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[Breast feeding: a program of orientation and support].

A program of orientation and support for breastfeeding was implemented at the Pediatric and Child Care Clinic of Irmandade da Santa Casa de Misericordia in Sao Paulo Brazil. It was observed that children often were not brought to the Clinic until they were on average 3 months old. A low percentage (17.5%) of mothers were breastfeeding their infants; a large number (82.5%) had introduced formula into their infants feeding regimen frequently making errors in preparation and dilution. The author hypothesized that the long period between hospital discharge and 1st clinic visit was a predisposing factor towards premature introduction of formula because the mother was at the mercy of her own faulty notions and the suggestions of others. An orientation about breastfeeding before leaving the hospital might increase the level of breastfeeding. 200 mothers who gave birth at the hospital between 27 April and 8 November 1979 were given a preliminary talk on the importance of breastfeeding. Upon discharge each mother was given an appointment at the Pediatric and Child Care Clinic within a weeks time to receive orientation. The orientation program consisted of a series of individual talks to the mother about feeding her child. In an informal interview she was questioned about what she considered adequate nutrition for her child; any misconceptions she had about breastfeeding were corrected at this time. When a mother related that she was breastfeeding she was praised and taught about the advantages of breastfeeding. In cases where the mother was providing artificial nourishment she was instructed about diluting the formula sterilizing and administering the bottle. Of the 200 mothers in the program 138 (69%) were breastfeeding 19 (9.5%) gave only formula to their children and 43 (21.5%) were breastfeeding with supplementary bottle feeding. The author concludes that 1) a delay in the 1st clinic visit and the consequent delay in breastfeeding orientation permits the mother to introduce formula prematurely and 2) the anticipated visit to the clinic for training contributes to increase the incidence of breastfeeding.