Revista Brasileira de Epidemiologia
Print version ISSN 1415-790X
BARROS, Fernando C.; SEMER, Tereza C.; TONIOLI FILHO, Santo and VICTORA, Cesar G.. Evaluating the impact of lactation centers on breastfeeding patterns, morbidity and nutritional status: a cohort study. Rev. bras. epidemiol. [online]. 2002, vol.5, n.1, pp. 5-14. ISSN 1415-790X. http://dx.doi.org/10.1590/S1415-790X2002000100003.
JUSTIFICATION: WHO has financed the creation of lactation centers in the city of Guarujá, São Paulo, Brazil, and has required an evaluation of their impact on breastfeeding patterns, morbidity and growth. OBJECTIVES: To measure the prevalence of breastfeeding, morbidity and nutritional status in a group of children differentiated by attendance to lactation centers. DESIGN: Cohort study from birth to 6 months of life. RESULTS: Of the 605 children recruited in the neonatal period, 54% were subsequently taken to lactation centers, whereas the remaining 46% were not. The first group was exclusively breastfed in a higher proportion than the second, both at 4 months (43% and 18%, respectively) and at 6 months (15% vs. 6%). These differences remained after adjustment for possible confounding factors. In addition, lactation center attendees presented fewer episodes of diarrhea in the two weeks before the interview (10% and 17%, respectively) and their weight according to age was more appropriate (mean z-scores of 0.26 e 0.02, respectively). CONCLUSIONS: although this is not a randomized trial, and there is always the possibility that non-studied intervening variables could account for the differences, it appears that lactation centers improve breastfeeding patterns and reduce morbidity. Lactation centers should be promoted in areas with low prevalence of breastfeeding.
Keywords : Breastfeeding; Human milk; Promotion; Lactation centers; Malnutrition; Diarrhea.