BREASTFEEDING-FRIENDLY PRIMARY CARE INITIATIVE: IMPACT REVIEW

Introduction: Breastfeeding-Friendly Primary Care Initiative (BFPCI) was proposed by the State Health Secretariat of Rio de Janeiro (RJ) in 1999. Objectives: investigate the impact of BFPCI. Methods: literature review in the MEDLINE database about BFPCI’ impact studies on the prevalence of exclusive breastfeeding (EBF) and other outcomes. Results: five studies were identified, one experimental and four cross-sectional. Experimental study with 20 FHP’ units, half of them was exposed to BFPCI’ 24 hours course, found a significant increase in median duration of EBF in the intervention group. Cross-sectional study in 24 basic healthcare center of the State of RJ found higher prevalence of EBF and maternal satisfaction in units with better performance in BFPCI (p<0.001). Study at a basic healthcare center in RJ comparing two periods, before and after BFPCI certification, found a higher prevalence of EBF and a reduction in the number of consultations motivated by some type of disease among infants more than 4 months old (p<0.05) after the certification. Study at 56 basic healthcare centers in Rio de Janeiro/RJ showed that, in the multivariate analysis, the upper tertile of performance was 34% higher prevalence of EBF (PR=1.34, 95% CI:1.24 to 1.44). Study at the municipality of Barra Mansa/RJ whose data source was obtained in two vaccination campaigns (before and after implantation of BFPCI certification), showed that EBF prevalence increased (30,2% to 46,7%) and the use of pacifier reduced (51% to 44%). Conclusions: BFPCI contributed to the practice of EBF and there were repercussions on maternal satisfaction, the use of pacifiers and infant health.