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Background: Early formula supplementation (EFS, formula on birthdate or day after) is associated with maternal obesity and reduced breastfeeding, but the effect of prenatal breastfeeding intention on these relationships is understudied. Objectives: We evaluated how EFS affected breastfeeding outcomes after controlling for obesity, sociodemographic and health factors. Methods: Multivariable regression modeling, stratified by prenatal breastfeeding intention. Conclusions: Our findings suggest that EFS may be less disruptive to breastfeeding in mothers with strong intention to meet breastfeeding recommendations, regardless of maternal BMI.

Background: Exclusive breastfeeding (EBF) remains the cornerstone of infant nutrition for the first six months of life, presenting multiple short and long term benefits. The purpose of this study is the demonstration of EBF rates of infants born in baby-friendly hospitals (BFH) and the factors that positively influence EBF. Methods: The study was conducted in all four of the BFH that exist in Greece, between 2020 and 2022. The study sample consisted of 1200 mothers, taken from the 7101 that delivered at those hospitals during the time of the study. A questionnaire was used that included questions to evaluate the infant’s nutrition after birth, after exiting the maternity hospital and during the 2nd, 4th and 6th month of age. The WHO guidelines on EBF and breastfeeding (BF), as well as the “Infant and Young Child Feeding” indicators, were used. Results: The EBF rate within 1 h after birth was 71.3%, which gradually declined to 21.2% in the 6th month. The respective rate of BF was 94.5% and declined to 66.1%. The logistic regression revealed that attending antenatal breastfeeding courses, vaginal delivery, full-term pregnancies and the mothers’ advanced education level constitute independent positive prognostic factors for increased EBF rates. Conclusion: The results of the first national study on BFH are presented. Despite the improvement of EBF rates in Greece, compared to the latest available data from 2018, reinforcement of EBF promotion measures is required in order to approach the WHO’s targets by 2025.

OBJETIVO: Avaliar as taxas e o padrão de aleitamento materno dos recém-nascidos internados em berçário de alto risco no momento de sua alta hospitalar e analisar os potenciais fatores que interferem na prática do aleitamento materno exclusivo. MÉTODOS: Foram estudados prontuários médicos de 495 recém-nascidos internados no berçário de alto risco da Maternidade Odete Valadares, Minas Gerais, antes e após receber o título de Hospital Amigo da Criança. Foram excluídos os nascidos fora da maternidade e durante o período de transição, crianças ou mães que foram a óbito ou transferidas da instituição e crianças abandonadas e/ou de mães com contra-indicação para amamentar. Foram calculadas razões de chance (odds ratio, OR) e intervalos de confiança de 95% a partir de análises bivariadas e multivariadas utilizando a técnica da regressão logística. RESULTADOS: A taxa de aleitamento materno exclusivo na alta passou de 36% no período anterior para 54,6% no período posterior à implementação da Iniciativa Hospital Amigo da Criança. Os fatores de risco independentemente associados com ausência de aleitamento exclusivo foram: uso da dieta por sonda (OR = 3,01), número de consultas pré-natais menor que seis (OR = 2,21), uso de translactação (OR = 2,66), peso ao nascer < 2.500 g (OR = 2,64) e internação em período anterior ao recebimento do título de Hospital Amigo da Criança pela maternidade (OR = 2,75). CONCLUSÃO: Este estudo mostra que, entre outros fatores, as mudanças nas práticas hospitalares com a implementação da Iniciativa Hospital Amigo da Criança foram determinantes para o aumento das taxas de aleitamento materno exclusivo na alta em crianças de alto risco.OBJECTIVE: To study the rate of exclusive breastfeeding at the moment of hospital discharge of newborns admitted to a neonatal Intensive Care Unit and to analyze potential risk factors. METHODS: Four hundred and ninety-five medical records were studied, pertaining to neonates born between 1998 and 1999, admitted to a neonatal intensive care unit, before and after the implementation of the Baby Friendly Hospital Initiative policies. Babies born during the Baby Friendly Hospital Initiative transition period and outside the Maternity ward were excluded from the study, as were children or mothers who were transferred from the institution, abandoned children and also mothers unfit to breastfeed. Risk factors for non-exclusive breast-feeding at discharge were studied. Odds ratio and 95% confidence intervals were calculated using multivariate logistic regression. RESULTS: The exclusive breastfeeding rate increased from 36% at discharge (before the Baby Friendly Hospital Initiative) to 54.7% (after CFHI). The independent risk factors associated with non-exclusive breastfeeding were the use of enteral feeding (OR = 3.01), ante-natal consultations < 6 (OR = 2.75), relactation use (OR = 2.66), birth weight < 2,500 g (OR = 2.64) and being born during the period before Baby-Friendly policies were implemented (OR = 2.75) CONCLUSION: This research shows the potential efficiency of adopting Baby-Friendly policies to increase the chance of successful breastfeeding at the point of discharge for high-risk newborns.