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Clinical Trial
. 2000 Nov 9;118(6):185-91.
doi: 10.1590/s1516-31802000000600007.

Breastfeeding training for health professionals and resultant changes in breastfeeding duration

J A Taddei  1 , M F Westphal, S Venancio, C Bogus, S Souza
Affiliations
Clinical Trial

Breastfeeding training for health professionals and resultant changes in breastfeeding duration

J A Taddei et al. Sao Paulo Med J. .

Abstract
in English, Portuguese

Context: Promotion of breastfeeding in Brazilian maternity hospitals.

Objective: To quantify changes in the breastfeeding duration among mothers served by hospitals exposed to the Wellstart-SLC course, comparing them with changes among mothers attended by institutions not exposed to this course.

Design: Randomized Institutional Trial.

Setting: The effects of training on breastfeeding duration was assessed in eight Brazilian hospitals assigned at random to either an exposed group (staff attending the Wellstart-SLC course) or a control group.

Sample: For each of the eight study hospitals, two cohorts of about 50 children were visited at home at one and six months after birth. The first cohort (n = 494) was composed of babies born in the month prior to exposure to the Wellstart-SLC course, and the second cohort (n = 476) was composed of babies born six months subsequent to this exposure.

Main measurements: Kaplan-Meier curves were plotted to describe the weaning process and log-rank tests were used to assess statistical differences among survival curves. Hazard ratio (HR) estimates were calculated by fitting Cox proportional hazard regression models to the data.

Results: The increases in estimated, adjusted rates for children born in hospitals with trained personnel were 29% (HR = 0.71) and 20% (HR = 0.80) for exclusive and full breastfeeding, respectively. No changes were identified for total breastfeeding.

Conclusion: This randomized trial supports a growing body of evidence that training hospital health professionals in breastfeeding promotion and protection results in an increase in breastfeeding duration.

CONTEXTO:: Promoção do aleitamento materno em maternidades brasileiras.

OBJETIVO:: Quantificar mudanças na duração do aleitamento materno de mães assistidas em maternidades expostas ao curso Wellstart-SLC, comparando-as com mudanças em mães assistidas por maternidades não expostas.

TIPO DE ESTUDO:: Ensaio institucional randomizado.

LOCAL:: Os efeitos do treinamento na duração do aleitamento materno foi avaliado em oito maternidades randomicamente alocadas ao grupo exposto (equipe freqüenta o curso Wellstart-SLC) ou controle.

AMOSTRA:: Em cada uma das oito maternidades, duas coortes de cerca de 50 crianças foram visitadas em suas casas ao completarem um e seis meses de vida. As primeiras coortes (n = 494) foram compostas de bebês nascidos no mês anterior ao treinamento, enquanto que as segundas coortes (n = 476) foram compostas por bebês nascidos seis meses após a exposição ao curso Weelstart-SLC.

VARIÁVEIS ESTUDADAS:: Para descrever o processo de desmame foram traçadas curvas de Kaplan-Meier. Para avaliar as diferenças estatísticas entre as curvas de sobrevivência foi utilizado o teste "logrank". Foram calculadas estimativas das razões de risco(HR) ajustando modelos de regressão de riscos proporcionais de Cox aos dados.

RESULTADOS:: O aumento estimado, a partir das razões ajustadas para crianças nascidas em hospitais com pessoal treinado, foi 29% (HR = 0,71) e 20% (HR = 0,80) para aleitamento exclusivo e pleno respectivamente. Não foram identificadas mudanças para o tempo de aleitamento total.

CONCLUSÕES:: Esse ensaio randomizado confirma evidências crescentes de que treinar profissionais de saúde em hospitais, na promoção e proteção do aleitamento materno, resulta em aumento do tempo de aleitamento materno.

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Conflict of interest statement

Conflict of interest: Not declared

Figures

Figure 1
Figure 1. Adjusted* Kaplan-Meier survival curves for breastfeeding duration components (exclusive, full and total), comparing before and after groups for exposed hospitals. *adjusted for hospital of birth, mother's age (≤ 19 and > 19 years), parity (primiparae and others), kind of delivery (normal and others), birth weight (< and ≥ 2500 g) and sex.
Figure 2
Figure 2. Adjusted* Kaplan-Meier survival curves for breastfeeding duration components (exclusive, full and total), comparing before and after groups for control hospitals. *adjusted for hospital of birth, mother's age (≤ 19 and >19 years), parity (primiparae and others), kind of delivery (normal and others), birth weight (< and ≥ 2500g) and sex.
See this image and copyright information in PMC

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