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PLoS One. 2018 Dec 19;13(12):e0208261. doi: 10.1371/journal.pone.0208261. eCollection 2018.

Exclusive breastfeeding changes in Brazil attributable to pacifier use.

Author information

1
Departament of Nutrition, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
2
Departament of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America.
3
Department of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
4
Department of Director, Instituto de Saúde, São Paulo, São Paulo, Brazil.

Abstract

BACKGROUND:

Identifying key interventions to increase exclusive breastfeeding duration has been a challenge. Pacifier use has been associated with exclusive breastfeeding discontinuation in Brazil. However, the proportion of the improvement in exclusive breastfeeding duration attributable to pacifier use remains unknown.

RESEARCH AIM:

Quantify the proportion of increases in exclusive breastfeeding prevalence that can be attributed to reduced pacifier use over time.

METHODS:

Secondary data analyses of two nationally representative cross-sectional surveys conducted in States' capitals in 1999 and in 2008 (N = 42,395 Brazilian infants under 6 months of age). We estimated the fraction of exclusive breastfeeding prevalence improvements that could be attributed to pacifier use based on multilevel regression analysis.

RESULTS:

From 1999 to 2008, there was an increase of 15.2 percentage points in exclusive breastfeeding prevalence and a decrease of approximately 17 percentage points in the prevalence of pacifier use among infants under 6 months. Reduction in pacifier use explained an increase in 5.5 percentage points' exclusive breastfeeding rates. If pacifier use were to decrease from 41.6% (prevalence in 2008) to 14% (as found in New Zealand), there would be an expected additional increase in exclusive breastfeeding of approximately 12 percentage points.

CONCLUSIONS:

About one-third of the improvements in EBF prevalence observed in Brazil over a decade can be attributed to the corresponding decline in pacifier use.

Conflict of interest statement

The authors have declared that no competing interests exist.

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