Mapping Breastfeeding Indicators in Brazil: An Analysis of Regional Differences From the Brazilian National Survey on Child Nutrition (ENANI) 2019

OBJECTIVES: Brazil has implemented important public policies to promote breastfeeding. However, differences in breastfeeding indicators across the country's regions persist. Therefore, this study aimed to assess regional differences in breastfeeding indicators in Brazil. PARTICIPANTS: Children under 5 years from the five Brazilian regions (North, Northeast, Southeast, South and Central-West). METHOD: This cross-sectional study used data from the Brazilian National Survey on Child Nutrition (ENANI-2019), conducted from February 2019 to March 2020. Breastfeeding indicators included: ever breastfed (EB), early initiation of breastfeeding (EIBF), exclusive breastfeeding under 6 months (EBF), and continued breastfeeding 12-23 months (CBF). Associations between region of residency and breastfeeding indicators were assessed using the Rao-Scott corrected chi-square test and adjusted Poisson regression. FINDINGS: In total, 14,558 children were studied. Crude analysis found associations between region of residence and three breastfeeding indicators. The associations remained after adjustment for potential confounders. EB was more prevalent in the North (PR = 1.04), Northeast (PR = 1.03), and Central-West (PR = 1.03) regions. The North region had a higher prevalence of EIBF (PR = 1.11), while Southeast (PR = 0.87) had lower prevalence. EBF showed a lower prevalence in the Central-West (PR = 0.89), whereas CBF (PR = 1.30) was more prevalent in the Northeast. The South region was the reference for all comparisons. CONCLUSIONS: The findings underscore the need for tailored regional public health strategies to achieve the World Health Organization-recommended breastfeeding practices in the Brazilian territory.