[en] ABSTRACT: AIM AND OBJECTIVES: The aim of this study was to determine the prevalence of breastfeeding (BF) in all the maternity units of Cantabria, to analyze factors associated with breastfeeding initiation and to evaluate the level of compliance of hospital practices that promote lactation. PATIENTS AND METHODS: Participants have been monitored from the date of birth of the child to the end of their BF period (2009-2017) in a prospective study. A total of 1026 mothers were consecutively included in the study from the 11th of May to the 26th of July 2009. Data were collected through direct interviews until the hospital discharge. From then on, participants were interviewed by phone 15 days postpartum, once a month until the 6th month, and once every three months until the end of BF, using a 24-hour recall period feeding questionnaire. Attitude towards breastfeeding, socio-demographic variables, prenatal and perinatal variables, and variables related to infant feeding were taken into account. RESULTS: The prevalence of breastfeeding initiation was 86,2 %,which was progressively reduced to 32,8 % in the 6th month, and to 11,6 % in the first year for all kinds of infant feeding. Prevalence of exclusive BF was 37,8 % in the 3rd month, and 7,3 % in the 6th month. Factors associated with a greater rate of breastfeeding initiation are higher level of maternal education, prenatal decision to breastfeed, birth at term and considering breastfeeding the most beneficial option for the, mother. Living in a semi-urban municipality, mother ≤ 25 years old with lower education level and smoking habits, having been breastfed < 6 months, not having seen breastfeeding, having breastfed < 3 months, and use of nipple shields, scheduled feedings or use of supplements during the puerperium period were associated with an earlier cease in breastfeeding CONCLUSIONS: Breastfeeding initiation is the only indicator that meets the target of Healthy People 2020. The remaining recommendations have not been accomplished. The strongest predictor of BF initiation was the prenatal decision to breastfeed. Maternal education level and previous experience with BF were the strongest predictors associated with a decrease in BF maintenance, Hospital implementation practices that enable women to breastfeed may contribute to the extension of lactation.

[es] RESUMEN: OBJETIVOS: Determinar la prevalencia de lactancia materna (LM), en todas las maternidades de Cantabria. Analizar los factores que se asocian con la iniciación y la duración de la LM, y evaluar el grado de cumplimiento de las acciones a favor de la LM que se realizan en las maternidades. PACIENTES Y MÉTODOS: Estudio prospectivo, con seguimiento desde el nacimiento hasta finalizar el periodo de lactancia (2009-2017). Participaron 1026 madres incluidas consecutivamente, desde 11 de mayo al 26 de julio de 2009. Recogida de datos mediante entrevistas directas hasta el alta hospitalaria y telefónicas al 15.° día; mensuales, hasta 6.° mes y trimestrales, hasta finalizar la lactancia. Cuestionario de recuerdo de alimentación del día anterior. Variables socio-demográficas, actitud hacia el amamantamiento, prenatales, perinatales y relacionadas con la alimentación del lactante. RESULTADOS: La prevalencia de iniciación del 86,2 % se reduce progresivamente, hasta el 32,8 %, en el 6.° mes y 11,6 % en el primer año para "cualquier lactancia"; prevalencia de LM exclusiva 37,8 % y 7,3 % al 3.° y 6.° mes, respectivamente. Son factores asociados con mayor iniciación: mayor nivel de estudios materno, experiencia previa exitosa, decisión prenatal de amamantar, opinar que amamantar es lo mejor para la madre y parto a término. Factores asociados con el riesgo de menor duración son: residir en un municipio semiurbano; madre ≤ 25 años, con menor nivel de estudios, hábito tabáquico; haber sido amamantada < 6 meses, no haber visto amamantar, haber amamantado < 3 meses y, durante el puerperio hospitalario: utilizar pezoneras, amamantar en horarios rígidos e incorporar suplementos. CONCLUSIONES: La iniciación, es el único indicador que supera el objetivo Healthy People 2020, el resto de recomendaciones no se han logrado. La decisión prenatal de amamantar es el mayor predictor de la iniciación. El nivel de estudios materno y la experiencia previa de LM, son los predictores de riesgo de duración con más magnitud. Implantar en las maternidades prácticas asistenciales favorecedoras de la LM, puede contribuir a prolongar la duración.