Tipo de aleitamento materno na alta hospitalar de prematuros: revisão integrativa

Abstract

The moment from conception to the arrival of the child in the life of the parents and the family is one of great expectation most of the time. However, when this arrival is associated with unexpected complications, such as premature birth requiring hospitalization, it can be a challenging period. Several studies affirm the low prevalence of Exclusive Breastfeeding in Premature Newborns, especially of very premature and extremely premature babies. Therefore, the main objective of this study is to investigate in consolidated bases the publications on the maintenance and persistence of breastfeeding after hospital discharge of preterm infants. In order to contemplate the proposed objectives, we opted for an integrative review carried out through the Scientific Electronic Library Online (SciELO) and National Library of Medicine (PUB-MED) databases. The study was conducted between October 2023 and February 2024. National and international articles published in the last five years, which address the prevalence of breastfeeding in preterm infants hospitalized in Neonatal Units. Articles that address breastfeeding in full-term newborns were excluded; studies that compared BF rates in preterm infants with versus without comorbidities, as well as experience reports, dissertations, reviews, theses, books, and duplicate articles. After cross-referencing the descriptors in the databases and applying the inclusion criteria, 92 articles were found, 23 in SciELO and 69 in PUB-MED. Of these, 12 were selected to compose the research. The study showed that despite the efforts of the health team involved in the care of premature newborns to leave the hospital exclusively breastfed, early weaning rates increase significantly, especially if investigated after the first month of life. There are several reasons that can lead to this weaning at home, such as cesarean section, maternal emotional delivery, inefficiency in the support network, clinical condition of the newborn and lack of support from health professionals inside and outside the hospital are pointed out as the most prevalent in the literature. Strategies to reduce weaning after hospital discharge include support and guidance to these families in prenatal care, childbirth and puerperium, encouragement of postpartum milking, permanence of parents in neonatal units to create bonds, the kangaroo method, use of instruments that assess the breastfeeding conditions of mother and child, support groups, among others.