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Introduction: Newborn hearing screening (NHS) programs are implemented across the globe to detect early hearing impairment. In order to meet this objective, the quality of these programs should be monitored using internationally recognized indicators., Objective: To evaluate a newborn hearing screening service (NHSS) using international quality indicators., Methods: A retrospective cohort study on the NHSS of Minas Gerais was conducted, analyzing the services performed between 2010 and 2011. Results were analyzed according to criteria from the American Academy of Pediatrics and the Joint Committee on Infant Hearing., Results: This study assessed 6987 children. The proportions of cases that were referred for a retest, that followed through with retest, and that were referred for diagnosis were 8.0%, 71.9%, and 2.1%, respectively. The proportion of assessed newborn children in the first 30 days of life in this study was 65%. The median age of those children who failed both the NHS and the retest was significantly higher than the other children. The chance of a child with a hearing impairment risk indicator to fail the NHS was 2.4 times higher than of those without a risk indicator., Conclusion: NHSS achieved three of four evaluated indicators. Despite this, it is still necessary to perform NHS earlier and to ensure that the subsequent steps are followed., (Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.)

Objective: To estimate the association between the implementation of the Brazilian Breastfeeding Network and prevalence of breastfeeding in a medium-size city in southern Brazil., Methods: This was a cross-sectional study involving 405 children under 1 year who participated in the second phase of the multivaccination campaign in 2012. Children's consumption of food on the day before the interview was obtained through interviews with mothers or guardians. The manager and one health professional from every health facility that joined the Network were interviewed in order to investigate the process of implementation of this initiative. The association between prevalence of breastfeeding and exclusive breastfeeding and adherence to the Network implementation process was tested using Poisson regression with robust variance., Results: Multivariate analysis revealed that among the children assisted by health facilities who joined the Network and those attending services that did not adhere to this strategy, the prevalence of breastfeeding (74% and 70.4% among children under 1 year, respectively) and exclusive breastfeeding (43.3% and 38.1% among children under 6 months, respectively) did not differ significantly. Difficulties in implementing the Network, such as high turnover of professionals, not meeting the criteria for accreditation, and insufficient participation of tutors in the process were identified., Conclusion: Contrary to the hypothesis of this study, there was no significant association between the implementation of the Brazilian Breastfeeding Network and prevalence of breastfeeding and exclusive breastfeeding in the studied city. It is possible that the difficulties found in implementing the Network in this city have influenced this result., (Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)

Objective: To analyze the association between the degree of compliance with the ten steps of the Breastfeeding-Friendly Primary Care Initiative (BFPCI) and the prevalence of exclusive breastfeeding (EBF) in infants younger than six months in the city of Rio de Janeiro., Methods: This was a cross-sectional study conducted in a representative sample of 56 primary health care units of this municipality. The assessment of compliance with the ten steps of the BFPCI was carried out by interviewing health care professionals, pregnant women, and mothers; the generated performance scores were classified into tertiles. To obtain the outcome, i.e., the EBF, a data collection questionnaire was applied to mothers of children younger than six months who were followed up at these units in November of 2007. Prevalence ratios were obtained for the EBF using Poisson regression with robust variance., Results: The prevalence of EBF was 47.6%. In the multivariate analysis, the upper tertile of performance showed a 34% higher prevalence of EBF (PR=1.34, 95% CI: 1.24 to 1.44) and the second tertile was 17% higher (PR=1.17, 95% CI: 1.08 to 1.27) than the first tertile. Mothers who did not work outside home had a 75% higher prevalence of EBF (PR=1.75, 95% CI: 1.53 to 2.01); assistance in a basic health unit, as opposed to a family health unit, implied a 10% higher prevalence (PR=1.10, 95% CI: 1.03 to 1.19). The prevalence of EBF decreased 1% for each day of the infant's life (PR=0.993, 95% CI: 0.992 to 0.993)., Conclusion: Given the contribution of BFPCI to the practice of EBF, a greater investment in the expansion and sustainability of this initiative is recommended, as well as its association with other strategies to promote, protect, and support breastfeeding., (Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)