Breastfeeding education, early skin-to-skin contact and other strong determinants of exclusive breastfeeding in an urban population: a prospective study
Objective The current study aims to demonstrate independent associations between social, educational and health practice interventions as determinants of exclusive breastfeeding in an urban Ecuadorian population.Design Prospective survival analyses.Setting Ecuadorian mother–child dyads in urban sett...
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BMJ Publishing Group
2021-03-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/3/e041625.full |
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| author | Iván Dueñas-Espín Ángela León Cáceres Angelica Álava Juan Ayala Karina Figueroa Vanesa Loor Wilmer Loor Mónica Menéndez David Menéndez Eddy Moreira René Segovia Johanna Vinces |
| author_facet | Iván Dueñas-Espín Ángela León Cáceres Angelica Álava Juan Ayala Karina Figueroa Vanesa Loor Wilmer Loor Mónica Menéndez David Menéndez Eddy Moreira René Segovia Johanna Vinces |
| author_sort | Iván Dueñas-Espín |
| collection | DOAJ |
| description | Objective The current study aims to demonstrate independent associations between social, educational and health practice interventions as determinants of exclusive breastfeeding in an urban Ecuadorian population.Design Prospective survival analyses.Setting Ecuadorian mother–child dyads in urban settings.Participants We followed-up 363 mother–baby dyads who attended healthcare centres in Portoviejo, province of Manabi, for a median time (P25–P75) of 125 days (121–130 days).Main outcome measures We performed a survival analysis, by setting the time-to-abandonment of exclusive breastfeeding measured in days of life, that is, duration of exclusive breastfeeding, periodically assessed by phone, as the primary outcome. Crude and adjusted mixed-effects Cox proportional hazards model were performed to estimate HRs for each explanatory variable.Results The incidence rate of abandonment of breastfeeding was 8.9 per 1000 person-days in the whole sample. Multivariate analysis indicated the three most significant protective determinants of exclusive breastfeeding were (a) sessions of prenatal breastfeeding education with an HR of 0.7 (95% CI: 0.5 to 0.9) per each extra session, (b) self-perception of milk production, with an HR of 0.4 (95% CI: 0.3 to 0.6) per each increase in the perceived quantity of milk production and (c) receiving early skin-to-skin contact with an HR of 0.1 (95% CI: <0.1 to 0.3) compared with those not receiving such contact, immediately after birth.Conclusions Prenatal education on breastfeeding, self-perception of sufficient breast-milk production and early skin-to-skin contact appear to be strong protectors of exclusive breastfeeding among urban Ecuadorian mother–baby dyads. |
| format | Article |
| id | doaj-art-4286fe1f19274cd58e11a842a6fcad13 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-4286fe1f19274cd58e11a842a6fcad132024-11-21T07:55:12ZengBMJ Publishing GroupBMJ Open2044-60552021-03-0111310.1136/bmjopen-2020-041625Breastfeeding education, early skin-to-skin contact and other strong determinants of exclusive breastfeeding in an urban population: a prospective studyIván Dueñas-Espín0Ángela León Cáceres1Angelica Álava2Juan Ayala3Karina Figueroa4Vanesa Loor5Wilmer Loor6Mónica Menéndez7David Menéndez8Eddy Moreira9René Segovia10Johanna Vinces111Hospital Clinic de Barcelona, Institut d`Investigacions Biomèdiques August Pii Sunyer (IDIBAPS), CIBERES, Universitat de Barcelona, Barcelona, SpainInstituto de Salud Pública, Postgrado de Medicina Familiar y Comunitaria, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, EcuadorDistrito 13D02, Centro de Salud San Juan, Ministerio de Salud Pública, Manta, Manabí, EcuadorDistrito 09d06, Ministerio de Salud Publica, Portoviejo, Manabí, EcuadorZona 4 Manabí - Santo Domingo Distrito de Salud 13D11 Sucre - San Vicente, Centro de Salud tipo A “San Clemente, Ministerio de Salud Publica, San Clemente, EcuadorDistrito 13D01, Centro de salud Palma Juntas y Centro de Salud de San Pablo, Ministerio de Salud Pública, San Pablo, Manabí, EcuadorDistrito de Salud 13d11, Centro de salud tipo A San Andrés de Canoa”, San Vicente, Ministerio de Salud Pública, San Vicente-Sucre, EcuadorZona 4 Manabí - Santo Domingo, Distrito de Salud 13d01 - Centro de Salud El Limón, Ministerio de Salud Pública, El Limón, EcuadorDistrito 13D01, Centro de Salud tipo A “Pimpiguasi”, Ministerio de Salud Publica, Portoviejo, EcuadorDistrito de Salud 13d11, Centro de Salud Tipo A “Salinas”, San Vicente-Sucre, Ministerio de Salud Publica, San Vicente-Sucre, EcuadorDistrito 13D04, Centro de Salud “Santa Ana”, Ministerio de Salud Pública, Santa Ana, Manabí, EcuadorCentro de Salud Tipo A Carapungo 1, Ministerio de Salud Publica, Quito, EcuadorObjective The current study aims to demonstrate independent associations between social, educational and health practice interventions as determinants of exclusive breastfeeding in an urban Ecuadorian population.Design Prospective survival analyses.Setting Ecuadorian mother–child dyads in urban settings.Participants We followed-up 363 mother–baby dyads who attended healthcare centres in Portoviejo, province of Manabi, for a median time (P25–P75) of 125 days (121–130 days).Main outcome measures We performed a survival analysis, by setting the time-to-abandonment of exclusive breastfeeding measured in days of life, that is, duration of exclusive breastfeeding, periodically assessed by phone, as the primary outcome. Crude and adjusted mixed-effects Cox proportional hazards model were performed to estimate HRs for each explanatory variable.Results The incidence rate of abandonment of breastfeeding was 8.9 per 1000 person-days in the whole sample. Multivariate analysis indicated the three most significant protective determinants of exclusive breastfeeding were (a) sessions of prenatal breastfeeding education with an HR of 0.7 (95% CI: 0.5 to 0.9) per each extra session, (b) self-perception of milk production, with an HR of 0.4 (95% CI: 0.3 to 0.6) per each increase in the perceived quantity of milk production and (c) receiving early skin-to-skin contact with an HR of 0.1 (95% CI: <0.1 to 0.3) compared with those not receiving such contact, immediately after birth.Conclusions Prenatal education on breastfeeding, self-perception of sufficient breast-milk production and early skin-to-skin contact appear to be strong protectors of exclusive breastfeeding among urban Ecuadorian mother–baby dyads.https://bmjopen.bmj.com/content/11/3/e041625.full |
| spellingShingle | Iván Dueñas-Espín Ángela León Cáceres Angelica Álava Juan Ayala Karina Figueroa Vanesa Loor Wilmer Loor Mónica Menéndez David Menéndez Eddy Moreira René Segovia Johanna Vinces Breastfeeding education, early skin-to-skin contact and other strong determinants of exclusive breastfeeding in an urban population: a prospective study BMJ Open |
| title | Breastfeeding education, early skin-to-skin contact and other strong determinants of exclusive breastfeeding in an urban population: a prospective study |
| title_full | Breastfeeding education, early skin-to-skin contact and other strong determinants of exclusive breastfeeding in an urban population: a prospective study |
| title_fullStr | Breastfeeding education, early skin-to-skin contact and other strong determinants of exclusive breastfeeding in an urban population: a prospective study |
| title_full_unstemmed | Breastfeeding education, early skin-to-skin contact and other strong determinants of exclusive breastfeeding in an urban population: a prospective study |
| title_short | Breastfeeding education, early skin-to-skin contact and other strong determinants of exclusive breastfeeding in an urban population: a prospective study |
| title_sort | breastfeeding education early skin to skin contact and other strong determinants of exclusive breastfeeding in an urban population a prospective study |
| url | https://bmjopen.bmj.com/content/11/3/e041625.full |
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