Objective: To test the hypothesis that a continuing educational strategy (ie, “the manual”) in primary health-care improves infant feeding practices among infants under 1 year of age. Methods: A before and after study was conducted at primary health-care units in Embu das Artes, Brazil. The intervention was the use of a manual created to support continuing educational activities on breastfeeding and complementary feeding to be performed by tutors of Estratégia Amamenta e Alimenta Brasil with health-care teams, in a period of 8 months. Five hundred sixty-one mothers before and 598 mothers after intervention were interviewed about breastfeeding and complementary feeding practices. Multivariate analysis was performed using Poisson multilevel regression to test the hypothesis. Results: Lack of minimum food diversity (before 62.9%; after 50.3%) and lack of food adequacy (before 77.5%; after 63.3%) decreased significantly. Regression analysis confirmed that infants after the intervention had lower prevalence of inadequacy of complementary feeding. While the intervention did not show significant association with exclusive breastfeeding, it showed association with the improvement of complementary feeding practices. Conclusions: The manual is a continuing educational strategy that improved complementary feeding practices in primary health care.

中文翻译：

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促进初级卫生保健中婴儿喂养做法的教育手册的有效性

目的：检验以下假设：初级卫生保健中的继续教育策略（即“手册”）可改善 1 岁以下婴儿的婴儿喂养做法。方法：在巴西 Embu das Artes 的初级卫生保健单位进行了一项前后研究。干预是使用一本手册来支持有关母乳喂养和补充喂养的继续教育活动，该活动将由 Estratégia Amamenta e Alimenta Brasil 的导师与卫生保健团队在 8 个月内进行。干预前的 561 名母亲和干预后的 598 名母亲就母乳喂养和补充喂养的做法接受了采访。使用泊松多级回归进行多变量分析以检验假设。结果：缺乏最低限度的食物多样性（62.9% 之前；50% 之后。3%）和食物充足性不足（前 77.5%；后 63.3%）显着下降。回归分析证实，干预后的婴儿辅食不足的发生率较低。虽然干预没有显示出与纯母乳喂养的显着关联，但它显示出与补充喂养做法的改进有关。结论：该手册是一项持续教育策略，可改进初级卫生保健中的补充喂养做法。它显示出与改善补充喂养做法有关。结论：该手册是一项持续教育策略，可改进初级卫生保健中的补充喂养做法。它显示出与改善补充喂养做法有关。结论：该手册是一项持续教育策略，可改进初级卫生保健中的补充喂养做法。