Weaning and associated factors in children from low-income communities

Introduction: The average duration of breastfeeding is still insufficient and differ widely taking in account the location and specific characteristic of local people involved in these studies.Aim: This research aimed at studying factors associated to weaning among South Brazilian children living in a low-income household.Material and method: Cross-sectional study was carried out enrolling 124 mothers of 1 to 12-month-old children, who were interviewed at "Pastoral da Criança" (non-governmental organization) in Almirante Tamandaré, Paraná, Brazil. The risk of weaning considered was the dependent variable and the information collected from the questionnaires, independent variables. The method used to collect information in this study was Kaplan-Meier method and Cox regression model and Spearman's rank correlation (α = 0.05).Result: Actuarial life table presented a higher weaning conditional probability at 12 months of age, followed by first and fourth months of age. Multivariate analysis pointed out that contact with bottle feeding before the sixth month of age [HR=17.16 (2.34-125.86)] and contact with pacifier before the sixth months of age [HR=3.48 (1.90-6.38)] are risk factors associated with weaning. Among children who were not breastfed at the moment of the interview, breastfeeding duration presented a positive correlation with the ages when the children had their first contact with sugar (r s=+0.419, p=0.001) and negative correlation with the use of pacifier (r s=-0.300, p=0.017).Conclusion: Results from this study showed that the use of the feeding bottle and pacifier were related to a shorter breastfeeding time span at these communities.

引言：目前母乳喂养的平均时长仍未达到理想水平，且因研究涉及地区及当地人群的具体特征而存在显著差异。
研究目的：本研究旨在探究巴西南部低收入家庭婴幼儿断奶（weaning）相关的影响因素。
材料与方法：本研究为横断面研究，招募了124名家中养育1至12月龄婴幼儿的母亲，并在巴西巴拉那州阿尔米兰特·塔曼达雷市的"儿童牧养会"（Pastoral da Criança，非政府组织）对其开展访谈。本研究将断奶风险设为因变量，以问卷采集的各项信息作为自变量；数据分析采用Kaplan-Meier法、Cox回归模型及Spearman秩相关分析，检验水准设定为α=0.05。
结果：生命表分析结果显示，婴幼儿在12月龄时的断奶条件概率最高，其次为4月龄与1月龄。多因素分析结果表明，在6月龄前接触奶瓶喂养[风险比（HR，Hazard Ratio）=17.16，95%置信区间：2.34~125.86]及6月龄前接触安抚奶嘴[HR=3.48，95%置信区间：1.90~6.38]均为与断奶相关的危险因素。在访谈时尚未接受母乳喂养的婴幼儿中，母乳喂养时长与首次摄入含糖食物的月龄呈正相关（秩相关系数rs=+0.419，p=0.001），与安抚奶嘴的使用呈负相关（rs=-0.300，p=0.017）。
结论：本研究结果显示，在上述研究群体中，奶瓶与安抚奶嘴的使用与更短的母乳喂养时长存在显著关联。