Reconfiguring insufficient breast milk as a sociosomatic problem: mothers of premature babies using the kangaroo method in Brazil

Abstract

This study focuses on Brazilian mothers who gave birth to premature babies who were discharged from hospital using the Kangaroo Mother Care Method. While mothers left the hospital breastfeeding exclusively, once back at home, they abandoned exclusive breastfeeding because of insufficient breast milk (IBM). In this project we explored how IBM was interpreted by mothers within their social context. Participatory research using the Creative Sensitive Method was done in the homes of mothers with family members and neighbours. We described the conflicting social discourse that influenced the mothers' perception of IBM and explored their sources of distress. At the hospital and Kangaroo ward, mothers considered that clinicians recognized they were experiencing IBM and thus supported them to overcome this problem. Back at home and in their community, other sources of stress generated anxiety such as: the lack of outpatient clinical support, and conflicting local norms to care and feed premature babies. These difficulties combined with economic constraints and discontinuity in models of health care led mothers to lose confidence in their breastfeeding capacity. Mothers, thus, rapidly replaced exclusive breastfeeding by mixed feeding or formula feeding. Our analysis suggests that IBM in our sample was the result of a socio-somatic process. Recommendations are proposed to help overcome IBM and corresponding contextual barriers to exclusive breastfeeding.

Familiares cuidadores articulando rede social de criança com necessidades especiais de saúde

“…A qualitative descriptive study was developed with the creative sensitive method that has been applied repeatedly since 1998 to studies about families with children with special health needs (2,(14)(15)(17)(18)(19)(20)(21) . The epistemological basis is the critical reflection of participant research, the group dynamics of social psychology and the artistic creation of the art-based research.…”

“…The epistemological basis is the critical reflection of participant research, the group dynamics of social psychology and the artistic creation of the art-based research. The foundation of the method is the dynamics of creativity and sensibility that combines artistic production with group discussion and participant observation (20)(21)(22) . During group research practices, that aim for alterity in the singular individual experience, this method favors the interaction of the researcher with participants that do not have enough vocabulary to express complex ideas.…”

“…The Creativity and Sensitivity Dynamics Speaking Map was selected due to the possibility of the participants singling out, in their artistic production, the locations and people that were part of the path of their experience. The socio-space dimension of the experience becomes visible on the drawings of the locations where people circulate (20)(21)(22)(23) .…”

Advocacy care on HIV disclosure to children

“…Wood () reports that it is helpful to guide interviews using maps, which provide us a way to access HIV/aids topics as a private subject. Many authors have addressed the use of art as a strategic and ethical way of approaching various sensitive topics (Archibald, Caine, & Scott, ; Groleau & Cabral, ; McNiff, ; Soratto et al., ). Furthermore, artistic strategies allow participants to relocate experiences from themselves to the art and enable them to speak about how difficult is to deal with issues and to approach issues from a necessary distance.…”

As (im)possibilidades de brincar para o escolar com câncer em tratamento ambulatorial

“…In this type of dynamic-group, the participants of the research prepare an artistic production mobilized by a subject that generates a debate related to the object of study. The production gives incentive the participants to talk about themselves through what they produced, evoking his values and beliefs in subjects that are of common interest to the group (11)(12)(13) . The researcher assumes the presenter's role with the help of a assistant who registers (verbal, photographic and phonographic) the meeting events.…”