Breastfeeding is natural but not always easy: intervention for common medical problems of breastfeeding mothers – a review of the scientific evidence

Abstract

Natural processes do not always function perfectly. In breastfeeding, problems are encountered in up to 80% of mother-infant dyads. Altogether, in Western societies, the difficulties reduce the breastfeeding rate within the first months drastically. To deal with the problems of breastfeeding efficiently requires a profound understanding of its physiology, as well as of its psychological and social determinants. This review focuses on the current knowledge of breastfeeding physiology, only touching the psychosocial factors, which are included in the promotion strategies. Subsequently, it scrutinizes definitions, incidences, prevention, and treatment of breastfeeding problems faced most frequently by nursing mothers and their consultants. Not all measures used in counseling mothers and not all treatments for the most common medical problems withstand a careful evaluation on the basis of current scientific data. However, applying proven prevention strategies will significantly improve the well being of mothers and their infants, and may contribute to an affective attitude that increases the success, frequency, and duration of breastfeeding.

Predictors of impaired breastfeeding initiation and maintenance in a diverse sample: what is important?

“…Postoperative care routines often interrupt bonding [45] and delay mothers holding their infants [41,46]. Furthermore, our results showed that the more difficulties breastfeeding mothers had during the first days, the less they continued.…”

When ‘breast’ is no longer ‘best’: Post-partum constructions of infant-feeding in the hospital

“…For example, one systematic review of 45 English printed articles from across 16 countries shows that among other institutional and organizational factors that constrain and facilitate the implementation of the BFI, health care providers often express reservation about promoting breastfeeding so as to be respectful of mothers' perceived cultural beliefs and practices and to avoid making mothers feel guilty about their non-breastfeeding decisions (Semenic et al, 2012). Likewise complications with breastfeeding (sore nipples, insufficient milk, tiredness), and infant incessant crying or fussiness are not uncommon in the initial attempts at feeding (Bergmann et al, 2013;Kelleher, 2006). In these moments, health care providers influence whether or not supplementation occurs, and thus whether or not breastfeeding is defined as 'successful' (Gagnon et al, 2005).…”

Fatores que influenciam o desmame precoce

“…Outro fator relacionado são os recém-nascidos que apresentam movimentos orais atípicos (disfunções orais) durante a mamada, os quais podem ocasionar problemas decorrentes de alterações temporárias do próprio funcionamento oral, ou mesmo algumas características particulares anatômicas que atrapalham o encaixe adequado entre a boca do bebê e o peito, e também fatores iatrogênicos (2). Um estudo realizado constatou que 57,3% dos binô-mios mães/recém-nascidos apresentavam alteração da mamada e a frequência da disfunção oral foi de aproximadamente 30% (3).…”