Protective factors for early initiation of breastfeeding among Brazilian nursing mothers.

Objectives: Evaluate the protective factors associated with early initiation of breastfeeding. Methods: Cross-sectional study conducted with Brazilian nursing mothers. Breastfeeding in the first hour of life and difficulty initiating breastfeeding in the birth room were adopted as outcome variables and associated with other maternal and child information. Poisson regression was conducted to synthesize the data. Results: Among 104 nursing mothers evaluated, 56.7% reported breastfeeding in the first hour of life and 43% had difficulty initiating breastfeeding in the birth room. There was a higher prevalence of breastfeeding in the first hour of life among mothers with previous breastfeeding experience (PR = 1.47, 95% CI 1.04-2.07). Difficulty initiating breastfeeding in the birth room was more prevalent among mothers who did not receive breastfeeding guidance during antenatal care (PR = 2.83, 95% CI 1.43-4.32) and those without previous breastfeeding experience (PR = 2.49, 95% CI 1.24-6.45). Conclusion: These findings highlight the importance of adequate professional guidance, especially for primiparous mothers.

Dietary Inflammatory Index during pregnancy is associated with birth weight and child anthropometry up to 10 years old: A systematic review and meta-analysis.

Based on previous studies, we hypothesized that the dietary inflammatory potential in pregnant women might influence maternal and child health. The objective of this work is to review the literature on the association of Dietary Inflammatory Index (DII) during pregnancy with early and late maternal and child health outcomes. We searched Cochrane, Embase, PubMed, Scopus, Web of Science, and the Virtual Health Library. Observational studies on DII in the gestational period that met the objective of this review were selected. There was a double-blind evaluation of 185 studies, of which 16 were included in narrative synthesis and 9 in meta-analysis. High methodological quality, longitudinal studies (87.5%) and the Food Frequency Questionnaire for DII evaluation (68.8%) prevailed. Outcomes studied were gestational diabetes mellitus (n = 5), gestational age at delivery (n = 7), type of delivery (n = 3), gestational weight gain or pregestational body mass index (n = 11), and anthropometry at birth (n = 8) and of the child up to age 10 years (n = 4). Higher maternal DII was associated with increased risk of small-for-gestational-age babies (odds radio, 1.15; 95% confidence interval, 1.08-1.21; I2, 29%; P = .24) and low birth weight (<2.500 g) (odds ratio, 1.16; 95% confidence interval, 1.06-1.26; I2, 56%; P = .10). The association between higher maternal DII and higher risk of obesity in late childhood is also suggestive. Thus, maternal diet may be a modifiable factor of inflammation in pregnancy associated with health outcomes of the offspring.

Weight retention 12 months postpartum: association with sociodemographic, gestational and puerperal factors / Retenção de peso 12 meses pós-parto: associação com fatores sociodemográficos, gestacionais e puerperais

Abstract Objectives: to investigate the association between sociodemographic, gestational/puerperal factors and postpartum weight retention (PPWR) after 12 months in Brazilian women at a university hospital. Methods: prospective cohort with puerperal women recruited at the maternity ward of a university hospital in a Brazilian metropolis. At baseline (n=260), sociodemographic and anthropometric information on the mother-child binomial and data related to the gestational period were collected. Maternal dietary patterns were measured using a food frequency questionnaire and subsequently determined by Principal Component Analysis. Results: 75 women, with a mean age of 28.4 years (CI95%= 27.0-29.7), 25.3% with excessive PPPR, with an average of 3.6 kg (CI95%= 1.7) continued in the follow-up. -5.4). Higher gestational weight gain (GWG) (ß= 0.36; CI95%= 0.18-0.70) and lower maternal age (ß= -0.41; CI95%= -0.92--0.22) were PRPP predictors (p=0.001) (adjusted for per capita income, parity, type of delivery, number of prenatal visits, baby's birth weight, breastfeeding and physical activity). Conclusion: there was a high occurrence of excessive PPPR, favored by higher GPG and lower maternal age. This highlights the importance of monitoring women's health during the reproductive period, with guidance on ways of life (diet and physical activity), to favor better outcomes for mother-child.

Resumo Objetivos: investigar a associação entre fatores sociodemográficos, gestacionais/puerperais com a retenção de peso pós-parto (RPPP) após 12 meses em mulheres brasileiras em hospital universitário. Métodos: coorte prospectiva com puérperas recrutadas na maternidade do hospital universitário de uma metrópole brasileira. Na linha de base (n=260) foram coletadas informações sociodemográficas, antropométricas do binômio mãe-filho e dados relativos ao período gestacional. O padrão alimentar materno foi mensurado por meio do questionário de frequência alimentar e posteriormente determinado pela Análise de Componentes Principais. A RPPP foi classificada como risco para obesidade se ≥7,5Kg. Resultados: 75 mulheres continuaram no seguimento, com média de 28,4 anos de idade (IC95%= 27,0−29,7), 25,3% com RPPP excessiva, sendo em média 3,6 Kg (IC95%= 1,7−5,4). Maior ganho de peso gestacional (GPG) (β= 0,36; IC95%= 0,18-0,70) e menor idade materna (β= −0,41; IC95%= −0,92--0,22) foram preditores da RPPP (p≥0,001) (ajustado pela renda per capita, paridade, tipo de parto, número de consultas pré-natal, peso ao nascer do bebê, aleitamento materno e atividade física). Conclusão: evidenciou-se elevada ocorrência de RPPP excessiva, favorecida pelo maior GPG e menor idade materna. Aponta-se assim a importância do monitoramento da saúde da mulher durante o período reprodutivo, com orientações sobre modos de vida (alimentação e atividade física), para favorecer melhores desfechos para mãe-filho.

Dietary Patterns during Pregnancy and Gestational Weight Gain: A Systematic Review / Padrões alimentares durante a gravidez e ganho de peso gestacional: Uma revisão sistemática

Abstract The present systematic review (PROSPERO: CRD42020148630) hypothesizes the association of excessive weight gain during pregnancywith dietary patterns composed of ultraprocessed foods. Thus, the objective was to investigate the association between dietary patterns after analysis and weight gain during pregnancy. The search for articles was performed in nine databases. Two reviewers selected the articles in the databases and extracted from them the data used in the review. Two scales were used to evaluate the quality of the selected studies: New Castle-Ottawa Quality Assessment for cohort-based studies and Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional-based studies. In total, 11 studies were identified with sample size variation (n=173-5,733). Women presenting more adherence to healthy and traditional patterns (fruits, vegetables, salads, nuts, and dairy) recorded less excessive gestational weight gain (GWG). Higher intake ofmixed patterns and western patterns rich in ultraprocessed foods were associated with a higher prevalence of excessive GWG (24.48- 55.20%). Gestational dietary patterns a posteriori-derived that have presented ultraprocessed components rich in fat and sugars presented association with high GWG; healthy and traditional dietary patterns were related to better mother-child health conditions, such as adequate GWG.

Resumo A presente revisão sistemática (PROSPERO: CRD42020148630) tem como hipótese que o ganho de peso excessivo durante a gravidez está associado aos padrões alimentares compostos por alimentos ultraprocessados. Desta forma, objetivou-se investigar a associação entre o padrão alimentar a posteriori e o ganho de peso durante a gestação. A busca de artigos foi realizada em nove bases de dados. Dois revisores selecionaram os artigos nestas bases e extraíram as informações utilizadas na revisão. Duas escalas foram utilizadas para avaliar a qualidade dos estudos selecionados: Escala de Avaliação da Qualidade de New Castle-Ottawa para estudos baseados em coortes e a Ferramenta de Avaliação de Estudos Transversais (escala AXIS) para estudos transversais. No total, foram identificados 11 trabalhos com variação do tamanho amostral (n=173-5.733). As mulheres que apresentaram maior adesão aos padrões alimentares saudáveis e tradicionais (frutas, hortaliças e vegetais, nozes e laticínios) apresentarammenor ganho de peso gestacional (GPG). A maior ingestão de padrões alimentares mistos e ocidentais ricos em alimentos ultraprocessados foi associada a uma maior prevalência de GPG excessivo (24,48-55,20%). Os padrões alimentares gestacionais derivados a posteriori que apresentaram componentes ultraprocessados ricos em gordura e açúcares apresentaram associação como maior GPG; os padrões alimentares saudáveis e tradicionais foram relacionados a melhores condições de saúde maternoinfantil, como GPG adequado.

Dietary Patterns during Pregnancy and Gestational Weight Gain: A Systematic Review.

The present systematic review (PROSPERO: CRD42020148630) hypothesizes the association of excessive weight gain during pregnancy with dietary patterns composed of ultraprocessed foods. Thus, the objective was to investigate the association between dietary patterns after analysis and weight gain during pregnancy. The search for articles was performed in nine databases. Two reviewers selected the articles in the databases and extracted from them the data used in the review. Two scales were used to evaluate the quality of the selected studies: New Castle-Ottawa Quality Assessment for cohort-based studies and Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional-based studies. In total, 11 studies were identified with sample size variation (n = 173-5,733). Women presenting more adherence to healthy and traditional patterns (fruits, vegetables, salads, nuts, and dairy) recorded less excessive gestational weight gain (GWG). Higher intake of mixed patterns and western patterns rich in ultraprocessed foods were associated with a higher prevalence of excessive GWG (24.48-55.20%). Gestational dietary patterns a posteriori-derived that have presented ultraprocessed components rich in fat and sugars presented association with high GWG; healthy and traditional dietary patterns were related to better mother-child health conditions, such as adequate GWG.

A presente revisão sistemática (PROSPERO: CRD42020148630) tem como hipótese que o ganho de peso excessivo durante a gravidez está associado aos padrões alimentares compostos por alimentos ultraprocessados. Desta forma, objetivou-se investigar a associação entre o padrão alimentar a posteriori e o ganho de peso durante a gestação. A busca de artigos foi realizada em nove bases de dados. Dois revisores selecionaram os artigos nestas bases e extraíram as informações utilizadas na revisão. Duas escalas foram utilizadas para avaliar a qualidade dos estudos selecionados: Escala de Avaliação da Qualidade de New Castle-Ottawa para estudos baseados em coortes e a Ferramenta de Avaliação de Estudos Transversais (escala AXIS) para estudos transversais. No total, foram identificados 11 trabalhos com variação do tamanho amostral (n = 173­5.733). As mulheres que apresentaram maior adesão aos padrões alimentares saudáveis e tradicionais (frutas, hortaliças e vegetais, nozes e laticínios) apresentaram menor ganho de peso gestacional (GPG). A maior ingestão de padrões alimentares mistos e ocidentais ricos em alimentos ultraprocessados foi associada a uma maior prevalência de GPG excessivo (24,48­55,20%). Os padrões alimentares gestacionais derivados a posteriori que apresentaram componentes ultraprocessados ricos em gordura e açúcares apresentaram associação com o maior GPG; os padrões alimentares saudáveis e tradicionais foram relacionados a melhores condições de saúde materno-infantil, como GPG adequado.

Diet during pregnancy: Ultra-processed foods and the inflammatory potential of diet.

OBJECTIVES: The aim of this study was to evaluate the association between the food consumption of pregnant women and the degree of industrial processing using the Energy-Adjusted Dietary Inflammatory Index (E-DII). METHODS: This was a cross-sectional study of 237 women in the immediate postpartum period, ages 19 to 43. Sociodemographic, anthropometric, and food consumption information related to the gestational period were collected. A semiquantitative food frequency questionnaire was used to determine the contribution of each food processing category to the energetic consumption. Using the calculation of the E-DII score (divided into quartiles), 27 dietary parameters were considered. Kruskal-Wallis, Mann-Whitney, and χ2 tests, as well as ordinal multinomial logistic regression models, were used. RESULTS: The increase in E-DII score was associated with an increase in the consumption of ultra-processed foods (quartile 1: 10.42% [0.00%-44.63%] < quartile 4: 34.17% [2.72%-74.90%]; P < 0.001) and a reduction in the consumption of unprocessed and minimally processed foods (quartile 1: 64.59% [34.08%-88.32%] > quartile 4: 44.64% [16.15%-70.59%]; P < 0.001). In the final regression model, women classified in the fourth quartile (most proinflammatory) were more likely to have a higher consumption of ultra-processed (odds ratio: 1.15; 95% confidence interval, 1.10-1.20) and processed products (odds ratio: 1.07; 95% confidence interval, 1.02-1.13). There was no association with gestational, sociodemographic, and maternal nutritional status information. CONCLUSIONS: The increase in the consumption of foods with a higher degree of processing is associated with a more proinflammatory potential of the maternal diet.

Dietary Patterns During Pregnancy and Their Association with Gestational Weight Gain and Anthropometric Measurements at Birth.

BACKGROUND: Dietary patterns can influence maternal and child health outcomes. The study aims to characterize dietary patterns during pregnancy as well as to identify their associations with gestational weight gain (GWG) and anthropometric measurements at birth. METHODS: A minimum sample size of 95 nursing mothers was estimated for this work. Socioeconomic, anthropometric, physical activity, obstetric and food consumption (food frequency questionnaire) data was collected from mothers and their newborns in immediate postpartum (n = 260) at the maternity hospital. Maternal pregestational weight and GWG were self-reported and the neonatal data was obtained from their records. The patterns were derived posteriori by Principal Component Analysis (PCA). Multinomial Logistic Regression and Poisson Regression with Robust Variance were applied. FINDINGS: Four dietary patterns were derived: "pattern 1", characterized by the consumption of meat and eggs, processed meat, vegetables and olive oil; "pattern 2", consisting of sweets, snacks and cookies; "pattern 3", which includes cereals and breads, coffee and tea, and processed fats; and "pattern 4", characterized by soft drinks, tubers and instant noodles. Together, the dietary patterns account for 49.16% of the total variance for food intake. Higher adherence to "pattern 3" was associated with inadequate birth weight (low and excessive birth weight); while greater adherence to "pattern 2" was associated with lower chances of inadequate GWG. CONCLUSION: The dietary patterns presented mixed composition and predominance of ultra-processed foods. They were associated with the investigated outcomes, denoting the importance of strategies to promote healthy eating habits during pregnancy in order to avoid possible complications.

The Influence of Nutrients Intake during Pregnancy on Baby's Birth Weight: A Systematic Review.

BACKGROUND AND OBJECTIVE: Maternal food intake during pregnancy can substantially interfere in the baby's anthropometric measurements at birth. Our objective was to perform a systematic review that investigate the influence of nutrient intake via food during pregnancy on the baby's anthropometric measurements at birth. METHODS: A search was performed without time limits on CINAHL, Embase, PubMed, Scopus and Web of Science databases and manual on studies references. All nutrients and baby's anthropometric measurements at birth were included as descriptors. RESULTS: Thirty articles were included, the majority of prospective cohort studies, with 15.39 (2.36) quality points (maximum value: 22). Thirty-six results of associations were found, of which 17 studies had direct associations between nutrient intake and birth outcomes. Inverse associations were identified in 8 studies and 11 articles showed no significant associations in all analyses. Maternal food intake of vitamin C, calcium and magnesium during pregnancy seems to have a positive influence on the baby's birth weight, while carbohydrates intake have an inverse association with the same outcome. CONCLUSION: It is suggested that vitamin C, calcium, magnesium and carbohydrates influence on baby's birth weight. So, these specific nutrients need more attention to the consumption, in addition to carried out new studies, with robust methodologies for measuring maternal food consumption and considering the several factors that can interfere in this assessment. REGISTRATION: This review has been registered to the PROSPERO (International prospective register of systematic reviews) (ID: CRD42020167889).

[Healthcare and gestational factors associated with anemia in nursing mothers attended in a human milk bank]. / Fatores assistenciais e gestacionais associados à anemia em nutrizes atendidas em um banco de leite humano.

Anemia is a public health problem that affects about 30% of Brazilian women, which may cause deleterious effects on the health and quality of life of mother and child. This article seeks to evaluate the healthcare and gestational factors associated with anemia among mothers receiving care at a human milk bank (HMB) of reference. It is a cross-sectional study with secondary data about sociodemographic and pregnancy information on 12283 nursing mothers from 2009 to 2012. The Kolmogorov-Smirnov and chi-square or Fisher's exact tests were applied. The prevalence ratios (PR) and their 95% confidence intervals were estimated by Poisson regression with robust variance. Anemia was identified in 29.2% of the sample and the prevalence was higher among mothers who did not have prenatal appointments (PR = 3.84; 95% CI 3.26 to 4.54); those who made 3 or less antenatal visits (PR = 1.92; 95% CI 1.21 to 3.06) and those who have had multiple pregnancies (OR = 2.29, 95% CI 1.25 to 4.19). The results showed a higher prevalence of anemia among women who did not have the appropriate prenatal care and who have had multiple pregnancies, highlighting the importance of healthcare as a factor in the prevention of anemia and other complications during pregnancy.

A anemia é um problema de saúde pública que acomete cerca de 30% das gestantes brasileiras, podendo acarretar efeitos deletérios à saúde e qualidade de vida do binômio mãe-filho. O objetivo deste artigo é avaliar os fatores assistenciais e gestacionais associados à anemia entre nutrizes atendidas em um banco de leite humano (BLH) de referência. Estudo transversal com dados secundários referentes a informações sociodemográficas e gestacionais de 12283 nutrizes no período de 2009 a 2012. Aplicaram-se os testes Kolmogorov-Smirnov e Qui-quadrado ou exato de Fisher. Estimaram-se as Razões de Prevalência (RP) e respectivos Intervalos de Confiança-IC95%, por meio da Regressão de Poisson com variância robusta. Identificou-se a prevalência de anemia em 29,2% da amostra, sendo maior entre as mães que não realizaram o pré-natal (RP = 3,84; IC95% 3,26-4,54); as que realizaram até 3 consultas pré-natais (RP = 1,92; IC95% 1,21-3,06) e aquelas que tiveram gestação múltipla (RP = 2,29; IC95% 1,25-4,19). Os resultados apontaram maior prevalência de anemia entre as mulheres que não realizaram o pré-natal apropriado e as que tiveram gestações múltiplas, destacando-se a importância da assistência à saúde como fator de prevenção à anemia e demais intercorrências gestacionais.

[Nutritional and sociodemographic characteristics of nursing mothers: a systematic review]. / Caracterização nutricional e sociodemográfica de lactantes: uma revisão sistemática.

A systematic review of nutritional and sociodemographic characteristics of nursing mothers, using the published literature from 2004 to 2014 in the Biblioteca Virtual de Saúde and Medline databases. Using the following key words, 561 articles were identified: "Human Milk" and "Milk Banks"; keywords: "Profile," "Nutritional," "Milk Donor," "Nursing Mother" and "Nursing Mothers"; available abstracts; date and language. From these, 84.1% were excluded for not dealing with the established subject, 1.8% for being a review and 7.5% for the unavailability of abstracts for study. Thirty-seven articles were selected, of which 18.9% analyzed the profile of the HM donor. Of the total, 89.2% reported age, the majority between 20 and 30 years of age. The level of schooling was mentioned in 32.4% ranging from elementary school and higher education. With respect to income, a higher prevalence of low socioeconomic status was observed. About the nutritional status, 45.9% of the studies measured the body mass index and 29.4% reported the predominance of excess weight. There were deficiencies, particularly of vitamin A, with frequencies between 9% and 26%. A majority of young adult mothers, varied schooling, low income and nutritional deficiencies were noted, demanding interventions to improve health and increase HM donations.

Revisão sistemática da caracterização nutricional e sociodemográfica de lactantes, por meio da literatura publicada entre 2004-2014, indexadas na Biblioteca Virtual de Saúde e Medline. Foram identificados 561 artigos com os descritores: "Leite Humano" e "Bancos de Leite"; palavras-chave: "Perfil", "Nutricional", "Doadoras de leite", "Nutriz" e "Nutrizes"; resumos disponíveis; data e idioma. Destes, 84,1% foram excluídos por não atenderem a temática, 1,8% por se tratarem de revisão e 7,5% por estarem indisponíveis para consulta. Foram selecionados 37 artigos, dos quais, 18,9% analisaram o perfil da doadora de LH. Do total, 89,2% referiram a idade, maioria entre 20 e 30 anos. Nível de escolaridade foi mencionado em 32,4%, variando entre ensino fundamental e superior. Quanto à renda, encontrou-se predominância de baixo nível socioeconômico. No âmbito nutricional, 45,9% dos estudos avaliaram o Índice de Massa Corporal e 29,4% o relataram na faixa de excesso de peso. Observaram-se carências, sobretudo de vitamina A, com as frequências de inadequações entre 9-26%. Observou-se predominância de adultas jovens, escolaridade variada, baixa renda e deficiências nutricionais demandando intervenções para contribuir na melhoria da saúde e aumento das doações de LH.

Caracterização nutricional e sociodemográfica de lactantes: uma revisão sistemática / Nutritional and sociodemographic characteristics of nursing mothers: a systematic review

Resumo Revisão sistemática da caracterização nutricional e sociodemográfica de lactantes, por meio da literatura publicada entre 2004-2014, indexadas na Biblioteca Virtual de Saúde e Medline. Foram identificados 561 artigos com os descritores: "Leite Humano" e "Bancos de Leite"; palavras-chave: "Perfil", "Nutricional", "Doadoras de leite", "Nutriz" e "Nutrizes"; resumos disponíveis; data e idioma. Destes, 84,1% foram excluídos por não atenderem a temática, 1,8% por se tratarem de revisão e 7,5% por estarem indisponíveis para consulta. Foram selecionados 37 artigos, dos quais, 18,9% analisaram o perfil da doadora de LH. Do total, 89,2% referiram a idade, maioria entre 20 e 30 anos. Nível de escolaridade foi mencionado em 32,4%, variando entre ensino fundamental e superior. Quanto à renda, encontrou-se predominância de baixo nível socioeconômico. No âmbito nutricional, 45,9% dos estudos avaliaram o Índice de Massa Corporal e 29,4% o relataram na faixa de excesso de peso. Observaram-se carências, sobretudo de vitamina A, com as frequências de inadequações entre 9-26%. Observou-se predominância de adultas jovens, escolaridade variada, baixa renda e deficiências nutricionais demandando intervenções para contribuir na melhoria da saúde e aumento das doações de LH.

Abstract A systematic review of nutritional and sociodemographic characteristics of nursing mothers, using the published literature from 2004 to 2014 in the Biblioteca Virtual de Saúde and Medline databases. Using the following key words, 561 articles were identified: "Human Milk" and "Milk Banks"; keywords: "Profile," "Nutritional," "Milk Donor," "Nursing Mother" and "Nursing Mothers"; available abstracts; date and language. From these, 84.1% were excluded for not dealing with the established subject, 1.8% for being a review and 7.5% for the unavailability of abstracts for study. Thirty-seven articles were selected, of which 18.9% analyzed the profile of the HM donor. Of the total, 89.2% reported age, the majority between 20 and 30 years of age. The level of schooling was mentioned in 32.4% ranging from elementary school and higher education. With respect to income, a higher prevalence of low socioeconomic status was observed. About the nutritional status, 45.9% of the studies measured the body mass index and 29.4% reported the predominance of excess weight. There were deficiencies, particularly of vitamin A, with frequencies between 9% and 26%. A majority of young adult mothers, varied schooling, low income and nutritional deficiencies were noted, demanding interventions to improve health and increase HM donations.

Fatores assistenciais e gestacionais associados à anemia em nutrizes atendidas em um banco de leite humano / Healthcare and gestational factors associated with anemia in nursing mothers attended in a human milk bank

Resumo A anemia é um problema de saúde pública que acomete cerca de 30% das gestantes brasileiras, podendo acarretar efeitos deletérios à saúde e qualidade de vida do binômio mãe-filho. O objetivo deste artigo é avaliar os fatores assistenciais e gestacionais associados à anemia entre nutrizes atendidas em um banco de leite humano (BLH) de referência. Estudo transversal com dados secundários referentes a informações sociodemográficas e gestacionais de 12283 nutrizes no período de 2009 a 2012. Aplicaram-se os testes Kolmogorov-Smirnov e Qui-quadrado ou exato de Fisher. Estimaram-se as Razões de Prevalência (RP) e respectivos Intervalos de Confiança-IC95%, por meio da Regressão de Poisson com variância robusta. Identificou-se a prevalência de anemia em 29,2% da amostra, sendo maior entre as mães que não realizaram o pré-natal (RP = 3,84; IC95% 3,26-4,54); as que realizaram até 3 consultas pré-natais (RP = 1,92; IC95% 1,21-3,06) e aquelas que tiveram gestação múltipla (RP = 2,29; IC95% 1,25-4,19). Os resultados apontaram maior prevalência de anemia entre as mulheres que não realizaram o pré-natal apropriado e as que tiveram gestações múltiplas, destacando-se a importância da assistência à saúde como fator de prevenção à anemia e demais intercorrências gestacionais.

Abstract Anemia is a public health problem that affects about 30% of Brazilian women, which may cause deleterious effects on the health and quality of life of mother and child. This article seeks to evaluate the healthcare and gestational factors associated with anemia among mothers receiving care at a human milk bank (HMB) of reference. It is a cross-sectional study with secondary data about sociodemographic and pregnancy information on 12283 nursing mothers from 2009 to 2012. The Kolmogorov-Smirnov and chi-square or Fisher's exact tests were applied. The prevalence ratios (PR) and their 95% confidence intervals were estimated by Poisson regression with robust variance. Anemia was identified in 29.2% of the sample and the prevalence was higher among mothers who did not have prenatal appointments (PR = 3.84; 95% CI 3.26 to 4.54); those who made 3 or less antenatal visits (PR = 1.92; 95% CI 1.21 to 3.06) and those who have had multiple pregnancies (OR = 2.29, 95% CI 1.25 to 4.19). The results showed a higher prevalence of anemia among women who did not have the appropriate prenatal care and who have had multiple pregnancies, highlighting the importance of healthcare as a factor in the prevention of anemia and other complications during pregnancy.