Follow-up at basic units

implied a slightly higher prevalence of EBF than follow-up at family health units. The assistance provided by the maternity ward staff to breastfeed, qualified according to the maternal perception, had no significant influence on EBF. Only one quarter of mothers (24.4%) who worked outside the home were exclusively breastfeeding their children, versus half (51.6%) of those who did not work. The prevalence of EBF among infants younger than 3 months was almost twice that observed in those aged between 3 and 6 months. In the multivariate analysis, the highest tertile of performance showed a prevalence of 34% higher EBF (PR = 1.34, 95% CI: 1.24 to 1.44) and a second tertile 17% higher (PR = 1.17 95% CI: http://www.selleckchem.com/products/pci-32765.html 1.08 to 1.27) than the first tertile. Mothers who did not work outside the home presented a higher prevalence of EBF by 75% (PR = 1.75, 95% CI: 1.53 to 2.01), and assistance at basic health units, as opposed to family health units increased the prevalence by 10% (PR = 1.10,

95% CI: 1.03 to 1.19). The prevalence of EBF decreased 1% for each day of the infant’s life (PR = 0.993, 95% CI: 0.992 to 0.993). As there is no monitoring system for the implementation stage of BFPCI, it was necessary to investigate the degree of compliance with the ten steps of this initiative in the primary healthcare network. An intermediate level of BFPCI implementation was observed in the primary health care network in the city of

Rio de Janeiro, after approximately five years since the beginning of the staff training in selleck chemicals the initiative. MEK activation The highest level of implementation of steps 3, 4, and 5 demonstrates that professionals have been advising the patients on the importance of hospital routines that promote breastfeeding at birth,3 and on their rights, promoting EBF for six months and continuing it for two years or more, according to the UNICEF/WHO recommendations.10 It also demonstrates that these guidelines are being provided within a paradigm of counseling,16 where pregnant women and mothers are heard and supported, aiming at strengthening their self-confidence. The change in this approach paradigm may ultimately be reflected in other health care activities, indicating that BFPCI can contribute to the improvement of the dialogue between the health staff and the patients, which is critical for the effectiveness of actions that have been developed. The absence of written rules (step 1), observed in most units, indicates the need for formalization of the practices that have been implemented. When verifying to what extent the advances in the practice to ten steps of the BFPCI were associated with EBF, not only an association was found between the two, but also an increase in this association due to the increase in the degree of adherence to the BFPCI, categorized into tertiles of performance. A similar result was found by Oliveira et al.