experimental group 2. Immediately after delivery, mothers and fathers in the three groups answered a test on breastfeeding knowledge; they completed the same test at the end of the first month. All families received home visits at the end of the first, second, fourth, and sixth months, or until breastfeeding ceased. Logistic regression was used to evaluate the association between the mothers' and fathers' knowledge and frequency of breastfeeding. RESULTS: Postpartum advice increased the breastfeeding knowledge of mothers and fathers. The mothers with the highest level of knowledge had a 6.5 times higher chance of exclusively breastfeeding at the end of the third month, and 1.97 times higher chance of continuing breastfeeding to the end of the sixth month compared with other mothers. The fathers' knowledge also significantly influenced breastfeeding rates. The children whose fathers knew more had a 1.76 higher chance of being exclusively breastfed at the end of the first month, and 1.91 higher chance of receiving maternal milk at the end of the third month. CONCLUSION: A simple, inexpensive strategy can increase the level of breastfeeding knowledge of mothers and fathers and, consequently, have a positive impact on the frequency of breastfeeding.

[A simple strategy increases mother's knowledge of breastfeeding and improves the breastfeeding rates] / Uma estratégia simples que aumenta os conhecimentos das mães em aleitamento materno e melhora as taxas de amamentação.

OBJECTIVE: To assess mother's knowledge of breastfeeding before and after guidance supplied during the postpartum period and its relationship to the prevalence of breastfeeding.METHODS: A clinical trial was performed with 405 mothers of normal children born at Hospital de Clínicas de Porto Alegre from July to December 1994. The intervention consisted of guidance given by means of a video film discussing basic topics on breastfeeding, an explanatory leaflet and open discussion after the video. The first 208 mothers constituted the Control Group and the remaining 197 the Experimental Group. All mothers answered a question form for identification purposes and a test on previous knowledge regarding breastfeeding in the maternity ward. The mothers in both groups were followed by means of home visits at the end of the first, second, fourth and sixth months, or until they stopped breastfeeding. At the end of the first month the mothers were submitted to the same test given right after delivery. Logistic regression was used to evaluate the association between the mothers knowledge of breastfeeding and the prevalence of breastfeeding.RESULTS: The mothers who received the intervention (Experimental Group) had a significantly higher score in the tests on knowledge of breastfeeding at the end of the first month as compared with the mothers in the Control Group (17.0 versus 14.7). The intervention increased by 1.7 mothers chances of achieving a score above the average. The mothers whose scores were above the average had a 8.2 higher chance of being breastfeeding exclusively at the end of the third month and twice as high of still being breastfeeding at the end of the sixth month.CONCLUSION: Simple strategies to increase mother's knowledge regarding breastfeeding can have a positive impact on breastfeeding rates.