Sociodemographic determinants associated with breastfeeding in term infants with low birth weight in Latin American countries

Table 1 Main characteristics of the included studies

Ref.	Location	Study design	Type of Sampling	Sample size LWB	Control group	Measurements	Analysis
Lizarazo et al[2], 2023	Colombia	Observational	Convenience	25	No	Investigator-designed survey. Medical records	Descriptive analysis
Ortelan et al[18], 2020	Brazil	Observational	Probabilistic	2370	No	Questionnaire on sociodemographic characteristics of mothers and breast milk consumption. BF prevalence survey	Poisson regression
Agudelo et al[23], 2021	Colombia	Clinical trial	Probabilistic	297	Yes	Infant BF assessment tool	Cox proportional hazards analysis. Cox regression models
Montoya et al[24], 2020	Colombia	Observational	Convenience	52	Yes	Investigator-designed survey. Medical records	Descriptive analysis
Charpak and Montealegre-Pomar[25], 2023	Colombia	Observational	Convenience	57.154	Yes	Griffiths test. INFANIB test	Bivariate analysis
Sequeiros et al[26], 2023	Peru	Observational	Convenience	489	No	Demographic and family health survey. Household questionnaire. Individual woman questionnaire. Health questionnaire	Bivariate and multivariate analysis
Ortiz Romaní and Loayza Alarico[20], 2023	Peru	Observational	Convenience	531	No	National database	Binary logistic regression
Wormald et al[19], 2021	Chile	Observational	Convenience	118	No	State trait anxiety inventory. Beck depression inventory; BDI-I. BF self-efficacy scale for mothers with hospitalized preterm infants	Multinomial logistic regression
Javela Rugeles et al[21], 2019	Colombia	Observational	Convenience	90	No	Medical records	Descriptive analysis
Mangialavori et al[22], 2022	Argentina	Observational	Probabilistic	1044	No	Investigator-designed survey. Medical records	Descriptive analysis
Ortelan et al[17], 2019	Brazil	Observational	Probabilistic	2112	Yes	Medical records	Multilevel Poisson regression models

LBW: Low birth weight; INFANIB: Infant neurological international battery; BDI-I: Beck depression inventory-I; BF: Breastfeeding.

Table 2 Sociodemographic characteristics and proximal determinants associated with breastfeeding outcomes in low-birth-weight term infants in Latin America

Ref.	BF results	Mother's socio-demographic characteristics			Associated proximate determinants
		Age	Education	Social stratum
Lizarazo et al[2], 2023	Information on prenatal BF: 67%. No information on BF: 32.3%. 1-4 prenatal checkups: 43.5%. More than 4 controls: 13.7%. Time to initiation of BF at birth: < 1 h: 33.9%. 1-12 h: 33.1%. > 12 h: 33%. Previous history of BF. BF up to 6 months: 58.5%. BF between 3 and 6 months: 18.5%. No previous BF: 7.1%	Average 28 ± 7.3 years	High School: 38.7%. Technical education: 19.4%. Professional: 31.5%	Low stratum: 31.5%. Very low stratum: 40.3%	Work-related causes: 10.5%. Study: 0.8%. Partially absent mother: 0.8%
Ortelan et al[18], 2020	BF prevalence: 54.5%	Age in years (%). < 20: 18.1%. 20-35: 66.9%. > 35: 15%	High School: 47.1%. Professional: 12.5%	No report	Working outside the home (PR = 1.28; 95%CI 1.11-1.48). Residence in municipalities with a prevalence of child undernutrition below 10% (PR = 1.66; 95%CI 1.23-2.24). Mothers with 12 years of schooling or more (PR = 1.35; 95%CI 1.16-1.58)
Agudelo et al[23], 2021	Average duration of exclusive BF: 5 months. BF up to 3 months: 78%. No BF up to 3 months: 19.5%. BF up to 6 months: 25%. No BF up to 6 months: 71%	Median age (IQR). Intervention group: 23 years (21-29). Control group: 24 years (20-25)	Elementary education: 11%. High school: 60%. Technical education: 13%. Professional: 16%	Low stratum: 64.3%. Very low stratum:33.6%	Working outside the home
Sequeiros et al[26], 2023	Interruption of exclusive BF: 26%. Initiation of BF at birth: Immediately: 70.1%. > 1 h: 29.8%	Age in years of mothers who discontinued BF. < 18: 31.7%. 18-25: 27.7%. 26-35: 25.7%. 36-45: 25.0%	Elementary education: 20.5%. High school: 26.7%. Professional: 31.2%	Low stratum: 22%. Middle stratum: 33%. High stratum: 36%	Higher educational level (PRa: 1.55; 95%CI: 1.06-2.27). Rich vs poor family wealth index (RPa: 1.13; 95%CI: 1.03-1.25). Residing in the jungle (RPa: 0.77; 95%CI: 0.71-0.84). Native indigenous language (PRa: 0.82; 95%CI: 0.75-0.91). BF training (PRa: 0.88; 95%CI: 0.82-0.94). Infant with health insurance (PRa: 0.91; 95%CI: 0.84-0.97)
Ortiz Romaní and Loayza Alarico[20], 2023	Prevalence of early initiation of BF: 49.6%.	Age in years (%). 12-14: 0.09%. 15-19: 6.11%. 20-49: 93.80%	High School: 47.2%	Low stratum: 47%. Middle stratum: 21.3%. High stratum: 31.5%	Factors interfering with early initiation of BF: Living in rural area (ORa: 2.37) and jungle (ORa: 1.72). High wealth index. Access to health services and prenatal care
Javela Rugeles et al[21], 2019	Children with BF for one year maintain anthropometric measurements below -2 SD.	Age in years (%). < 20: 17%. > 35: 18%	High school: 64%. Elementary education: 18%. Technical education: 18%	Very low stratum: 57%. Low stratum: 36%. High stratum: 8%	Low social stratum
Mangialavori et al[22], 2022	Prevalence of BF: 34.7% (95%CI: 31.6-37.9). BF before the first hour of birth: 40.1% (95%CI: 36.9-43.4)	No report	Elementary education: 9.3%. High school: 91.3%	No report	Mother's educational level
Ortelan et al[17], 2019	Prevalence of BF: 43.9%	Age in years (%). < 20: 21.3%. 20-35: 65.3%. > 35: 13.4%	High School: 47.6%	No report	Factors favoring BF practices: Age between 20-35 years (PR = 1.35; 95%CI: 1.09-1.69). Work at home. Birth in BF-friendly hospital services. Increased availability of human milk banks per 10000 inhabitants

BF: Breastfeeding; PR: Prevalence radius; IQR: Interquartile range; OR: Odds ratio.

Table 3 Individual characteristics related to self-efficacy for breastfeeding maintenance and adherence in low-birth-weight term infants in Latin America

Ref.	Reason for BF desertion/difficulties	Barriers	Enablers
Lizarazo et al[2], 2023	Perception of low milk production. Newborn's feeling of not satiety. Newborn rejection. Maternal decision	Mother's mood as an influence on BF practice. Work commitments	Family support for housework
Ortelan et al[18], 2020	Age, education, multiparity	Inadequate supplementary feeding	High educational level
Agudelo et al[23], 2021	Supported to stimulate BF in the first hour of life	Interference with newborn routines; availability of time for skin-to-skin contact at birth; obesity; smoking	Educational support. Immediate skin-to-skin contact in the maternity ward
Montoya et al[24], 2020	Newborn hospitalization for low birth weight. Maternal hospitalization. BF technique. No previous experience in BF	Feeding with milk substitutes suggested by health personnel	Mother's willingness to breastfeed. Support from family and health personnel. Mother's previous BF experience
Charpak and Montealegre-Pomar[25], 2023	Respiratory pathology of the newborn	Pathologies of the newborn	Monitoring and follow-up of the health of low-birth-weight newborns and maternal care in mother Kangaroo programs.
Sequeiros et al[26], 2023	Lack of knowledge of BF during pregnancy	Mothers with higher education. Infant only child. Age < 18 years. Birth by caesarean section	Early BF training during pregnancy. Early initiation of BF
Ortiz Romaní and Loayza Alarico[20], 2023	Cesarean delivery. First gestation. Pre-milk feeding of the newborn	Lack of BF skills. Limitations for skin-to-skin contact in the first hour of life	Develop skills and abilities in relation to the promotion of BF. Management of the mother's own symptoms that are contemplated in the different prenatal services and delivery room
Wormald et al[19], 2021	Manifestation of emotional symptoms	Exposure to triggers for depression or anxiety	Self-efficacy
Javela Rugeles et al[21], 2019	Newborn comorbidities	Extreme ages. No support during the first month of the newborn's life	Family support
Mangialavori et al[22], 2022	Cesarean delivery	Limitations to BF in the first hour of life. Separation of mother-infant dyad > 4 h	Educational level

BF: Breastfeeding.