Sociodemographic, health and pro-breast-feeding policies and programmes associated with breast-feeding duration in Latin American countries.

OBJECTIVE: To describe the duration of breast-feeding between 1990 and 2013 and to estimate the association between breast-feeding duration and sociodemographic, health and pro-breast-feeding policies and programmes in Latin American countries. DESIGN: This is a cross-sectional study with data from Demographic and Health Surveys programme conducted in Bolivia, Brazil, Colombia, Peru and the Dominican Republic between 1990 and 2013. The median duration of breast-feeding was estimated by survival analysis. Information on pro-breast-feeding policies and programmes was extracted from the World on Breastfeeding Trends Initiative (WBTi) tool. The association between the duration of breast-feeding and WBTi tool score was analysed by multilevel survival regression. SETTING: Nationally representative cross-sectional survey from Bolivia, Brazil, Colombia, Peru and Dominican Republic. PARTICIPANTS: We included children under 24 months of age, totalling 17 318 children. RESULTS: Breast-feeding duration showed a significant increase in all countries, except the Dominican Republic. Mothers with higher schooling level (HR = 1·66; 95 % CI 1·35, 2·04), higher income (HR = 1·58; 95 % CI 1·40, 1·77) and overweight (HR = 1·14; 95 % CI 1·05, 1·23) breastfed for a shorter time. Breast-feeding in the first hour of life (HR = 0·79; 95 % CI 0·74, 0·83) was associated with increase in the duration of breast-feeding. Regarding WBTi, Peru presented the lowest score and the Dominican Republic presented the highest score. WBTi score was inversely related to the duration of breast-feeding for this set of countries (HR = 1·07; 95 % CI 1·02, 1·12). CONCLUSIONS: Mothers with better socio-economic conditions and overweight breastfed for a shorter time. Breast-feeding in the first hour was associated with longer duration of breast-feeding. In this set of countries, higher scores from WBTi tool did not result in longer duration of breast-feeding.

CHARCTERIZATION OF FEEDING OF CHILDREN UNDER 24 MONTHS IN UNITS CARED BY THE FAMILY HEALTH STRATEGY.

OBJECTIVE: To describe the median age of introduction and regular food intake by young children in units of the Family Health Strategy. METHODS: Cross-sectional study with 283 young children chosen by uniform stratified cluster sampling. Socio-demographic data on the mother and the child's food intake were collected (age of food introduction and weekly frequency). Foods were grouped into in natura/minimally processed (G1); culinary ingredients (G2); processed (G3) and ultra-processed (G4). The survival analysis was applied to define the median age of food introduction and the chi-square test was used to compare the frequency of food intake, according to the age range (0-5.9; 6-11.9; and 12-23.9 months old). RESULTS: The median duration of exclusive breastfeeding and breastfeeding were three and 19 months, respectively. The age of median food introduction of G1 was six months, except for eggs, milk and coffee (12 months). For oil and salt (G2), the median was 6 months, and for sugar (G2), seven months. The median age of introduction of most food of G4 was 12 months; for infant formulas, it was seven months; cookies and baby food, eight months. Most food had not yet been introduced for children under six months old. For children from six to 11.9 months old, the regular consumption of G4 (≥5 days/week) was higher for cookies (23.8%), bread (21.2%), infant formulas (21.2%) and baby food (35%); and for children from 12 to 23.9 months old, it was higher for cookies (31.2%), bread (57.5%) and baby food (48.7%). CONCLUSIONS: Food introduced and consumed on a regular basis was mainly in natura, at all ages. Processed and ultra-processed food presented a higher frequency of consumption after 12 months old.

Charcterization of feeding of children under 24 months in units cared by the family health strategy / Caracterização da alimentação de crianças menores de 24 meses em unidades da estratégia saúde da família

ABSTRACT Objective: To describe the median age of introduction and regular food intake by young children in units of the Family Health Strategy. Methods: Cross-sectional study with 283 young children chosen by uniform stratified cluster sampling. Socio-demographic data on the mother and the child's food intake were collected (age of food introduction and weekly frequency). Foods were grouped into in natura/minimally processed (G1); culinary ingredients (G2); processed (G3) and ultra-processed (G4). The survival analysis was applied to define the median age of food introduction and the chi-square test was used to compare the frequency of food intake, according to the age range (0-5.9; 6-11.9; and 12-23.9 months old). Results: The median duration of exclusive breastfeeding and breastfeeding were three and 19 months, respectively. The age of median food introduction of G1 was six months, except for eggs, milk and coffee (12 months). For oil and salt (G2), the median was 6 months, and for sugar (G2), seven months. The median age of introduction of most food of G4 was 12 months; for infant formulas, it was seven months; cookies and baby food, eight months. Most food had not yet been introduced for children under six months old. For children from six to 11.9 months old, the regular consumption of G4 (≥5 days/week) was higher for cookies (23.8%), bread (21.2%), infant formulas (21.2%) and baby food (35%); and for children from 12 to 23.9 months old, it was higher for cookies (31.2%), bread (57.5%) and baby food (48.7%). Conclusions: Food introduced and consumed on a regular basis was mainly in natura, at all ages. Processed and ultra-processed food presented a higher frequency of consumption after 12 months old.

RESUMO Objetivo: Descrever a idade mediana de introdução e consumo regular de alimentos por crianças menores de 24 meses em unidades da Estratégia Saúde da Família. Métodos: Estudo transversal realizado com 283 crianças selecionadas por amostragem por conglomerado estratificada uniforme. Foram coletados dados sociodemográficos da mãe e do consumo alimentar da criança (idade de introdução e frequência semanal). Os alimentos foram agrupados em: in natura/minimamente processados (G1); ingredientes culinários (G2); processados (G3) e ultraprocessados (G4). Utilizou-se análise de sobrevida para definição da idade mediana de introdução dos alimentos e teste do qui-quadrado para comparação da frequência de consumo segundo a faixa etária (0 a 5,9; 6 a 11,9; e 12 a 23,9 meses). Resultados: A duração mediana do aleitamento materno exclusivo foi de três meses e do aleitamento materno, de 19 meses. A mediana de introdução dos alimentos do G1 foi de seis meses, exceto para ovo, leite e café (12 meses). Para óleo e sal (G2), a mediana foi de 6 meses e para o açúcar (G2), de sete meses. A mediana da maioria dos alimentos do G4 foi de 12 meses, para fórmulas foi de sete meses, biscoitos e alimentos infantis, oito meses. A maioria dos alimentos ainda não tinha sido introduzida para crianças menores de seis meses. Para crianças de seis a 11,9 meses, o consumo regular (≥5 dias/semana) de G4 foi superior para biscoitos (23,8%), pão (21,2%), fórmulas (21,2%) e alimentos infantis (35,0%); e para crianças de 12 a 23,9 meses foi para biscoitos (31,2%), pão (57,5%) e alimentos infantis (48,7%). Conclusões: Os alimentos introduzidos e consumidos regularmente foram principalmente alimentos in natura, em todas as idades. Alimentos processados e ultraprocessados apresentaram maior frequência de consumo após os 12 meses.