Amamentação e desconforto músculo-esquelético da mulher
Elhane Glass Morari-Cassol
DATA DE PUBLICAÇÃO
The exclusive breastfeeding, for six months, has shown a unique way of providing ideal food for the baby. However, the early weaning is still very frequent in our environment. The difficulties and/or obstacles for breastfeeding, among others, are the physical discomfort of women, in particular those related to mammary events. Nevertheless, the puerperium also has been shown as a period of risk for the musculoskeletal discomfort (MSD). This attributed to the physical overload, related to the care with the baby and breastfeeding, subject that has not been investigated. So, this research presents as objective to study the association between the woman MSD and breastfeeding, in the first six months after delivery. For this, it was accomplished a cross study involving 76 women, that had their first child, and vaccinated their children in the José Erasmo Crosseti Health Unit, in the city of Santa Maria RS. Thirty-eight women who breastfeed composed the Group 1 (G1), and 38 women who did not breastfeed composed the Group 2 (G2). A questionnaire was applied and it provided information about the woman, her child, breastfeeding and musculoskeletal symptoms. For the control of the symptoms of psychopathological nature, it was applied two instruments: the Scale for Depression after Childbirth from Edinburgh and the Inventory of Anxiety of Beck. It was still observed a complete breastfeeding in every mothers house of G1 to verify her and the babys position and the catch of the breast by the baby, using a formulary of observation and evaluation of the breastfeeding, that was adapted from instrument of assessment distributed by WHO (1993). For the analysis of data, it was used the chi-square test to compare the frequencies between the groups; at the end, the data were submitted to the analysis of univariate and multivariate logistic regression to determine the influence of the variables studied on the MSD. In the final model, the independent variables, that presented a significant level ≤ 0.25 in the univariate analysis, were included. The comparisons and associations were submitted to the statistical significant test, in which α=5% was adopted as a critical level, and α=10% for the multiple logistics analysis. The results showed similarities between the groups in most of the studied variables. The prevalence of MSD was of 78.9%, in the sample in general, with no significant statistical difference between the groups. However, in perception of the G1 women, the breastfeeding was indicated as the second cause of the discomfort in the lumbar and cervical regions, shoulders and the back, just below the index for uncomfortable postures and / or physical effort during the caring for the baby. In multivariate analysis, the problems with the breasts (p = 0.040) and the maternal occupation (p = 0.020) were associated positively to the MSD, that is, women with mammary trauma, malformations and mammary engorgement have a higher risk of MSD than women who reported no such problems (OR = 3.60; CI = 1.06-12.26). Women who had activities outside home also exhibited greater risk of MSD than the ones with the activities at home (OR = 4.20; CI = 1.24-14.15). According to the results, it is concluded that there is association between the woman MSD and breastfeeding in the first six months after delivery. As a result, the musculoskeletal discomfort needs to be more valorized, both by women and by the health professional, to find effective ways to prevent and treat it. Thus, we can contribute to the well-being of the mother and baby, the essential conditions for breastfeeding and maternal and child health.
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