Breastfeeding during the first hour of life and neonatal mortality

Siqueira Boccolini, Cristiano; Lazaro de Carvalho, Márcia; Couto de Oliveira, Maria Inês; Pérez-Escamilla, Rafael

doi:10.1016/j.jpedp.2012.09.002

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Abstract

Objective

To analyze the correlation between breastfeeding in the first hour of life with neonatal mortality rates.

Methods

The present study used secondary data from 67 countries, obtained from the Demographic and Health Surveys. Initially, for data analysis, Spearman Correlation (95% CI) and Kernel graphical analysis were employed, followed by a Negative Binomial Poisson regression model, adjusted for potential confounders.

Results

Breastfeeding within the first hour of life was negatively correlated with neonatal mortality (Spearman's Rho=−0.245, p=0.046), and this correlation was stronger among countries with more than 29 neonatal deaths per 1000 newborns (Spearman's Rho=−0.327, p=0.048). According to the statistical model, countries with the lowest breastfeeding tertiles had 24% higher neonatal mortality rates (Rate ratio=1.24, 95% CI=1.07-1.44, p<0.05), even when adjusted for potential confounders.

Conclusion

The protective effect of breastfeeding during the first hour of life on neonatal mortality in this ecological study is consistent with findings from previous observational studies, indicating the importance of adopting breastfeeding within the first hour as a routine neonatal care practice.

Keywords:

Maternal and child health

Breastfeeding

Child mortality

Epidemiologic measurements

Resumo

Objetivo

Analisar a correlação entre o percentual de amamentação na primeira hora de vida e as taxas de mortalidade neonatal.

Métodos

Foram utilizados dados secundários de 67 países obtidos das pesquisas realizadas com a metodologia do Demographic and Health Surveys. Inicialmente, para a análise dos dados, foram empregadas a Correlação de Spearman (IC 95%) e a análise gráfica com modificação de Kernel, seguidas de regressão de Poisson Binomial Negativa, ajustando para possíveis fatores de confundimento.

Resultados

O percentual de aleitamento materno na primeira hora de vida esteve negativamente associado com as taxas de mortalidade neonatal (Rho=−0,245, p=0,046), e esta correlação foi mais forte entre os países com mortalidade neonatal superior a 29 mortes/1.000 nascidos vivos (Rho = −0,327, p=0,048). Os países com os menores tercis de aleitamento materno na primeira hora de vida tiveram uma taxa 24% maior de mortalidade neonatal (razão de taxa = 1,24, IC 95% = 1,07-1,44), mesmo ajustando para fatores de confundimento.

Conclusão

O efeito protetor da amamentação na primeira hora de vida sobre a mortalidade neonatal encontrado nesse estudo ecológico é consistente com o de estudos observacionais, e aponta para a importância de se adotar a amamentação na primeira hora de vida como prática de atenção neonatal.

Palavras-chave:

Saúde materno- infantil

Aleitamento materno

Mortalidade infantil

Medidas em epidemiologia

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Referências

[1]

World Health Organization, UNICEF. Baby-friendly Hospital Initiative: Revised, updated, and expanded for integrated care. Geneva: World Health Organization; 2009.

[2]

K.M. Edmond, C. Zandoh, M.A. Quigley, S. Amenga-Etego, S. Owusu- Agyei, B.R. Kirkwood.

Delayed breastfeeding initiation increases risk of neonatal mortality.

Pediatrics., 117 (2006), pp. e380-e386

http://dx.doi.org/10.1542/peds.2005-1496 | Medline

[3]

K.M. Edmond, B.R. Kirkwood, S. Amenga-Etego, S. Owusu-Agyei, L.S. Hurt.

Effect of early infant feeding practices on infection- specific neonatal mortality: an investigation of the causal links with observational data from rural Ghana.

Am J Clin Nutr., 86 (2007), pp. 1126-1131

Medline

[4]

R. Albesharat, M.A. Ehrmann, M. Korakli, S. Yazaji, R.F. Vogel.

Phenotypic and genotypic analyses of lactic acid bacteria in local fermented food, breast milk and faeces of mothers and their babies.

Syst Appl Microbiol., 34 (2011), pp. 148-155

http://dx.doi.org/10.1016/j.syapm.2010.12.001 | Medline

[5]

Parm U, Metsvaht T, Sepp E, Ilmoja ML, Pisarev H, Pauskar M, et al. Risk factors associated with gut and nasopharyngeal colonization by common Gram-negative species and yeasts in neonatal intensive care units patients. Early Hum Dev. 2011; 87:391-9.

[6]

C. Castellote, R. Casillas, C. Ramírez-Santana, F.J. Pérez-Cano, M. Castell, M.G. Moretones, et al.

Premature delivery influences the immunological composition of colostrums and transitional and mature human milk.

J Nutr., 141 (2011), pp. 1181-1187

http://dx.doi.org/10.3945/jn.110.133652 | Medline

[7]

Araújo ED, Carbonare SB, de Araújo MC, Palmeira P, Amaral JA, Sales VS. Total and specific IgA in colostrum and milk of mothers of Natal –Rio Grande do Norte, Brasil. Acta Cir Bras. 2005;20: 178-84.

[8]

J.E. Lawn, S. Cousens, J. Zupan.

Lancet Neonatal Survival Steering Team 4 million neonatal deaths: when?. Where?. Why?.

Lancet., 365 (2005), pp. 891-900

http://dx.doi.org/10.1016/S0140-6736(05)71048-5 | Medline

[9]

S. Horton, T. Sanghvi, M. Phillips, J. Fiedler, R. Perez-Escamilla, C. Lutter, et al.

Breastfeeding promotion and priority setting in health.

Health Policy Plan., 11 (1996), pp. 156-168

Medline

[10]

MEASURE DHS STATcompiler [acessado em 21 Nov 2011]. Disponível em: http://www.statcompiler.com.

[11]

Brasil. Ministério da Saúde. Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS) [acessado em 12 Set 2012]. Disponível em: http://bvsms.saude.gov.br/bvs/pnds/index.php.

[12]

Sheather SJ, Jones MC. A reliable data-based bandwidth selection method for Kernel Density Estimation. J R Stat Soc Series B Stat Methodol. 1991;53:683-90.

[13]

Breslow N. A generalized Kruskal-Wallis test for comparing K samples subject to unequal patterns of censorship. Biometrika. 1970;57:579-94.

[14]

Rodríguez G. Generalized linear models. Lecture notes [acessado em 1 Mai 2010]. Disponível em: http://data. princeton.edu/wws509/notes/.

[15]

Fox J. An R and S-Plus Companion to Applied Regression. Thousand Oaks, CA: Sage Publications; 2002.

[16]

Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;375:1969-87.

[17]

Garcia CR, Mullany LC, Rahmathullah L, Katz J, Thulasiraj RD, Sheeladevi S, et al. Breast-feeding initiation time and neonatal mortality risk among newborns in South India. J Perinatol. 2011;31:397-403.

[18]

Mullany LC, Katz J, Li YM, Khatry SK, LeClerq SC, Darmstadt GL, et al. Breast-feeding patterns, time to initiation, and mortality risk among newborns in southern Nepal. J Nutr. 2008;138:599-603.

[19]

Boccolini CS, Carvalho ML, Oliveira MI, Vasconcellos AG. Factors associated with breastfeeding in the first hour of life. Rev Saúde Pública. 2011;45:69-78.

[20]

Pérez-Escamilla R, Vianna RP. Breastfeeding and infant pneumonia in Brazil: the value of electronic surveillance information systems. J Pediatr (Rio J). 2011;87:371-2.

[21]

C.S. Boccolini, M.L. Carvalho, M.I. Oliveira, M. Boccolini Pde.

Breastfeeding can prevent hospitalization for pneumonia among children under 1 year old.

J Pediatr (Rio J)., 87 (2011), pp. 399-404

[22]

S. Schwartz.

The fallacy of the ecological fallacy: the potential misuse of a concept and the consequences.

Am J Public Health., 84 (1994), pp. 819-824

Medline

[23]

C.G. Victora, E.M. Aquino, M. do Carmo Leal, C.A. Monteiro, F.C. Barros, C.L. Szwarcwald.

Maternal and child health in Brazil: progress and challenges.

Lancet., 377 (2011), pp. 1863-1876

http://dx.doi.org/10.1016/S0140-6736(11)60138-4 | Medline

[24]

N.E. Adler, T. Boyce, M.A. Chesney, S. Cohen, S. Folkman, R.L. Kahn, et al.

Socioeconomic status and health. The challenge of the gradient.

Am Psychol, 49 (1994), pp. 15-24

Medline

[25]

Huffman SL, Zehner ER, Victora C. Can improvements in breast- feeding practices reduce neonatal mortality in developing countries? Midwifery. 2001;17:80-92.

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Como citar este artigo: Boccolini CS, de Carvalho ML, de Oliveira MI, Pérez-Escamilla R. Breastfeeding during the first hour of life and neonatal mortality. J Pediatr (Rio J). 2013;89:131−6.

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