Sociodemographic, perinatal and behavioral factors associated to types of milk consumed by children under in six months: birth coort

Abstract This study evaluated factors associated with the consumption of breast milk (BM), infant formula (IF) and cow milk (CM) in children. This was a cohort study with 256 children followed-up at the 1st, 4th and 6th month of age in Viçosa (MG), Brazil. With respect to CM and IF, consumption was recorded regardless of BM intake. Regarding BM, only exclusive or predominant consumption was considered. From the 1st to the 6th month, an increase was recorded in the number of children who did not consume BM exclusively or predominantly (31.6%), as well as the consumption of CM (27.2%) and IF (9.3%). BM was associated with pacifier use at 1st month, and mother's employment status and pacifier use in the 4th and 6th month. Pacifier use was a risk factor for IF consumption in every month, while belonging to the lower income group was inversely associated in the 6th month. As for CM, the number of prenatal visits was a risk factor in every month, the mother's employment status and use of pacifier in the 4th month, family income, mother's employment status, low birth weight, number of prenatal visits and pacifier use in the 6th month. Since the 1st month, the introduction of other milk types is high, revealing that there is still much to go to ensure exclusive breastfeeding up to 6 months.

摘要 本研究评估了儿童摄入母乳（BM）、婴儿配方奶（IF）与牛乳（CM）的相关影响因素。本研究为一项队列研究，共纳入256名儿童，在巴西维索萨市（MG）对其分别于出生后第1、4、6月龄开展随访。针对牛乳与婴儿配方奶，其摄入记录无需考虑母乳摄入情况；而对于母乳，则仅统计纯母乳喂养或主要母乳喂养的情形。从第1月龄至第6月龄，未采用纯母乳喂养或主要母乳喂养的儿童人数增幅达31.6%，牛乳摄入儿童人数增幅为27.2%，婴儿配方奶摄入儿童人数增幅为9.3%，三类指标均呈上升态势。母乳摄入与儿童第1月龄的安抚奶嘴使用情况存在关联，同时与母亲就业状态以及第4、6月龄时的儿童安抚奶嘴使用情况相关。各月龄阶段的安抚奶嘴使用均为婴儿配方奶摄入的危险因素，而低收入群体身份则在第6月龄时与婴儿配方奶摄入呈负相关。至于牛乳摄入，产前检查次数在所有月龄阶段均为其危险因素；第4月龄时，母亲就业状态与儿童安抚奶嘴使用同样为相关危险因素；第6月龄时，家庭收入、母亲就业状态、低出生体重、产前检查次数以及儿童安抚奶嘴使用均为其危险因素。自第1月龄起，其他乳类的引入比例较高，这表明实现6月龄以内纯母乳喂养仍任重道远。