Aleitamento materno entre recém-nascidos de risco de Cuiabá – MT : prevalência e fatores dificultadores/facilitadores

Abstract

The breastmilk is the most adequate source of nutrients to the child, rich in antibodies, providing satisfactory growth, decreases the child mortality risks, protects against infections and allergies, besides economics advantages and strength of the link mother-child. However, the breastfeeding is still a little frequent and short time practice, which is an apart trouble when it comes to newborns at risk, according to the weakness they are exposed. Aims – to analyze the breastfeeding on the six firsts months of life among the newborns at risk from Cuiabá – MT. Methods – a cross sectional descriptive study, with quantitative analysis. Were studied the newborns at risk born on January 2011, in Cuiabá, living in this city, which answered, at least one of the classification standards defined by the Ministry of Health to newborns at risk. The first data source was the “Declaração de Nascido Vivo”, which adds the identification and inclusion of the newborns in this study. Six months after birth, it was done a household survey for the others data gathering. Also, it was used the program EPINFO, version 3.5.1 to the data processing and analysis. It were done univariates and bivariates statistical techniques, considering p < 0,05. Results – it were studied 107 newborns at risk. 45,8% of the newborns were included due to the mother low instruction; 38,3% had mothers under 18 years old; 26,2% with under 37 weeks of gestation; 15,0% present the weight under 2.500 grams on birth and 2,8% a severe asphyxia. In relation to breastfeeding, 74,8% of the newborns received exclusive breastfeeding in the first 24 hours of life, and about it duration, only 5,6% remained on exclusive breastfeeding until six firsts months of life. Among the mothers which don’t exclusively breastfed, 41,7% were under 18 years old. High level of maternal educational was associated with lower duration of breastfeeding. The lactating mothers resort to her owns mothers when they have doubts about breastfeeding (48,6%); 30,8% of the newborns at risk received breastmilk substitutes; 78,5% used bottles and 42,1% used pacifiers. The main reason for the offering of substitutes was the lack of milk, and this practice causes a greater occurrence of diseases. It was a bigger proportion of inadequate weight and morbidities among child who used bottles and pacifiers. A greater frequency in the prenatal resulted in best results regarding the exclusive breastfeeding maintenance. The rate of exclusive 9 breastfeeding after the birth was 53,6% among mothers which had under 37 weeks gestation, 86,4% among mothers who had 37 to 42 weeks of gestation and 100% among the mothers the gestation lasts 42 weeks or more. Among the child which received exclusive breastfeeding in the firsts hours of life, 37,5% were born under 2.500 grams, and 81,8% were born weighting between 2.500 and 3.500 grams; the vaginal birth was associated with greater grades of exclusive breastfeeding. The prevailing facilitator breastfeeding factor was the family support (91,6%), followed by the breastfeed desire (89,7%) and orientations about breastfeeding received on maternity (80,4%). Mammary diseases was the most mentioned barrier (43,0%), followed by the lack of breastmilk (33,6%) and breastfeeding inexperience (23,4%). Conclusions – it contrasts the low prevalence of the breastfeeding on the six months of life, besides the expressivity of the use of bottle and pacifier. To characterize the newborns at risk, regarding the breastfeeding, enables to orientate the specifics practices and politics to this group. The results indicate the importance of the attendance and monitoring for the newborns at risk and their mothers, in order to foment and keep the breastfeeding.