THE ASSOCIATION OF SOCIAL DETERMINANTS OF HEALTH WITH THE TYPE OF BREASTFEEDING

Abstract

Introduction: The practice of breastfeeding is influenced by several social determinants of health (SDH), such as maternal age, education, family income, and insertion in the labor market. This study, carried out in coastal municipalities in the state of Alagoas, Brazil, seeks to understand how these variables impact the type of breastfeeding, considering their associations with early weaning and the continuity of exclusive breastfeeding. The analysis shows that older mothers with low family income are more likely to start mixed or partial breastfeeding, while higher income levels favor the practice of exclusive breastfeeding. These results reinforce the importance of public policies that prioritize breastfeeding support, especially among more vulnerable populations. Objective: To describe the influence of maternal age, schooling, maternal work and profession, and family income on the type of breastfeeding. Methods: This is a cross-sectional descriptive study with a quantitative approach, based on the population. It was conducted in the Basic Health Units (Family Health Strategy) in the coastal municipalities of the state of Alagoas, Brazil. The interviews with the participants took place from May to November 2017. Scenario and participants: The Basic Health Units provided a good representation of participants who used the Unified Health System for their health needs. A random sample of 150 breastfeeding women was recruited. The Ethics Committee of the Federal University of Alagoas approved the study. All participants provided formal consent. Results: The mean age of the participants was 24.8 years; 60 (40%) identified themselves as evangelical, 68 (45.3%) did not complete elementary school, 85 (56.7%) were housewives, and most had a family income of one to two minimum wages per month. Maternal age and family income were statistically related to the type of breastfeeding (p < 0.05). Notably, the largest number of participants who used mixed or partial breastfeeding (30%) were 30 years or older. Most mothers who underwent mixed or partial breastfeeding (87.1%) had a family income of less than two minimum wages per month. On the other hand, most mothers (14.3%) with a family income of three or more minimum wages per month practiced exclusive breastfeeding. Main conclusions: The data indicate that higher maternal age and lower monthly family income are social determinants of health that increase the chances of interrupting exclusive breastfeeding, while higher monthly family income increases the chances of maintaining exclusive breastfeeding. Implications for practice: These findings indicate the need for greater breastfeeding support, especially for low-income mothers, who are more likely to interrupt exclusive breastfeeding, thus increasing the chances of infant morbidity.