No abstract

Resumo Objetivo Analisar a associação entre o tipo de aleitamento e as dificuldades relacionadas à essa prática entre mulheres e crianças assistidas em um ambulatório especializado em amamentação. Métodos Estudo transversal retrospectivo realizado por meio da análise de prontuários de crianças e mulheres atendidas entre 2004 e 2016 em um ambulatório especializado em aleitamento materno. Foram excluídos os registros referentes às mulheres com gestação múltipla e àqueles não realizados em formulário padrão, totalizando 1.608 prontuários. Utilizaram-se os testes Qui-Quadrado e Kruskal-Wallis para comparar o tipo de aleitamento materno com variáveis categóricas; e com os dias de vida e idade materna, respectivamente. O teste Mann-Whitney utilizou-se para comparar a frequência do aleitamento materno exclusivo. Resultados O aleitamento materno exclusivo foi praticado por 72,6% das mulheres atendidas, nos primeiros 30 dias após o parto. Houve associação significativa entre esta prática e as dificuldades: percepção materna quanto à quantidade de leite produzida, de mamas cheias antes das mamadas, de vazamento de leite e extração manual do leite com facilidade; posicionamento materno e da criança, preensão, sucção e deglutição da criança adequados; além das variáveis: maior escolaridade, situação conjugal estável; ter tido experiência prévia com aleitamento materno, ter mamilos protrusos, ter realizado contato precoce pele a pele, ter filhos com menor média de dias de idade e que faziam uso de chupeta. Conclusão O aleitamento materno exclusivo foi o mais prevalente nos primeiros 30 dias pós-parto e diversas variáveis maternas e neonatais estiveram associadas à essa prática no primeiro atendimento em ambulatório especializado.

Objective: to verify the factors associated with the practice of skin-to-skin contact with breastfeeding in the first hour of life and its influence on exclusive breastfeeding in the first month. Method: a retrospective cross-sectional study with medical records from a breastfeeding outpatient clinic in São Paulo, Brazil. The sample included all the medical records of the mother-baby dyad who had been consulted by nurses between 2004 and 2010. Data were collected from the medical records between 2014 and 2015. Results: 1,030 medical records were identified, 71 were excluded and the final sample was 959. The prevalence of skin-to-skin contact with breastfeeding in the first hour was 37.2%. The Apgar score between 8 and 10 in the first minute of life and the higher birth weight of the newborn were protective factors of contact with early breastfeeding; lower maternal age and cesarean delivery and forceps were risk factors for this practice. Exclusive breastfeeding was statistically higher in the group of newborns who had contact with breastfeeding in the first hour; however, there was no association with duration of exclusive breastfeeding. Conclusion: good birth conditions were protective factors for breastfeeding followed by skin-to-skin contact in the first hour, while younger maternal age and surgical deliveries proved to be risk factors. Exclusive breastfeeding in the baby´s first month of life was not associated with skin-to-skin contact followed by breastfeeding in the first hour of life.

No abstract

Aims To describe and evaluate pain scales used to measure nipple pain in breastfeeding women and to identify nipple pain intensity in women with or without nipple damage. Background Nipple pain is one of the most common reasons given for premature cessation of breastfeeding. However, there are no agreed tools to measure pain and no previous reviews have provided summary estimates of pain scores. Design Systematic review. Data sources Medline, CINAHL, Scopus, Web of Science, SciELO, and LILACS. Review methods We followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. The guiding question was: How is nipple pain in breastfeeding women measured and how severe is it? We analysed articles published up to February 2018, excluded review articles and those that did not present the level of nipple pain or tools to estimate pain severity. Results A total of 1,023 articles were identified and 25 were included in the review after applying the exclusion criteria. The Numeric Rating Scale (nine studies) and Visual Analogue Scale (seven studies) were the most prevalent tools for measuring pain. Using a pain score between 0–10, women with nipple damage reported a weighted mean of 6.2 in the first week and 5.8 after that period; women without damage reported a weighted mean of 2.7. Conclusion Women with nipple damage consistently reported a higher level of pain than women without damage. To prevent premature cessation of breastfeeding, it is important to help new mothers avoid nipple damage.