Breastfeeding is an important and relatively affordable health promotion and disease prevention activity with positive health outcomes for both the women who breastfeed and the infants who receive human milk as their first source of nutrition. As these benefits are dose dependent, the duration of breastfeeding and exclusivity of breastfeeding are important in the development of these protective effects. The purpose of this study is to understand the process younger mothers, ages 18 to 24 years, undergo to be able to sustain breastfeeding for longer than most women their age breastfeed. Ten women, ages 21 to 24 years, participated in individual, in-depth interviews in this grounded theory study. Following the iterative process of data collection and analysis, focus of the interviews changed as the data analysis guided the data collection process. Data underwent open, focused, axial, and theoretical/selective coding. The analysis process resulted in the development of a middle-range, descriptive theory grounded in the data. Prolonged Breastfeeding Through Fierce Determination succinctly explains the central phenomenon, fierce determination, and the relationship it shares with the other concepts identified as important contributing factors as the women moved through their breastfeeding journeys. Facing and Deciding to Overcome Obstacles, influenced most heavily by fierce determination, exerted its influence upon the outcome of the theory, "Trucking Along", an in vivo code provided by Participant 10, which captured her ongoing breastfeeding even in the face of obstacles. Normalized Infant Feeding Method contributed to the participants' fierce determination. Availability of Support positively impacted the participants' ability to face and overcome their breastfeeding obstacles. Personal Agency had a reciprocal relationship with fierce determination and, like availability of support, also positively impacted their ability to face and overcome obstacles. The concepts within the theory were found to be congruent with a focused review of the literature around long-term goal achievement, healthful behavior adaptation, and breastfeeding. This study contributed to the breastfeeding literature, providing insight into how young mothers engage in prolonged breastfeeding.

SAMMANFATTNING Amningsfrekvensen i Sverige är lägre än vad som rekommenderas enligt Livsmedelverket och WHO. Sett ur ett folkhälsoperspektiv skulle mödrars och barns hälsa kunna förbättras om fler kvinnor ammade sina spädbarn mer exklusivt och under längre tid, varför bra metoder för amningsförberedelse bland blivande spädbarnsfamiljer behövs. Det amningsförberedande arbetet bör initieras av mödravårdsbarnmorskan redan under graviditeten.   Syfte: Att utforma en standardiserad mall för utförandet av amningsförberedande samtal under graviditet.   Metod: En kvalitativ pilotstudie genomförd med litteraturgranskning och fokusgruppintervju med barnmorskor, analyserade med innehållsanalys.   Resultat: Utifrån identifierade faktorer med visad positiv påverkan på amningsfrekvens samt barnmorskors kliniska erfarenhet utformades en standardiserad mall för amningsförberedande samtal. Mallen innehåller en individanpassad och en generell del. Den individanpassade delen behandlar tidigare amningserfarenheter, förväntningar inför kommande amning samt tankar kring brösten och deras funktion. Den generella delen behandlar information om bröst och bröstmjölk, amningsinformation, övriga tankar/frågor, EDS-screening samt fortsatt planering gällande amning.   Slutsats: Resultaten från litteraturgranskningen och fokusgruppsintervjustudien, med förslag på vad amningsförberedelse kan innehålla, överensstämmer till stor del. Barnmorskorna i fokusgruppsintervjustudien ger dock mer utförliga beskrivningar än de faktorer som sammanställts i litteraturgranskningen. Tillsammans har det gett en grund för utarbetandet av en standardiserad mall för amningsförberedande samtal. Fortsatt forskning får visa om samtalsmallen kan ge positiv effekt på amningsfrekvensen. Mallens användbarhet bör också vidare utvärderas. / ABSTRACT The breastfeeding frequency in Sweden is lower than the recommendation by the Swedish National Food Agency and WHO. From a public health perspective mothers´ and their children´s health would be improved if more women breastfed their infants more exclusively and during a longer period. Therefore good methods for breastfeeding preparation among parents to be is needed. The breastfeeding preparation should be initiated by the midwife at the maternity health care already during the women’s pregnancy.   Aim: To design a standardised guide for performing an anamnesis and care plan for breastfeeding during pregnancy.   Method: A qualitative pilot project based on literature review and focus group interviews with midwives, analysed by content analysis.   Results: A standardised guide for performing an anamnesis and care plan for breastfeeding were designed based on identified factors with proved positive impact on breastfeeding frequency and midwives´ clinical experiences in the interviews. The guide includes an individualised and a general part. The individualised part deals with previous breastfeeding experience, expectations for the coming breastfeeding and thoughts about breasts and their function. The general part deals with information about breasts and breast milk, information about breastfeeding, other thoughts/questions, EDS-screening and continued planning regarding breastfeeding.   Conclusion: The results of the literature review and the focus group interviews with suggestions on what breastfeeding preparation can include correspond to a large extent. Though the midwives in the focus group interviews gives more detailed and wide-ranging descriptions than the factors presented in the literature review. Altogether this has given a base for designing a standardised guide. Coming research will show if the guide can have positive impact on breastfeeding frequency. The usability of the guide should also be further evaluated.

Bakgrund: Kvinnor rekommenderas av Världshälsoorganisationen att amma exklusivt i sex månader och delvis i två år eller längre. Studier visar att amning har hälsofrämjande effekter på både modern och barnet. Trots detta är amningsförekomsten en sjunkande trend i Sverige. Råd och stöd av sjuksköterskor har betydelse för amningsförekomsten. Studier visar att mödrar som har hög self-efficacy till sin förmåga att amma, ammar i högre utsträckning. Syfte: Att undersöka om en intervention i form av evidensbaserad amningsinformation kan öka mödrars self-efficacy kring amning samt om förekomsten av exklusiv amning ökade när barnet var fyra veckor gammalt. Metod: Studien genomfördes med kvantitativ ansats och var baserad på en kvasiexperimentell före- och efter design med en kontrollgrupp (n=23) och en interventionsgrupp (n=27). Ett konsekutivt urval användes för att rekrytera förstföderskor. Interventionen bestod av en evidensbaserad amningsbroschyr samt strukturerad muntlig information med hjälp av ett blädderblock som gavs på BB. Mätning av self-efficacy genomfördes med hjälp av Breastfeeding Self-Efficacy Score-Short Form på BB samt när barnet var fyra veckor gammalt. Resultat: De mödrar som ammade exklusivt när barnet var fyra veckor gammalt hade högre self-efficacy till skillnad från de mödrar som ammade delvis. Skattningen av self-efficacy ökade inom båda grupperna från första till andra mättillfället. Interventionsgruppen skattade sig ha högre self-efficacy än mödrar i kontrollgruppen. Slutsats: Att mäta self-efficacy på BB kan indikera hur amningsförekomsten kommer att föreligga. Interventionen påverkade mödrarnas self-efficacy och förekomsten av exklusiv amning när barnet var fyra veckor. / Background: Women are recommended by the World Health Organization to breastfeed exclusively for six months and partially for two years or beyond. Studies show that breastfeeding has health benefits for both mother and infant. Despite this, the breastfeeding prevalence is declining in Sweden. Advice and support from nurses are important for the breastfeeding prevalence. Studies show that having high self-efficacy in relation to breastfeeding is associated with high prevalence of breastfeeding. Aim: To investigate whether an intervention in the form of evidence-based breastfeeding information can increase maternal self-efficacy in relation to breastfeeding and whether this increased the prevalence of exclusive breastfeeding when the infant was four weeks old. Method: The study was conducted with a quantitative approach and was based on a quasiexperimental before-and-after design with a control group (n=23) and an intervention group (n=27). A consecutive sample was used for the recruitment of mothers, all primiparous. The intervention consisted of an evidence-based breastfeeding brochure and structured verbal information using a flipchart that was given at the postnatal ward. Maternal breastfeeding self-efficacy was measured at the postnatal ward on BB and when the infant was four weeks old using the Breastfeeding Self-Efficacy Score-Short From. Result: Mothers who breastfed exclusively when the baby was four weeks old had higher selfefficacy compared to mothers who breastfed partially. Self-efficacy increased in both groups from the first to the second measurement. The intervention group had higher breastfeeding self-efficacy than mothers in the control group. Conclusion: Measuring maternal breastfeeding of self-efficacy at the postnatal ward can indicate future breastfeeding prevalence. The intervention had an impact on mothers' breastfeeding self-efficacy and the prevalence of exclusive breastfeeding when the baby was four weeks old.

Vital statistics data were statistically analyzed to determine who is breastfeeding in central Kentucky and if factors differ between those in a WIC and non-WIC population. The sample consisted of 479 postpartum women aged 18-44 in central Kentucky. Participants in the study were analyzed as a whole, then divided by their participation in the WIC program (n=304) or non-participation in the WIC program (n=175). Variables recorded in the vital statistics form were analyzed. These variables included age, education level, marital status, and ethnicity of the mother, household income status, and gender, gestational age, and birth weight of the infant. In the population studied, education level, ethnicity, marital status, household income status, and gestational age of the infant were significantly different between mothers who initiated breastfeeding and those who did not. In the WIC population, mothers were more likely to initiate breastfeeding if they were of non-white ethnicity or if the infant was born at greater than 37 weeks gestation; whereas, in the non-WIC population, mothers were more likely to initiate breastfeeding if they had some college or a college degree or if they were not enrolled in Medicaid. WIC participants were significantly less likely to initiate breastfeeding than non-WIC participants.

Abstract Background The National Health and Medical Research Council and the Royal Australian College of General Practitioners recommend exclusive breastfeeding for the first six months of an infant’s life and continued breastfeeding with the addition of appropriate complementary food until at least 12 months. While most Australian women initiate breastfeeding, many wean earlier than recommended due to breastfeeding difficulties. As most women consult their GP frequently in the first six months postpartum, GPs are in an ideal position to provide encouragement, evidence-based information and advice that breastfeeding women need. In addition, women are more likely to initiate and continue to breastfeed if their doctor supports and encourages them to do so. The limited Australian data available question whether GPs have the skills to be able to effectively assist breastfeeding women, although no research has specifically addressed the breastfeeding knowledge or attitudes of Australian GPs. Additionally, there are no data detailing the breastfeeding training available to medical students, GP registrars or GPs. Aim This study aimed to identify the breastfeeding educational needs of Australian GP registrars and to develop a relevant and applicable breastfeeding educational resource within the context of these identified needs. Research design Triangulation methodology, using more than one data source and qualitative and quantitative data-collection methods, was chosen for this study to give a richer, more inclusive and wider reaching understanding of the issues involved than could be obtained by using one method alone. Therefore, to meet the aims of the study, a three phase mixed-method project with triangulation of data was designed. Phase 1 had three distinct data-collection arms: a quantitative survey of medical school curricula; focus groups with medical students from two Queensland medical schools; and interviews with eight GP registrars. Data from Phase 1 provided information about breastfeeding attitudes, knowledge needs and learning opportunities, and informed the development of a questionnaire sent to final-year GP registrars Australia-wide (Phase 2). The aim of this phase was to ascertain the GP registrars’ breastfeeding attitudes and knowledge gaps. Phase 3 used the outcomes of Phases 1 and 2 to design an educational resource that would meet the needs of GP registrars. Results Breastfeeding was included in the curricula of most of the Australian medical schools surveyed (n = 10). Many medical schools relied on contact between the student and patients to provide clinical experience and practical knowledge. Medical students and GP registrars reported marked variability in breastfeeding learning opportunities. Although both groups had positive breastfeeding attitudes, participants had differing opinions regarding doctors’ involvement in infant feeding decisions and the type of support and information offered to women. Overall, the breastfeeding attitudes of the 161 GP registrars who returned the questionnaire were positive (mean 3.99, 1 = least positive, 5 = most positive). However, while the mean breastfeeding knowledge score was 3.40, (1 = minimum score, 5 = maximum score) 40 percent of the knowledge items were incorrectly answered by more than half the cohort. Approximately 40 percent of the registrars were confident and thought they were effective assisting breastfeeding women. Nevertheless, only 23 percent thought they had had sufficient breastfeeding training. Registrars who thought their previous training was inadequate had lower knowledge scores, were less confident and perceived that they were less effective than the remainder of the cohort. A new finding from this study was that Australian-born registrars had more positive breastfeeding attitudes and higher knowledge scores than their overseas-born counterparts. In addition, while parents with more than 26 weeks’ personal breastfeeding experience (self or partner) had more positive breastfeeding attitudes and higher breastfeeding knowledge, confidence and perceived effectiveness scores, parents with less experience had less positive attitudes and poorer knowledge than non-parent participants. Similar to previous studies, gender had no effect on breastfeeding knowledge or attitudes. Using adult learning principles, a five-session, case-based breastfeeding educational resource addressing the knowledge deficits identified in the previous phases of the study was developed. Evaluation activities before and after each session, as well as exercises designed for reflection and critical thinking, were an integral part of the resource. Conclusion This study found that the breastfeeding training of Australian medical students and GP registrars was inadequate and, regardless of their positive breastfeeding attitudes, resulted in registrars being ill-prepared to assist breastfeeding women. Based on the training needs identified in the study and in the literature, an educational resource was developed that presented information within real-life case-based scenarios. Additional background information provided logic and rationale for diagnosis, management and treatment. While the implementation of the resource is outside the scope of this thesis (but will be the focus of post-doctoral work), it is believed that the resource has the potential to provide GP registrars with training opportunities to improve their breastfeeding knowledge and skills, thus better meeting the needs of breastfeeding women.

Bakgrund: Helamning är när det nyfödda barnet enbart får bröstmjölk, vitaminer och läkemedel vilket rekommenderas i 6 månader till alla världens mödrar. Amning har många positiva fördelar för både barnet och modern. När amningen inte fungerar bidrar det ofta till negativa känslor av skuld, oro och misslyckande. För att hjälpa mödrarna att få amningen att fungera bedrivs amningsstöd av vårdpersonalen på olika sätt. Amningsstöd beskrivs som en blandning av praktisk hjälp, information och psykiskt stöd. Det har visats att amningsstöd både ökar durationen av helamning och mödrarnas tro på den egna förmågan. Syfte: Syftet är att studera hur amningsstöd upplevs av nyblivna mödrar. Metod: En litteraturstudie baserad på 16 vetenskapliga studier med kvalitativ ansats. De databaser som användes var CINAHL, PubMed och SveMed. Resultat: Utifrån de inkluderade studiernas resultat framkom det att mödrarnas upplevelser av amningsstöd kunde delas in i positiva och negativa upplevelser. De positiva upplevelserna hade att göra med bemötande, ageranden och social miljö som upplevdes stödjande, samt ett adekvat praktiskt stöd och uppföljning efter hemgång. Bekräftelse, uppmuntran, praktiska tips och ett individuellt utformat amningsstöd värderades högt av många mödrar. De negativa upplevelserna handlade om bemötande, information, praktiskt- och känslomässigt stöd som upplevts bristande, samt otillräcklig tid. Motstridiga råd, ett kallt bemötande och för lite tid med personalen var några faktorer som bidrog till en negativ upplevelse. Slutsats: När amningsstödet resulterade i att mödrarna kände sig bekräftade, bra bemötta och bidrog med praktisk kunskap upplevdes det positivt. Amningsstöd som istället bidrog till förvirring och känslor av att inte vara prioriterad eller unik som individ upplevdes som negativt. Resultaten från denna studie kan bidra till utveckling av ett personcentrerat amningsstöd. / Background: Exclusive breastfeeding is when the newborn baby receives only breastmilk, vitamins and medicine in terms of nutrition. This is what is recommended globally, to all women the first six months of their baby’s life. Breastfeeding comes with multiple benefits for both the baby and the mother. Encountering breastfeeding difficulties often results in negative emotions such as guilt, worry and failure. To help these mothers towards successful breastfeeding, different kinds of breastfeeding support are used by health care professionals. Breastfeeding support is described as a mixture of practical help, information and psychological support. Research has shown that breastfeeding support increases both the duration of exclusive breastfeeding and the mothers faith in their own ability to breastfeed. Aim: To study the experiences of new mothers concerning breastfeeding support. Method: A literature review based on sixteen scientific articles with qualitative inquiry. The databases used were CINAHL, PubMed and SveMed. Results: The results of the included articles on the experiences of breastfeeding support could be divided into positive and negative experiences. The positive experiences were related to how the health care workers treated them, acted and the social environment. Also fulfilling practical support and follow-up was considered positive. Factors greatly valued were confirmation, encouragement, practical tips and follow-up after leaving the hospital. The negative experiences described themes of attitudes, information, time and also practical- and emotional support that were all lacking. Factors contributing to negative experiences were conflicting advice, harsh attitudes and not enough time with the health care professionals.   Conclusion: It was received as positive experiences when the breastfeeding support resulted in feelings of confirmation, being well treated and given the practical knowledge the mothers needed. When the support instead resulted in confusion and feelings of not being a priority or a unique individual it became a negative experience. The results of this study can be a foundation for the development of breastfeeding support focusing on every unique mother.

Prior research has shown that African Americans are less likely than are Hispanics and Whites to breastfeed their children. Compounding this problem is the scarcity of research that examines African American's culture, perceptions, and beliefs about breastfeeding. This study was conducted to gain a greater understanding of the phenomenon of breastfeeding through the perspectives of African American mothers. Guided by the theories of reasoned action and planned behavior, this ethnographic study elicited African American mothers' perspectives on breastfeeding by examining what influenced their decision to breastfeed or not. This study took place in Washington State. Ten women recruited through purposeful sampling took part in the study. Data were largely collected through interviews utilizing open-ended semi-structured questions, which were used as the level-1 priori codes for data analysis. Inductive codes were developed from additional information provided by subjects during interviews. Sublevels were developed as needed. Codes with 2 or more responses from subjects were utilized in the analysis. Findings were based on the data and solely on the experiences and information shared by the subjects. The findings revealed that, among this sample of women, breastfeeding figured prominently in the African American culture. Most participants indicated they would breastfeed regardless of any support. Barriers to breastfeeding included the stigma that only the poor breastfeed, perceived inconsistency in information and assistance provided by health care personnel to African Americans as compared to other groups, and mothers not being aware of available resources. These results can be used to enhance social change initiatives, laws, and policies on breastfeeding for African Americans.

No description available.

Introdução-O aleitamento materno promove vantagens para a criança, mulher e sociedade. Entretanto as taxas de amamentação, principalmente o aleitamento materno exclusivo estão abaixo dos níveis desejados em diversos países. A identificação dos determinantes da interrupção precoce e a quantificação da interação destes fatores é crucial para estabelecer, avaliar e promover políticas públicas em prol das práticas de amamentação. Objetivo-Estimar os efeitos dos fatores associados à prevalência do aleitamento materno exclusivo, predominante e continuado no primeiro e segundo anos de vida em países da América Latina e Caribe no período de 2000 a 2016. Métodos-Foram utilizados microdados coletados no projeto Monitoring and Evaluation to Assess and Use Results Demographic and Health Survey. Para complementar as informações foram recolhidos dados agregados do World Bank. Os indicadores analisados foram aleitamento materno exclusivo (AME), aleitamento materno predominante (AMP) e aleitamento materno continuado (AMC) no primeiro e segundo anos de vida; os valores foram expressos em prevalência e estratificados por quintos de riqueza. Selecionou-se o último inquérito disponível de cada país da América Latina e Caribe com dados entre os anos de 2000 e 2016. As variáveis foram selecionadas segundo disponibilidade e enquadramento no modelo conceitual proposto por ROLLINS et al. (2016). O modelo utilizado no estudo foi elegido após análise com Regressão de Poisson e, posteriormente, foi realizada análise logística multinível de efeitos mistos para quantificar o efeito de cada determinante do efeito fixo ajustado pelo efeito randômico. Resultados-A variação das prevalências dos indicadores foi de 7,4% a 60,3% no AME, 13,9% a 71% no AMP, 35,0% a 86,6%no AMC no primeiro ano e 18,9% a 55,0% no AMC no segundo ano de vida. Bolívia e Guatemala se destacam por apresentar as maiores taxas de AME, 60,3% e 54,2%, respectivamente. Os países apresentaram maior prevalência dos indicadores nos quintos inferiores de renda, destacando-se as associações do padrão de aumento da magnitude do efeito negativo à medida que o quinto de renda aumenta. O AME e AMP se associaram diretamente à \"amamentação na primeira hora\", \"estado conjugal\" e \"queria o último filho; \"idade materna\" e \"status de trabalho\" se associaram inversamente aos indicadores AMC no 1º e 2º anos de vida. Na análise de efeitos mistos, os indicadores AME e AMP se associaram diretamente a \"amamentação na primeira hora\" e \"estado conjugal\" e inversamente às variáveis \"local do parto\" e \"status de trabalho\". A escolaridade materna apresentou associação inversa com os indicadores AMP, AMC no 1º e 2º anos de vida e o quinto de riqueza apresentou associação inversa com todos os indicadores estudados. O AME apresenta maior variância explicada pelo nível individual, enquanto o AMC no 2º ano de vida sofre grande influência pelo nível contextual (8,99e-15% e 69,7%, respectivamente). Conclusão-As variáveis relacionadas ao indivíduo foram as que melhor explicaram a variância do modelo para o AME, AMP e AMC no 1º ano de vida. As variáveis relacionadas ao contexto explicam maior variabilidade da prevalência do AMC no 2º ano de vida, exibindo a maior interferência do PIB e de influências de âmbito nacional. / Introduction-Breastfeeding promotes benefits for the child, woman and society. However, breastfeeding rates, especially exclusive breastfeeding, are below desired levels in many countries. The identification of the determinants of the interruption precociated and the quantification of interaction factors are crucial to establish, evaluate and promote public policies in breastfeeding practices. Objective-Estimate the effects of factors associated with the prevalence of exclusive, predominant and continued breastfeeding in the first and second years of life in Latin American and Caribbean countries from 2000 to 2016.Methods- We used microdata collected in the project Monitoring and Evaluation to Assess and Use Results Demographic and Health Survey. In addition to the information, aggregated World Bank data was collected. The indicators analyzed were exclusive breastfeeding (EB), predominant breastfeeding (PB) and continuous breastfeeding (CB) in the first and second years of life; the values were expressed in prevalence and stratified by quintiles of wealth. The last available survey of each Latin American and Caribbean country with data between the years 2000 and 2016 was selected. The variables were selected according to availability and framing in the conceptual model proposed by ROLLINS et. al. (2016). The model used in the study was chosen after analysis with Poisson Regression and later, multi-level mixed-effects logistic analysis was performed to quantify the effect of each determinant of the fixed effect adjusted by the random effect. Results- The prevalence of indicators ranged from 7.4% to 60.3% EB, 13.9% to 71% in PB, 35.0% to 86.6% in CB in the first year, and 18.9% to 55.0% in CB in the second year of life. Bolivia and Guatemala stand out for having the highest rates of EB, 60.3% and 54.2%, respectively. The countries presented a higher prevalence of indicators in the lower quintiles of income, especially the associations of the pattern of increase of the magnitude of the negative effect as the fifth of income increases. EB and PB were directly associated with \"first-time breastfeeding\", \"marital status\" and \"wanted the last child; \"maternal age\" and \"work status\" were inversely associated with the CB indicators in the 1st and 2nd years of life. In the mixed effects analysis, the EB and PB indicators were directly associated with \"first-hour breastfeeding\" and \"marital status\" and inversely to the variables \"place of birth\" and \"work status\".The maternal schooling presented an inverse association with the PB, CB indicators in the 1st and 2nd years of life, and the fifth of the wealth had an inverse association with all the indicators studied. The EB shows greater variance explained by the individual level, while the CB in the second year of life suffers great influence at the contextual level (8.99e-15% and 69.7%, respectively). Conclusion- The variables related to the individual were the ones that best explained the variance of the model for EB, PB and CB in the 1st year of life. The variables related to the context explain a greater variability of the prevalence of CB in the second year of life, showing the greater interference of GDP and national influences.

p. 1-120 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-10T18:36:17Z No. of bitstreams: 2 Dissertacao Parte 2.pdf: 24236499 bytes, checksum: ea4dc30b6d1b6861420cba0654e71d2f (MD5) Dissertacao Parte 1.pdf: 3026671 bytes, checksum: a678bf690c74eac913070db10fcebe43 (MD5) / Approved for entry into archive by Rodrigo Meirelles(rodrigomei@ufba.br) on 2013-04-13T20:15:57Z (GMT) No. of bitstreams: 2 Dissertacao Parte 2.pdf: 24236499 bytes, checksum: ea4dc30b6d1b6861420cba0654e71d2f (MD5) Dissertacao Parte 1.pdf: 3026671 bytes, checksum: a678bf690c74eac913070db10fcebe43 (MD5) / Made available in DSpace on 2013-04-13T20:15:57Z (GMT). No. of bitstreams: 2 Dissertacao Parte 2.pdf: 24236499 bytes, checksum: ea4dc30b6d1b6861420cba0654e71d2f (MD5) Dissertacao Parte 1.pdf: 3026671 bytes, checksum: a678bf690c74eac913070db10fcebe43 (MD5) Previous issue date: 2010 / Este estudo objetivou identificar a duração mediana do aleitamento materno e os fatores associados. Envolveu uma coorte de 532 crianças de dois municípios do Recôncavo da Bahia. Utilizou-se a análise de sobrevivência para estimar a duração do aleitamento e o modelo multivariado de Cox para identificar as associações. A duração mediana foi de 74,73, 211,25 e 432,63 dias, respectivamente, para o aleitamento materno exclusivo, misto complementado e total. A ausência materna ao pré-natal elevou em 167% (HR=2,67; IC95%=1,85-3,83) o risco da diminuição da duração do aleitamento materno exclusivo, em 82% (HR=1,82; IC95%=1,06-3,16) o risco da adoção do aleitamento misto complementado e em 38% (HR=1,38; IC95%=1,06-1,81) o risco da descontinuidade do aleitamento materno total. O trabalho materno fora do domicílio e a área de residência urbana aumentaram o risco da interrupção precoce do aleitamento materno. A ampliação do acesso ao pré-natal e da rede de proteção às mães que trabalham fora e residem na área urbana poderiam aumentar a duração do aleitamento materno no Recôncavo da Bahia. / Salvador