Violência entre parceiros íntimos e interrupção precoce do aleitamento materno exclusivo no quinto mês de vida

Abstract

The aim of this study was to investigate the role of intimate partner violence (IPV) in the early interruption of exclusive breastfeeding (EIEB) among children in the fifth month of life. This is a cross-sectional study of 244 children (mean age 126.55 days ± SD = 5.29) who attended to four primary health clinics in the city of Rio de Janeiro between 2005 and 2009 for monitoring growth and presented data on the last 24 hours food intake and on intimate partner violence in the second and fifth month of life. Feeding practices were measured by a 24-hour recall and the outcome of the study was the early interruption of exclusive breastfeeding, defined as the consumption of any food or liquid other than breast milk. The IPV was measured using the Portuguese version of the Conflict Tactics Scales-1 (CTS-1), classified in Global IPV (presence of physical aggression in couples) and according to their severity (Minor IPV and Severe IPV), and categorized as: (a) absent, (b) present in one of two moments, and (c) present at both times (recurrent). The violence against women (VAW) was also investigated in the study population being classified and categorized in a similar way of IPV. The initial analysis consisted of prevalence estimates of EIEB, IPV and other population characteristics. The association between IPV and EIEB was verified by a logistic regression model, based on crude and adjusted odds ratios (OR) and their corresponding 95% confidence intervals (95%CI). The variables associated with the outcome with a p-value ≤ 0.20 in the crude analysis were considered covariables for adjusting in multivariate models. The findings of this study show that, even after adjusting for parity, maternal age, education and work, social network and living conditions, Global IPV increased by almost four times the chance of EIEB when recurrent in relationships (OR = 3.95; 95%CI = 1.13 13.87; p-value = 0.032), and recurrent Minor IPV increased by more than three times the chance of IPAME (OR = 3.78; 95%CI = 1.08 13.25; p-value = 0.038). In all families where violence against women was recurrent, the women had already interrupted exclusive breastfeeding. The results of this study reinforces the importance of the development of actions to identify situations of family violence, providing help to these families, and that encourage not only the practice of exclusive breastfeeding, but also healthy and harmonious life styles