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. 2023 Sep;8(9):e012529.
doi: 10.1136/bmjgh-2023-012529.

Trends of breastfeeding indicators in Brazil from 1996 to 2019 and the gaps to achieve the WHO/UNICEF 2030 targets

Cristiano Siqueira Boccolini  1 , Elisa Maria de Aquino Lacerda  2 , Neilane Bertoni  3 , Natália Oliveira  4 , Nadya Helena Alves-Santos  5 , Dayana Rodrigues Farias  4 , Sandra Patricia Crispim  6 , Leticia Barroso Vertulli Carneiro  7 , Raquel Machado Schincaglia  4 , Elsa Regina Justo Giugliani  8 , Inês Rugani Ribeiro de Castro  9 , Gilberto Kac  10
Affiliations

Trends of breastfeeding indicators in Brazil from 1996 to 2019 and the gaps to achieve the WHO/UNICEF 2030 targets

Cristiano Siqueira Boccolini et al. BMJ Glob Health. 2023 Sep.

Abstract

Background: The comprehension of breastfeeding patterns and trends through comparable indicators is essential to plan and implement public health policies.

Objective: To evaluate the trends of breastfeeding indicators in Brazil from 1996 to 2019 and estimate the gap to achieve the WHO/UNICEF 2030 targets in children under 5 years.

Methods: Microdata from two National Surveys on Demography and Health of Women and Children (PNDS-1996 and PNDS-2006) and the Brazilian National Survey on Child Nutrition-2019 were used. The indicators of early initiation of breastfeeding (EIBF), exclusive breastfeeding of infants 0-5 months of age (EBF<6 mo), continued breastfeeding at 1 year of age (CBF1yr) and CBF at 2 years of age (CBF2yr) were analysed using prevalence and 95% CI. The average annual variation and years to achieve the WHO/UNICEF 2030 targets were calculated for Brazil and the macroregions. Statistical analyses considered the survey's complex sample design for each database.

Results: EIBF increased from 36.3% (95% CI 33.6% to 39.0%) in 1996 to 60.9% (95% CI 56.5% to 65.3%) in 2006 (statistically significant) and 62.5% (95% CI 58.3% to 66.6%) in 2019. EBF<6 mo increased from 26.9% (95% CI 21.3% to 31.9%) in 1996 to 39.0% (95% CI 31.0% to 47.1%) in 2006 and 45.8% (95% CI 40.9% to 50.7%) in 2019 (significant increases for 1996-2019 for Brazil, Northeast and Midwest regions). CBF1yr rose from 36.6% (95% CI 30.8% to 42.4%) in 1996 to 48.7% (95% CI 38.3% to 59.0%) in 2006, and 52.1% (95% CI 45.4% to 58.9%) in 2019. CBF2yr increased from 24.7% (95% CI 19.5% to 29.9%) in 1996 to 24.6% (95% CI 15.7% to 33.5%) in 2006 and 35.5% (95% CI 30.4% to 40.6%) in 2019 (significant increase for 1996-2019). The South and Southeast regions need to double the 2019 prevalence to reach the target for the CBF1yr and CBF2yr; the Northeast and North need to increase 60% the current prevalence for the indicator of EBF<6 mo.

Conclusion: A substantial improvement in breastfeeding indicators occurred in Brazil from 1996 to 2019, although at an insufficient rate to achieve the WHO/UNICEF 2030 targets.

Keywords: Child health; Nutrition; Public Health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Prevalence of breastfeeding indicators in ENANI-2019, according to Brazilian regions, and the percentage increase needed to achieve WHO/UNICEF 2030 target. CBF1yr, continued breastfeeding at 1 year old (12–15 months old); CBF2yr, continued breastfeeding at 2 years old (20–23 months old); EBF<6 mo, exclusive breastfeeding under 6 months (0-5 months of age); EIBF, early initiation of breastfeeding; ENANI, Brazilian National Survey of Child Nutrition.
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