Orientações sobre amamentação no pré-natal: evidências para a promoção do aleitamento materno exclusivo

Abstract

This study aimed to analyze the guidelines on breastfeeding received by mothers during prenatal care in primary healthcare, for the promotion of exclusive breastfeeding, from the healthcare service users' perspective. To achieve the intended objective, the research was carried out in two stages: the development of an integrative review and the conduction of a descriptive correlational study. The search for primary studies for inclusion in the integrative review was carried out in the National Library of Medicine - National Institutes of Health, Cumulative Index to Nursing and Allied Health Literature, and Latin American and Caribbean Literature in Health Sciences databases. The integrative review sample consisted of 26 primary studies, grouped into three categories: breastfeeding knowledge and perception, education in healthcare for breastfeeding promotion, and factors associated with the interruption of breastfeeding. It was possible to synthesize the evidence regarding breastfeeding guidelines through the development of the integrative review, in which it was possible to verify that mothers have a superficial perception and knowledge on breastfeeding; that group education activities, prenatal breastfeeding guidelines, and counseling interventions were the most prominent breastfeeding promotion practices; and that the main factors associated with the interruption of breastfeeding were the perception of weak or insufficient milk and the occurrence of breast problems. The descriptive correlational study was carried out in 18 Family Healthcare Units, in a city located in the south of the State of Minas Gerais, where 140 mothers of children aged under six months were registered through home visits. A previously validated instrument consisting of 56 questions was used for data collection. The Chi-square, Fisher's Exact, G Test, and Odds Ratio statistical tests were used to verify the association between the study variables. The sample consisted of women aged between 25 and 30 years, who selfdeclared as white, had completed high school, and did not work. A total of 41.43% of the mothers were instructed on prenatal breastfeeding. Among the guidelines received by them, 65.00% concerned exclusive breastfeeding, 54.29% concerned position, and also 54.29% concerned not using baby bottles. The frequencies of breastfeeding and exclusive breastfeeding were 80.71% and 55.00%, respectively. Significant associations were found between the variables of monthly income; children's age group; leaving the maternity ward during exclusive breastfeeding; breastfed the last child; the child was breastfed; how many times a day the child was breastfed; the child drank water, tea, juice or other kinds of milk; the child ate fruit, soup, porridge or pot food; a baby bottle or pacifier was used, and also a pacifier was used with the exclusive breastfeeding outcome variable. This study's findings point to the importance of prenatal care among other factors, in terms of supporting and encouraging breastfeeding, through the implementation of educational actions and guidelines, in order to promote exclusive breastfeeding for the time proposed by healthcare organizations, as well as to leverage the rates of exclusive breastfeeding in the country.