Fatores relacionados ao desmame precoce em bebês nascidos a termo em uma maternidade pública

Abstract

The World Health Organization (WHO) and the Ministry of Health (MH) of Brazil recommend exclusive breastfeeding (EBF) up to the 6th month and in a complementary way up to 2 years. However, despite being physiological, breastfeeding is a complex process that is influenced by several factors, and currently EBF reaches only 45,8% of babies up to 6 months of age. Early weaning is compromising for child development. In view of this, knowing and understanding the factors that affect the continuity of BF is important so that one can think of ways to help women in the breastfeeding process and avoid problems related to early weaning. Therefore, the objective of this study was to understand how socioeconomic factors, pregnancy and childbirth are related to the situation of feeding in the sixth month of life of full-term newborns. This is an observational, longitudinal, descriptive study with a quantitative approach, consisting of 98 postpartum women, mothers of full-term babies. The study was approved by the Research Ethics Committee of the HMOB under report number 4.480.984. Data collection was structured by capturing data referring to the clinical history and the moment of delivery – consulted in the babies’ medical records, followed by the application of two structured questionnaires to the mothers, with questions related to sociodemographic data, pre and post gestational data and the baby food in the 6th month. A descriptive analysis of the data was performed, through the frequency distribution of categorical variables, using Pearson’s chi-square test, with significant associations with p≤0,05. Most of the mothers who participated in the study were aged between 21 and 35 years old (75,5%), single (65,3%), had finished high school (73,5%), mixed race (63,3%), had a family income of two minimum wages or more (55,1 %) and worked as self-employed or at home (63,3%). 83,7% of the women reported having had 6 or more prenatal consultations, 55,1% had a normal delivery, 53,1% were multiparous and 60,2% had complaints about breastfeeding. As for the babies, 56,1% were male, 89,8% were on EBF at the time of postpartum hospital discharge, 83,7% had not received EBF until the 6th month of life, 64,3% had no more contact with breast milk in the 6th month, 34,7% were on artificial feeding in the 6th month, 56,1% had already started the introduction of food in the 6th month and 41,8% started porridge at the 5th month. There was an association between exclusive breastfeeding in the 6th month and maternal education, in which it was observed that mothers with secondary education maintained EBF less, when compared to mothers with higher education. In the analysis of the association between the offer of porridge up to the 6th month and sociodemographic and pre/postnatal data, there was an association between the period of offering porridge and family income. It was observed that families with higher income started offering porridge later, when compared to families with lower income. The other associations did not show statistically significant results. In view of this, it is possible to conclude that access to information and knowledge regarding breastfeeding, as well as the introduction of food in the appropriate period, are favorable to the maintenance of breast milk for a longer period.