# Factors associated with exclusive breastfeeding in “Near Miss” neonates in Brazil

## TL;DR

The study explores factors influencing exclusive breastfeeding in Brazilian neonates who nearly died, finding links to maternal education and hospital practices.

## Contribution

The study identifies specific sociodemographic and hospital practice factors associated with exclusive breastfeeding in near-miss neonates in Brazil.

## Key findings

- Mothers with incomplete primary education were more likely to breastfeed exclusively at hospital discharge.
- Hospital practices like joint accommodation and newborns being in the delivery room increased exclusive breastfeeding rates.
- Primiparous mothers were more likely to continue exclusive breastfeeding 45 days post-delivery.

## Abstract

To assess the association between sociodemographic and perinatal factors and hospital practices to encourage exclusive breastfeeding in near miss neonates in maternity hospitals.

This is a prospective cohort of live births from the survey “To be born in Brazil” conducted between 2011 and 2012. The weighted number of newborns who met the neonatal near miss criteria was 832. Exclusive breastfeeding at hospital discharge and 45 days after delivery were dependent variables of the study. The sociodemographic and perinatal factors of the puerperal women and hospital practices to encourage breastfeeding were independent variables. The data were analyzed with Poisson regression and set with p value<0.05. Is exclusive breastfeeding in neonatal near misses associated with factors related to sociodemographic conditions, maternal characteristics and the organization of health services?

Data from 498 women and their children were analyzed. Mothers with incomplete primary education were more likely (36%) to have exclusive breastfeeding (RR: 1.36; 95% CI: 1.06-1.74) at discharge. Women who did not offer the breast to the newborn in the joint accommodation (65%) were less likely to be breastfeeding exclusively (RR: 0.65; 95% CI: 0.56-0.75) at discharge. Variables that increased the probability of exclusive breastfeeding after 45 days of delivery were primiparity (RR: 1.36; 95% CI: 1.08-1.69) and having the newborn in the delivery room (RR: 1.90; 95% CI: 1.12-3.24).

Exclusive breastfeeding in neonatal near misses was associated with maternal characteristics and important hospital practices, such as being breastfed in the joint accommodation and the newborn being in the mother’s lap in the delivery room.