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Marina Ferreira Rea is Brazilian and born on 19 Feb 1946, physician, Bachelor's at Medicine from University of São Paulo (1972), master's at Collective Health from University of São Paulo (1981) and doctorate at Collective Health from University of São Paulo (1989), POST DOC in Human Nutrition at Columbia Univ. NY, USA; Member of Pediatric Society São Paulo, Dept. of Breastfeeding. Specialist in Human Lactation by Wellstart International She has experience in Nutrition, focusing on breastfeeding, acting on the following subjects: BREASTFEEDING, BABY-FRIENDLY HOSPITAL INITIATIVE, CODE, INFANT FOOD AND HIV, PLANNING PROGRAMMES ON MCH. Consultant on human lactation in different countries for WHO, PAHO, UNICEF. Editor of Breastfeeding Briefs. Articles and books published. Active member of IBFAN since 1981, and has founded IBFAN Brazil in 1983, a network present in 17 states (provinces) of this country. Member of IBFAN Global Coordinating Committee. Medical officer at WHO- Geneva, 1989-1992 – coordinated the Breastfeeding Programme at the Control of Diarrhea Diseases Division. She retired from Research Institute in Sao Paulo, where she worked for more than 30 years in MCH and Nutrition. Active researcher at Brazilian Center for Analysis and Planning (CEBRAP) and at Post –graduate Studies on Nutrition in Public Health
Breastfeeding should be implemented from birth, as it contributes to the reduction of infant mortality. OBJECTIVE: To estimate the number of deaths potentially avoided by the Baby-Friendly Hospital Initiative (BFHI) in Brazil, this enables strategies that allow breastfeeding exclusively from birth. METHODS: The analysis consisted of: estimating the effectiveness of BFHI in breastfeeding in the first hour of life (BF1h), the exclusive breastfeeding in infants 0-5 months (EBF) and of any breastfeeding. The potential impact of BFHI on the reduction of infant mortality mediated by increased breastfeeding was estimated by subtracting the prevalence of each breastfeeding indicator for both BFH and NBFH born babies. For this purpose, the Population Attributable Fraction (PAF) of breastfeeding was used for the following indicators: late neonatal mortality mediated by non-breastfeeding in the first hour of life, all-cause mortality in infants less than 6m and mortality due to infection in infants under 6 months; The latter two, mediated by non-breastfeeding. The PAF was obtained for children born in BFH and NBFH, using the prevalence of non-breastfeeding and the estimated relative risks. Finally, it was estimated the number of deaths potentially preventable by the BFHI, considering the data on infant mortality occurred in 2008. RESULTS: The sample consisted of 18,929 children under 6 months of age; Of these 34.1% were born in BFH. The BFHI promoted a statistically significant increase in the 3 indicators of BF: 11.7% in BF1h; 7.9% in EBF and 2.1% in any breastfeeding. If all children were born in BFH, the fraction of mortality attributable to non-breastfeeding (PAF) would be lower, potentially avoiding 4.2% of late neonatal mortality, 3.5% of all-cause mortality, and 4.2% mortality from infection. CONCLUSION: BFHI improves breastfeeding and contributes to a reduction in mortality.