• J A Taddei, M F Westphal, S Venancio, C Bogus, and S Souza.
• Breastfeeding promotion in Health Services, Universidade Federal de São Paulo/ Escola Paulista de Medicina, São Paulo, Brazil. taddei.dped@epm.br
• Sao Paulo Med J. 2000 Nov 9; 118 (6): 185191185-91.

ContextPromotion of breastfeeding in Brazilian maternity hospitals.ObjectiveTo quantify changes in the breastfeeding duration among mothers served by hospitals exposed to the Wellstart-SLC course, comparing them with changes among mothers attended by institutions not exposed to this course.DesignRandomized Institutional Trial.SettingThe effects of training on breastfeeding duration was assessed in eight Brazilian hospitals assigned at random to either an exposed group (staff attending the Wellstart-SLC course) or a control group.SampleFor each of the eight study hospitals, two cohorts of about 50 children were visited at home at one and six months after birth. The first cohort (n = 494) was composed of babies born in the month prior to exposure to the Wellstart-SLC course, and the second cohort (n = 476) was composed of babies born six months subsequent to this exposure.Main MeasurementsKaplan-Meier curves were plotted to describe the weaning process and log-rank tests were used to assess statistical differences among survival curves. Hazard ratio (HR) estimates were calculated by fitting Cox proportional hazard regression models to the data.ResultsThe increases in estimated, adjusted rates for children born in hospitals with trained personnel were 29% (HR = 0.71) and 20% (HR = 0.80) for exclusive and full breastfeeding, respectively. No changes were identified for total breastfeeding.ConclusionThis randomized trial supports a growing body of evidence that training hospital health professionals in breastfeeding promotion and protection results in an increase in breastfeeding duration.

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