Fatores facilitadores, principais dificuldades e estratégias empregadas no aleitamento materno de bebês com síndrome de down: uma revisão sistemática

Abstract

Purpose: To investigate in the literature the main difficulties related to breastfeeding in babies with Down syndrome, facilitating factors and indicated strategies. Methods: A systematic review was accomplished on PubMed, Scielo and VHL databases. The following descriptors were used: Down Syndrome and Breastfeeding and their correspondents in Portuguese and Spanish. Selection criteria: Original articles that addressed breastfeeding in Down syndrome, published in Portuguese, English or Spanish, between 1998 and 2018, were included. The following information was considered: year of publication, country of the research, sample, difficulties perceived in breastfeeding, facilitating factors, strategies, methodology and results. Results: 758 references were found, of which six contemplated the proposed selection criteria. Maternal emotional state due to the impact of the news, baby specificities, sucking difficulties, frequent hospitalizations and lack of support and knowledge on the part of health professionals were aspects that made breastfeeding difficult. The main facilitating factors cited were previous experience and family and professional support. As a direct strategy, stabilization of the baby’s head and mandible during feeding was pointed out. The indirect strategies cited were related to professional training and early multidisciplinary intervention. Conclusion: after analyzing the selected articles, it was concluded that breastfeeding difficulties in babies with Down Syndrome arise from the condition of the baby and the mother. Previous maternal experience and family support were cited as facilitators of breastfeeding. The main recommended strategies were indirect and related to the improvement of the health system.