The effect of risk at birth on breastfeeding duration and exclusivity: A cohort study at a Brazilian referral center for high-risk neonates and infants.

<h4>Background and aim</h4>Both breastfeeding and the use of human milk are strategies that provide better conformation to health throughout an individual's life and bring countless short- and long- term benefits, which are well established in the scientific literature. For at-risk...

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Autores principales:	Maíra Domingues Bernardes Silva, Raquel de Vasconcellos Carvalhaes de Oliveira, Davi da Silveira Barroso Alves, Enirtes Caetano Prates Melo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b0ae2193d225444bb90cc414d56bf8b8
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spelling	oai:doaj.org-article:b0ae2193d225444bb90cc414d56bf8b82021-12-02T20:15:09ZThe effect of risk at birth on breastfeeding duration and exclusivity: A cohort study at a Brazilian referral center for high-risk neonates and infants.1932-620310.1371/journal.pone.0255190https://doaj.org/article/b0ae2193d225444bb90cc414d56bf8b82021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255190https://doaj.org/toc/1932-6203<h4>Background and aim</h4>Both breastfeeding and the use of human milk are strategies that provide better conformation to health throughout an individual's life and bring countless short- and long- term benefits, which are well established in the scientific literature. For at-risk newborns (NBs), these strategies are crucial interventions to enable neonatal survival with better quality of life due to the distinctive and complex composition of human milk, which serves as personalized food-medicine-protection. However, there is limited knowledge about breastfeeding practices in high-risk NBs. The aim was to estimate the duration of EBF and to investigate the effect of risk at birth on EBF discontinuity in the first six months of life'.<h4>Methods</h4>This cohort study included 1,003 NBs from a high-risk referral center, followed up from birth to the sixth month of life, between 2017 and 2018. Correspondence and cluster analysis was used to identify neonatal risk clusters as the main exposure. The object of interest was the time until EBF discontinuity. The Kaplan-Meier methods and the Cox proportional hazards model were used to estimate the hazard ratio and 95% confidence intervals.<h4>Results</h4>The prevalence and median duration of EBF decreased proportionally in the three groups. The multiple model revealed a gradient in EBF discontinuity, which was 40% higher in risk group 1 and 111% higher in risk group 2 compared to healthy full-term NBs. Additionally, EBF during hospitalization predicted a longer median duration of this practice for high-risk NBs.<h4>Conclusion</h4>This study confirms a high proportion of high-risk NBs who have EBF discontinued before six months of life. The risk of EBF discontinuity is higher in risk groups, with a gradual effect even when adjusted by several factors. Effective interventions are needed to promote, protect, and support breastfeeding in different profiles of risk-at-birth groups.Maíra Domingues Bernardes SilvaRaquel de Vasconcellos Carvalhaes de OliveiraDavi da Silveira Barroso AlvesEnirtes Caetano Prates MeloPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255190 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Maíra Domingues Bernardes Silva Raquel de Vasconcellos Carvalhaes de Oliveira Davi da Silveira Barroso Alves Enirtes Caetano Prates Melo The effect of risk at birth on breastfeeding duration and exclusivity: A cohort study at a Brazilian referral center for high-risk neonates and infants.
description	<h4>Background and aim</h4>Both breastfeeding and the use of human milk are strategies that provide better conformation to health throughout an individual's life and bring countless short- and long- term benefits, which are well established in the scientific literature. For at-risk newborns (NBs), these strategies are crucial interventions to enable neonatal survival with better quality of life due to the distinctive and complex composition of human milk, which serves as personalized food-medicine-protection. However, there is limited knowledge about breastfeeding practices in high-risk NBs. The aim was to estimate the duration of EBF and to investigate the effect of risk at birth on EBF discontinuity in the first six months of life'.<h4>Methods</h4>This cohort study included 1,003 NBs from a high-risk referral center, followed up from birth to the sixth month of life, between 2017 and 2018. Correspondence and cluster analysis was used to identify neonatal risk clusters as the main exposure. The object of interest was the time until EBF discontinuity. The Kaplan-Meier methods and the Cox proportional hazards model were used to estimate the hazard ratio and 95% confidence intervals.<h4>Results</h4>The prevalence and median duration of EBF decreased proportionally in the three groups. The multiple model revealed a gradient in EBF discontinuity, which was 40% higher in risk group 1 and 111% higher in risk group 2 compared to healthy full-term NBs. Additionally, EBF during hospitalization predicted a longer median duration of this practice for high-risk NBs.<h4>Conclusion</h4>This study confirms a high proportion of high-risk NBs who have EBF discontinued before six months of life. The risk of EBF discontinuity is higher in risk groups, with a gradual effect even when adjusted by several factors. Effective interventions are needed to promote, protect, and support breastfeeding in different profiles of risk-at-birth groups.
format	article
author	Maíra Domingues Bernardes Silva Raquel de Vasconcellos Carvalhaes de Oliveira Davi da Silveira Barroso Alves Enirtes Caetano Prates Melo
author_facet	Maíra Domingues Bernardes Silva Raquel de Vasconcellos Carvalhaes de Oliveira Davi da Silveira Barroso Alves Enirtes Caetano Prates Melo
author_sort	Maíra Domingues Bernardes Silva
title	The effect of risk at birth on breastfeeding duration and exclusivity: A cohort study at a Brazilian referral center for high-risk neonates and infants.
title_short	The effect of risk at birth on breastfeeding duration and exclusivity: A cohort study at a Brazilian referral center for high-risk neonates and infants.
title_full	The effect of risk at birth on breastfeeding duration and exclusivity: A cohort study at a Brazilian referral center for high-risk neonates and infants.
title_fullStr	The effect of risk at birth on breastfeeding duration and exclusivity: A cohort study at a Brazilian referral center for high-risk neonates and infants.
title_full_unstemmed	The effect of risk at birth on breastfeeding duration and exclusivity: A cohort study at a Brazilian referral center for high-risk neonates and infants.
title_sort	effect of risk at birth on breastfeeding duration and exclusivity: a cohort study at a brazilian referral center for high-risk neonates and infants.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/b0ae2193d225444bb90cc414d56bf8b8
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The effect of risk at birth on breastfeeding duration and exclusivity: A cohort study at a Brazilian referral center for high-risk neonates and infants.

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