Early weaning and anemia in children under 2 years old from indigenous peoples in Alagoas state, Brazil

To investigate the frequency of breastfeeding (BF) practices and factors associated with early weaning and anemia in indigenous children under 2 years of age. A household cross-sectional study was conducted in 13 indigenous communities in Alagoas state, northeastern Brazil. Mothers of eligible children were interviewed to gather socioeconomic, demographic, health, and feeding practice data. Blood samples were collected to assess the hemoglobin concentration (Hb). Multiple Cox, linear, and Poisson regression models were employed to examine the factors associated with weaning and anemia (Hb < 110 g/L in children aged 6 months and older). Of the 1303 households surveyed, 145 had children under 2 years old. The prevalence of exclusive BF at 6 months was only 19 %. High frequencies of anemia (42.5 %), bottle-feeding (70 %), and pacifier use (31 %) were observed. The use of bottle and pacifier was associated with early weaning. Bottle-feeding was significantly associated with anemia (PR = 2.62; 95 % CI: 1.42–4.84) after adjusting for household wealth index. BF practices among indigenous children do not meet WHO recommendations. The use of artificial nipples was linked to early weaning, and bottle feeding was associated with anemia after 6 months of age. These findings underscore the urgent need for interventions to promote, protect, and support BF in indigenous people, guiding multidisciplinary health teams in properly caring for young children in indigenous communities. • This is the first nutritional household survey of indigenous children in Alagoas state in Brazil. • Early weaning trends, a high prevalence of anemia associated with pacifier and bottle use were observed. • The results identify critical aspects of indigenous child health that may inform culturally sensitive interventions. • Intensive, sustainable, and culturally respectful actions to promote, protect, and support breastfeeding practices are needed.