Padrões de aleitamento materno em recém-nascidos pré-termo internados e no primeiro mês após a alta hospitalar

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

2011

RESUMO

Background: The benefits of human milk for preterm infants are recognized in the scientific literature. However, the establishment of preterm infant breastfeeding involves many factors that complicate this process. Objective: To analyze breastfeeding patterns in hospitalized preterm babies and one month after the hospital discharge. Methods: Prospective cohort study with 116 mothers and their preterm babies hospitalized at ¿Hospital de Clínicas de Porto Alegre¿ (HCPA) Neonatal Unit from September 1st 2009 to August 25th 2010 born of a gestational age between 32 and 36 weeks, hospitalized for the entire time at HCPA Neonatal Unit and having been breastfed until the time of the hospital discharge. The variables were collected via consultation of babies¿ and mothers¿ medical records, registers books of human milk bank and through three interviews with the mother: the first one was personal, done right before the babies¿ hospital discharge day, the second and the third ones were done by telephone, respectively, on the 14th and the 28th days after the hospital discharge. This project, approved by HCPA under number 09.291, was supported by HCPA¿s Research Incentive Fund and Events. Results: The babies included in this study presented the following characteristics: average gestational age of 34.5±1.4 weeks, average birth weight of 2.130,5±567.7g, median hospital stay of 15 (10-29) days, and 59.5% were males. Among the mothers¿ characteristics, we can highlight the following: average age of 27.3±7.5, average school attendance of 9.4±3.4 years; 57.8% were white; 50.9% did not have previous breastfeeding experience. At the moment of the hospital discharge, all the babies were being breastfed. On the 14th day after the hospital discharge, 36.2% were being exclusively breastfed; 55.2% were breastfed, e 8.6% had been weaned. On the 28th day after hospital discharge, 25% were exclusively breastfed, 60.3% were breastfed, and 14.7% were weaned. A multivariate analysis was separately performed with variables related to the babies and mothers. The results of the multivariate analysis with variables related of the baby, when adjusted to birth weight, gestational age at birth, hospital stay and complementary to breastfeeding during hospital stay, have shown that the beginning of exclusive breastfeeding after the hospital discharge was only associated with non-use of pacifier before the beginning of exclusive breastfeeding (HR= 4,01; IC95%: 2,13-7,52). The multivariate analysis of the mother¿s factors, when adjusted to baby satisfied only with breastfeeding during hospital stay according to mother¿s perception and place where the mother was during her child¿s hospital stay, has shown association between the beginning of exclusive breastfeeding after the hospital discharge with recommendation of exclusive breastfeeding at the baby¿s hospital discharge (HR=6,6; IC 95%: 2,90-15,16). Conclusions: It was found that the patterns of breastfeeding changed along the first month after the hospital discharge. Exclusive breastfeeding occurred only at home, and its beginning was associated with the recommendation at hospital discharge of offering only breast milk to the baby at home and not offering the pacifier before initiating exclusive breastfeeding. Therefore, this study has led us to the reflection on the importance of both proceeding with breastfeeding and the results of recommendations given to the women along the pre-natal period, during hospital stay and at home.

ASSUNTO(S)

enfermagem neonatal patient discharge alta do paciente prematuro estudos de coortes lactancia materna enfermería neonatal alta del paciente prematuro premature infant aleitamento materno breastfeeding neonatal nursing

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