Determinants of exclusive breast-feeding discontinuation in southeastern Brazil, 2008-2013: a pooled data analysis.

Objective To analyse the determinants of exclusive breast-feeding (EBF) discontinuation in southeastern Brazil between 2008 and 2013. Design Secondary cross-sectional data were analysed from three waves of child feeding surveys conducted in the city of Marilia, Sao Paulo, Brazil, in 2008, 2011 and 2013 (n 1645 children under 6 months). Multivariable Poisson regression models were used to test the association between EBF discontinuation and socio-economic, demographic and biomedical factors in a pooled sample and within each survey wave. Setting Regionally representative cross-sectional survey from Brazil. Participants The analytical sample included 1645 infants under 6 months old. Results In the pooled sample, 40·7 % of the infants were exclusively breastfed. Between 2008 and 2013, there was a significant increase in C-section (35·1-42·7 %) and pacifier use (41·4-48·8 %). The determinants of EBF discontinuation in the pooled analysis were mothers working outside the home (adjusted prevalence ratio (APR) = 1·10; 95 % CI 1·00, 1·21), first-time mothers (APR = 1·10; 95 % CI 1·01, 1·20), pacifier use (APR = 1·48; 95 % CI 1·36, 1·61) and low birth weight (APR = 1·17; 95 % CI 1·05, 1·32). Conclusions Mothers working outside the home, first-time moms, pacifier use and low birth weight were the factors associated with EBF discontinuation. Evidence-based counselling strategies during antenatal and early postpartum care in primary healthcare are needed to address the modifiable determinants of EBF discontinuation and ultimately to improve its rates in southeastern Brazil.