Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T16:52:34.910Z Has data issue: false hasContentIssue false

Perceptions of Breastfeeding in Mothers of Babies Born Preterm in Comparison to Mothers of Full-Term Babies

Published online by Cambridge University Press:  10 January 2013

Flávia Helena Pereira Padovani
Affiliation:
Universidade de São Paulo (Brazil)
Geraldo Duarte
Affiliation:
Universidade de São Paulo (Brazil)
Francisco Eulógio Martinez
Affiliation:
Universidade de São Paulo (Brazil)
Maria Beatriz Martins Linhares*
Affiliation:
Universidade de São Paulo (Brazil)
*
Correspondence concerning this article should be addressed to Maria Beatriz Martins Linhares. Laboratório de Pesquisa em Prevenção de Problemas de Desenvolvimento e Comportamento da Criança (salas 52/ 53). Avenida Tenente Catão Roxo, 2650. Prédio da Saúde Mental - Faculdade de Medicina de Ribeirão Preto – USP. Campus Monte Alegre – USP. Ribeirão Preto - São Paulo, Brasil. Phone: +55-1636024610. Fax: +55-1636024504. E-mail: [email protected]

Abstract

The purpose of the present study was: a) to describe the theme of verbalizations about breastfeeding in mothers' pre-term (M-PT) and full-term (M-FT) infants; b) to examine the association between these themes and mother's anxiety and depression indicators and socio-demographic characteristics and, neonatal characteristics of the infants. The sample consisted of 50 M-PT and 25 M-FT. The mothers were assessed through State-Trait Anxiety Inventory and Beck Depression Inventory and were interviewed using a Guide focusing breastfeeding issues. The M-PT group had significantly more mothers with clinical symptom of anxiety than the M-FT group. The M-PT reported more uncertainties and worries about breastfeeding and figured out more obstacles for the successful breastfeeding than the M-FT. These reports were associated positively with the infants' risk neonatal status; lower birth-weight, higher neonatal clinical risk, and more length time stay in NICU were associated with more mothers' worries and seeing obstacles for breastfeeding. In conclusion, the strategies to enhance the breastfeeding rate in the preterm population have to take into account the mothers' psychological status and their ideas in addition to offering information about the advantages of breastfeeding for child development.

La presente investigación pretende: (a) ahondar en el tema de las verbalizaciones sobre amamantamiento en madres de niños prematuros y no prematuros; (b) evaluar la relación entre amamantamiento e indicadores de ansiedad y depresión en las madres, así como características socio-demográficas y neonatales de los niños. En el estudio participaron 50 madres de niños prematuros y 25 madres de niños llegados a término. Como herramientas de evaluación se utilizaron el Inventario Ansiedad-Rasgo y el Inventario de depresión de Beck; asimismo, se entrevistó a las madres siguiendo una guía específica para el tema del amamantamiento. Los resultados sugieren que las madres con más síntomas de ansiedad fueron las del grupo de bebés prematuros. Quienes, además, mostraron mayor inseguridad, preocupación y esperaban encontrar más obstculos para desarrollar con éxito el amamantamiento que las madres de niños llegados a término. Estos informes se relacionaron con riesgo neonatal en los niños. Por otra parte, factores como bajo peso al nacer, alto riesgo clínico al nacer, y estancias más largas en la UCI neonatal, se relacionaron con un mayor número de madres preocupadas y que preveían más obstáculos para el amamantamiento. En conclusión, las estrategias para aumentar la tasa de amamantamiento en madres de niños prematuros deben considerar el estado psicológico de las madres, sus ideas sobre el mismo, y ofrecer más información sobre las ventajas del amamantamiento en el desarrollo infantil.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alfaya, C., & Schermann, L. (2005). Sensibilidade e aleitamento materno em díades com recém-nascidos de risco [Breastfeeding and maternal sensitivity in dyads with infants born at risk]. Estudos de Psicologia (Natal), 10, 279285. doi:10.1590/S1413-294X2005000200015CrossRefGoogle Scholar
Anderson, J. W., Johnstone, B. M., & Remley, D. T. (1999). Breast-feeding and cognitive development: a meta-analysis. The American Journal of Clinical Nutrition, 70, 525535.CrossRefGoogle ScholarPubMed
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561571. doi:10.1037//0022-006X.43.5.746CrossRefGoogle ScholarPubMed
Biaggio, A. M. B., & Natalício, L. (1979). Inventário de ansiedade traço-estado - IDATE [State-Trait Anxiety Inventory – STAI]. Rio de Janeiro, Brazil: CEPA.Google Scholar
Biasoli-Alves, Z. M. M. (1998). A pesquisa em Psicologia - análise de métodos e estratégias na construção de um conhecimento que se pretende científico [Psychology research –methodology and strategies analysis for scientific knowledge framework]. In Romanelli, G. & Biasoli-Alves, Z. M. M. (Org.) Diálogos metodológicos sobre prática de pesquisa [Methodologic dialogues about research practice]. (pp. 135157). Ribeirão Preto, Brazil: Legis Summa.Google Scholar
Boo, N. Y., & Goh, E. S. (1999). Predictors of breastfeeding in very low birthweight infants at the time of discharge from hospital. Journal of Tropical Pediatrics, 45, 195201. doi:10.1093/tropej/45.4.195CrossRefGoogle ScholarPubMed
Caldeira, A. P., & Gonçalves, E. (2007). Assessment of the impact of implementing the Baby-Friendly Hospital Initiative. Jornal de Pediatria, 83, 127132. doi:10.2223/JPED.1596CrossRefGoogle ScholarPubMed
Camelo, J. S. Jr,. & Martinez, F. E. (2005) Dilemas nutricionais no pré-termo extremo e repercussões na infância, adolescência e vida adulta [Nutritional dilemmas in extremely low birth weight infants and their effects on childhood, adolescence and adulthood]. Jornal de Pediatria, 81, 3342. doi:10.1590/S0021-75572005000200005CrossRefGoogle Scholar
Carvalho, A. E. V. (2005). Indicadores emocionais maternos e intervenção psicológica durante hospitalização do bebê pré-termo em UTI Neonatal. [Maternal emotional indicators and psychological intervention during hospitalization of preterm infants in NICU] (Unpublished doctoral thesis). Universidade de São Paulo, São Paulo, Brazil.Google Scholar
Chaves, R. G., Lamounier, J. A., & César, C. C. (2007). Factors associated with duration of breastfeeding. Jornal de Pediatria, 83, 241246. doi:10.2223/JPED.1610Google ScholarPubMed
Cockburn, F., Cooke, R. W. I., Gamsu, H. R., Greenough, A., Hopkins, A., Mcintosh, N., … Wilkinson, A. R. (1993). The CRIB (Clinical Risk Index for Babies) score: A tool for assessing initial neonatal risk and comparing performance of Neonatal Intensive Care Units. The Lancet, 342, 193198. doi:10.1016/0140-6736(93)92296-6Google Scholar
Cunha, J. A. (2001). Manual for the Portuguese version of the Beck Scales. São Paulo, Brazil: Casa do Psicólogo.Google Scholar
Espy, K. A., & Senn, T. E. (2003). Incidence and correlates of breast milk feeding in hospitalized preterm infants. Social Science & Medicine, 57, 14211428. doi:10.1016/S0277-9536(02)00542-7CrossRefGoogle ScholarPubMed
Faleiros, F. T. V., Trezza, E. M. C., & Carandina, L. (2006). Factors influencing breastfeeding decision and duration. Revista de Nutrição, 19, 623630.CrossRefGoogle Scholar
Feldman, R., & Eidelman, A. I. (2003). Direct and indirect effects of breast milk on the neurobehavioral and cognitive development of premature infants. Developmental Psychobiology, 43, 109119. doi:10.1002/dev.10126CrossRefGoogle ScholarPubMed
Fuente, S. N. L., Klava, R., Ribeiro, L. C., & Taddei, J. A. A. C. (2006). Caracterização da prática do aleitamento materno em crianças menores de 2 anos atendidas em creches públicas e filantrópicas no município de São Paulo [Characterization of the practice of breastfeeding in children under 2 years old attending public and charities day care centers in the São Paulo city]. Revista Paulista de Pediatria, 24, 316322.Google Scholar
Furman, L., Minich, N. M., & Hack, M. (1998). Breastfeeding of very low birth weights infants. Journal of Human Lactation, 14, 2934. doi:10.1177/089033449801400112CrossRefGoogle Scholar
Giugliani, E. R. J., Issler, R. M. S., Justo, E. B., Seffrin, C. F., Hartman, R. M., & Carvalho, N. M. (1992). Risk factors for early termination of breast feeding in Brazil. Acta Paediatrica, 81, 484487.CrossRefGoogle ScholarPubMed
Gorenstein, C., & Andrade, L. (2000). Inventário de Depressão de Beck – Propriedades psicométricas da versão em Português [Beck Depression Inventory - Psychometric properties of the Portuguese Version]. In Gorenstein, C., Andrade, L. H. S. G., & Zuardi, A. W. (Eds.), Escalas de avaliação clínica em psiquiatria e psicofarmacologia. (pp. 8995). São Paulo, Brazil: Lemos-Editorial.Google Scholar
Kavanaugh, K., Mead, L., Meier, P., & Mangurten, H. H. (1995). Getting enough: mothers' concerns about breastfeeding a preterm infant after discharge. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 24, 2332. doi:10.1111/j.1552-6909.1995.tb02375.xCrossRefGoogle ScholarPubMed
Kavanaugh, K., Meier, P., Zimmermann, B., & Mead (1997). The rewards outweigh the efforts: breastfeeding outcomes for mothers of preterm infants. Journal of Human Lactation, 13, 1521. doi:10.1177/089033449701300111CrossRefGoogle ScholarPubMed
Lamounier, J. A. (1996). Promoção e incentivo ao aleitamento materno: Iniciativa Hospital Amigo da Criança [Promotion and enhancing the breastfeeding: Baby Friendly Hospital Initiative]. Jornal de Pediatria, 72, 363368.CrossRefGoogle Scholar
Leff, E. W., Gagne, M. P., & Jefferis, S. C. (1994). Maternal perceptions of successful breastfeeding. Journal of Human Lactation, 10, 99104. doi:10.1177/089033449401000216CrossRefGoogle ScholarPubMed
Lucas, A., Morley, R., & Cole, T. J. (1998). Randomised trial of early diet in preterm babies and later intelligence quotient. British Medical Journal, 317, 14811487.CrossRefGoogle ScholarPubMed
Lucas, A., Morley, R., Cole, T. J., Lister, G., & Leeson-Payne, C. (1992). Breast milk and subsequent intelligence quotient in children born preterm. The Lancet, 339, 261264. doi:10.1016/0140-6736(92)91329-7CrossRefGoogle ScholarPubMed
Miracle, D. J., Meier, P. P., & Bennett, P. A. (2004). Mothers' decisions to change from formula to mothers' milk for very-low-birth-weight infants. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 33, 692703. doi:10.1177/0884217504270665CrossRefGoogle ScholarPubMed
Nascimento, M. B. R., & Issler, H. (2004). Breastfeeding in premature infants: in-hospital clinical management. Jornal de Pediatria, 80, 163172. doi:10.2223/1250CrossRefGoogle ScholarPubMed
Padovani, F. H. P., Linhares, M. B. M., Carvalho, A. E. V., Duarte, G., & Martinez, F. E. (2004). Anxiety and depression symptoms assessment in pre-term neonates' mothers during and after hospitalization in neonatal intensive care unit. Revista Brasileira de Psiquiatria, 26, 251254.CrossRefGoogle ScholarPubMed
Pinelli, J., Saigal, S., & Atkinson, S. (2003). Effect of breastmilk consumption on neurodevelopmental outcomes at 6 and 12 months of age in VLBW infants. Advances in Neonatal Care, 3, 7687. doi:10.1053/adnc.2003.50017CrossRefGoogle ScholarPubMed
Porter, L. S., & Sobong, L. (1990). Differences in maternal perception of the newborn among adolescents. Pediatric Nursing, 16, 101104.Google ScholarPubMed
Procianoy, R. S., Fernandes Filho, P. H., Lázaro, L., & Sartori, N. (1982). Influence of neonatal factors on breastfeeding. Jornal de Pediatria, 53, 327329.Google Scholar
Rea, M. F. (1998). Breastfeeding and the use of human milk: what recommends the American Academy of Pediatrics. Jornal de Pediatria, 74, 171172.CrossRefGoogle ScholarPubMed
Rocha, N. M. N., Martinez, F. E., & Jorge, S. M. (2002). Cup or bottle for preterm infants: effects on oxygen saturation, weight gain, and breastfeeding. Journal of Human Lactation, 18, 132138. doi:10.1177/089033440201800204CrossRefGoogle ScholarPubMed
Santoro Junior, W., & Martinez, F. E. (2007). Effect of intervention on the rates of breastfeeding of very low birth weight newborns. Jornal de Pediatria, 83, 541546.Google ScholarPubMed
Schanler, R. J., Hurst, N. M., & Lau, C. (1999). The use of human milk and breastfeeding in premature infants. Clinics in Perinatology, 26, 379398.CrossRefGoogle ScholarPubMed
Serra, S. O. A., & Scochi, C. G. S. (2004). Mother's difficulties in breastfeeding premature babies in the neonatal ICU. Revista Latino-Americana de Enfermagem, 12(4), 597605.CrossRefGoogle ScholarPubMed
Sisk, P. M., Lovelady, C. A., Dillard, R. G., & Gruber, K. J. (2006). Lactation counseling for mothers of very low birth weight infants: Effect on maternal anxiety and infant intake of human milk. Pediatrics, 117, 6775. doi:10.1542/peds.2005-0267CrossRefGoogle ScholarPubMed
Soares, N. E., & Fernandes, L. M. (1989). A medida do nível sócio-econômico-cultural [The socio-economic-cultural level measurement]. Arquivos Brasileiros de Psicologia, 41, 3543.Google Scholar
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). Manual for the Strait-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Spitzer, R. L., Williams, J. R., Gibbon, M., & First, M. B. (1989). Instruction manual for the structured clinical interview for DSM III – R. New York, NY: New York State Psychiatric Institute, Biometrics Research Department.Google Scholar
Thome, M., Alder, E. M., & Ramel, A. (2006). A population-based study of exclusive breastfeeding in Iceland women: is there a relationship with depressive symptoms and parenting stress? International Journal of Nursing Studies, 43, 1120.CrossRefGoogle Scholar
Vohr, B. R., Poindexter, B. B., Dusick, A. M., McKinley, L. T., Wright, L. L., Langer, J. C., & Poole, W. K. (2006). Beneficial effects of breast milk in the Neonatal Intensive Care Unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics, 118, 115123. doi:10.1542/peds.2005-2382CrossRefGoogle ScholarPubMed
Xavier, C. C., Jorge, S. M., & Gonçalves, A. L. (1991). Prevalence of breast feeding of low birthweight infants. Revista de Saúde Pública, 25, 381387.CrossRefGoogle Scholar
Zanardo, V., & Freato, F. (2001). Home oxygen therapy in infants with bronchopulmonary dysplasia: assessment of parental anxiety. Early Human Development, 65, 3946. doi:10.1016/S0378-3782(01)00190-6CrossRefGoogle ScholarPubMed