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    Duração do aleitamento materno e seu impacto sobre a variação da massa corporal materna durante o primeiro ano de vida de crianças pertencentes a uma coorte de nascimentos
    (Universidade Federal de São Paulo (UNIFESP), 2021) Marinho, Patricia De Menezes [UNIFESP]; Taddei, Jose Augusto De Aguiar Carrazedo [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Despite the efforts and actions to promote breastfeeding (BF), in Brazil, the estimates on its duration (exclusive and total) remains below the recommended by the World Health Organization, with gaps regarding regional, economic, social, cultural and behavioral determinants of early interruption. Furthermore, although the benefits of breastfeeding in women’s health are widely recognized, its role in post-pregnancy weight control and/or loss is not consensual in the literature, indicating the need for more studies to better understand this complex interaction. Objectives: this dissertation, consisting of two scientific papers aimed to analyze the BF duration and determinants and its impact on the variation of maternal body mass during the first year of life of children belonging to a cohort of live births in Rio Largo, Alagoas. Methods: we used data from the birth cohort “Child Health, Feeding, Nutrition and Development – HFND: a cohort study”, carried out in Rio Largo, AL., composed of children born between February and August 2017 in the only maternity in the city. Socio-demographic, economic, anthropometric and food consumption information, from mother and child, were collected at birth (up to 24 hours post-childbirth), at 3, 6 and 12 months of the child. The considered dependent variables were: (paper 1) duration of EBF and BF, analyzed by Kaplan-Meier survival curves and the risk factors for early weaning through Cox proportional hazards model and; (paper 2) maternal body mass index variation twelve months post-childbirth, the effect of BF duration (≤60/>60days) on this variation was analyzed by linear mixed-effect models. Results: the low duration of EBF and BF was evidenced, with an average of 30 (15-60) and 330 (91-365) days, respectively. The low maternal schooling (HR:1.40 [95%IC:1.04-1.87]) and cesarean section births (HR:1.41 [95%IC:1.04-1.90]) were the risk factors for early EBF weaning, while the use of pacifier (HR:2.37 [95%IC:1.62-3.48]) and child consumption, before the third month, of meals with added salt and sugar (HR:1.63 [95%IC:1.12-2.38]) composed the factors for early BF interruption. Furthermore, in the second study, the results indicate that, in the baseline, the difference between BMI measures, according to BF duration, was 1.37 kg/m² (p=0.146). Breastfeeding for a longer time had a more pronounced effect on lowering BMI at three months. Throughout the analyzed period, the BMI of women who breastfed for more than 60 days went from 26.54 kg/m² (95%IC: 25.78-27.29) to 24.49 kg/m² (95%IC: 23.73-25.25). Conclusions: BF duration was below the international recommendations, identifying risk factor sensible to change with intervention strategies in the different health attention levels. Additionally, it was observed that BF for longer was significantly associated with reduction in maternal BMI twelve months after childbirth, which reinforces the importance of this practice for mother-child health, specially in contexts of high social vulnerability.