Preditores do aleitamento materno exclusivo: estudo longitudinal
DOI:
https://doi.org/10.4025/ciencuidsaude.v24i1.73037Palavras-chave:
Aleitamento Materno, Desmame, Gravidez de Alto Risco, Saúde da criança, Saúde da Mulher, Saúde Materno-Infantil.Resumo
Objetivo: investigar os fatores que influenciam a manutenção do aleitamento materno exclusivo até os seis meses após o parto. Métodos: estudo longitudinal com 150 gestantes atendidas em unidades básicas de saúde de um município no noroeste do estado do Paraná. A variável dependente foi a amamentação exclusiva, enquanto as variáveis independentes incluíram fatores sociodemográficos, obstétricos, neonatais e psicossociais. Os dados foram coletados entre outubro de 2019 e novembro de 2020 por meio de questionários estruturados e da escala Infant Feeding Intentions Scale. A análise foi realizada por meio de estatística descritiva e inferencial, incluindo distribuição de frequências e aplicação do modelo de regressão de Cox. Resultados: menos da metade (43,3%) das mulheres do estudo mantiveram o aleitamento materno exclusivo por seis meses. Entre os fatores independentes que influenciaram positivamente, destacam-se a experiência prévia de amamentação, a ausência de riscos gestacionais e a intenção de amamentar. No modelo final, apenas o risco gestacional e a intenção de amamentar permaneceram significativos. Conclusão: os resultados apontam características que exigem atenção especial e ressaltam o papel dos profissionais de saúde na mediação e implementação de ações voltadas a fatores intervenientes na amamentação que podem ser modificados.
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Referências
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3. Souza CB, Melo DS, Relvas GRB, Venancio SI, Silva RPGVCD. Promotion, protection, and support of breastfeeding at work, and achieving sustainable development: a scoping review. Cien Saude Colet. 2023; 28(4):1059-1072. DOI:10.1590/1413-81232023284.14242022.
4. United Nations Children’s Fund, Division of Data, Analysis, Planning and Monitoring. Global UNICEF Global Databases: Infant and Young Child Feeding: Exclusive breastfeeding, New York, 2024. Disponível em: https://data.unicef.org/topic/nutrition/breastfeeding/.
5. Rio de Janeiro. Universidade Federal do Rio de Janeiro. Aleitamento materno: Prevalência e práticas de aleitamento materno em crianças brasileiras menores de 2 anos 4: ENANI. [Internet]. 2021. Disponível em:https://enani.nutricao.ufrj.br/index.php/relatorios.
6. Wu Q, Tang N, Wacharasin C. Factors influencing exclusive breastfeeding for 6 months postpartum: A systematic review. Int J Nurs Knowl. 2022; 33(4):290-303. DOI:10.1111/2047-3095.12360.
7. Lima MEV, Corrêa L da C, Freitas UC de, Mercês MM das, Pinto JCT, Martins MI da S, et al. Determinantes que influenciam na continuidade da prática do aleitamento materno. REAS 2023; 23(12):e13440. DOI: https://doi.org/10.25248/reas.e13440.2023.
8. Chen Y, Zhao Y, Wang WL, Wang F, Jiang H, Wang L. Factors associated with exclusive breastfeeding during postpartum in Lanzhou city, China: a cross-sectional study. Front Public Health. 2023; 30(11):1089764. DOI:10.3389/fpubh.2023.1089764.
9. Inano H, Kameya M, Sasano K, Matsumura K, Tsuchida A, Hamazaki K, et al. Factors influencing exclusive breastfeeding rates until 6 months postpartum: the Japan Environment and Children’s Study. Sci Rep. 2021; 11:6841. DOI: 10.1038/s41598-021-85900-4.
10. Souza BS, Assunção EG, Guimarães GC. Fatores associados ao desmame precoce no contexto brasileiro. Saberes Plur. 2023; 7(2):e133427. DOI: 10.54909/sp.v7i2.133427.
11. Saavedra SS, Rodríguez-Gallego I, Leon-Larios F, Andina-Diaz E, Perez-Contreras R, Gonzalez-Sanz JD. Influence of Perceived Maternal Self-Efficacy on Exclusive Breastfeeding Initiation and Consolidation: A Systematic Review. Healthcare (Basel). 2024; 12(23):2347. DOI: 10.3390/healthcare12232347.
12. Islam MJ, Broidy L, Baird K, Rahman M, Zobair KM. Early exclusive breastfeeding cessation and postpartum depression: Assessing the mediating and moderating role of maternal stress and social support. PLoS One. 2021; 16(5):e0251419. DOI: 10.1371/journal.pone.0251419.
13. Achike M, Akpinar-Elci M. The Role of Maternal Prepregnancy Body Mass Index in Breastfeeding Outcomes: A Systematic Review. Breastfeed Med. 2021;16(9):678-686. DOI: 10.1089/bfm.2020.0376.
14. Brasil. Ministério da Saúde. E-gestor: Informação e Gestão da Atenção Básica. [Internet]. Relatórios públicos. Cobertura da Atenção Básica. Vigência 07/2020. 2020. [acesso em 03 abr. 2025]. Disponível em: https://relatorioaps.saude.gov.br/cobertura/pnsl.
15. Paraná. Instituto Paranaense de Desenvolvimento Econômico e Social (IPARDES). Paraná em números. [Internet]. 2020 [acesso em 12 jun. 2024]. Disponível em:http://www.ipardes.gov.br/index.php?pg_conteudo=1&cod_conteudo=1.
16. Góes FGB, Ledo BC, Santos AST, Pereira-Ãvila FMV, Silva ACSS, Christoffel MM. Cultural adaptation of Infant Feeding Intentions Scale (IFI) for pregnant women in Brazil. Rev. Bras. Enferm. 2020; 73(4). DOI: https://doi.org/10.1590/0034-7167-2019-0103
17. Salama ES, Hussein M, Fetih AN, Abul-Fadl AMA, Elghazally SA. High-risk pregnancy and risk of breastfeeding failure. J Egypt Public Health Assoc. 2024; 99(1):27. DOI: 10.1186/s42506-024-00172-w.
18. Al-Anazi OM, Heneef MSM, Zafar M, Ahsan M. Association of Maternal Obesity and Diabetes Mellitus with Exclusive Breastfeeding Among Saudi Mothers in Jubail, Saudi Arabia. InT J Prev Med. 2022; 13(68). DOI: 10.4103/ijpvm.IJPVM_61_20.
19. Sokou R, Parastatidou S, Lliodromiti Z, Lampropoulou K, Vrachnis D, Boutsikou T, et al. Knowledge Gaps and Current Evidence Regarding Breastfeeding Issues in Mothers with Chronic Diseases. Nutrients. 2023; 15(13):2822. DOI:10.3390/nu15132822.
20. Wallenborn JT, Perera, RA, Masho SW. Breastfeeding after Gestational Diabetes: Does Perceived Benefits Mediate the Relationship? J Pregnancy. 2017; 2017:9581796. DOI: 10.1155/2017/9581796.
21. Jirakittidul P, Panichyawat N, Chotrungrote B, Mala A. Prevalence and associated factors of breastfeeding in women with gestational diabetes in a University Hospital in Thailand. Int Breastfeed J. 2019; 14:34. DOI: 10.1186/s13006-019-0227-8.
22. Kozhimannil KB, Jou J, Attanasio LB, Joarnt LK, McGovern P .Medically Complex Pregnancies and Early Breastfeeding Behaviors: A Retrospective Analysis. PLoS ONE. 2014; 9(8). DOI: 10.1371/journal.pone.0104820.
23. Cordero L, Stenger MR, Blaney SD, Finneran MM, Nankervis CA. Prior breastfeeding experience and infant feeding at discharge among women with pregestational diabetes mellitus. J Neonatal Perinatal Med. 2020; 13(4):563-570. DOI:10.3233/NPM-19030824.
24. Shi H, Yang Y, Yin X, Li J, Fang J, Wang X. Determinants of exclusive breastfeeding for the first six months in China: a cross-sectional study. Int Breastfeed J. 2021; 17;16(1):40. DOI: 10.1186/s13006-021-00388-y.
25. Shafaei FS, Mirghafourvand M, Havizari S. The effect of prenatal counseling on breastfeeding self-efficacy and frequency of breastfeeding problems in mothers with previous unsuccessful breastfeeding: a randomized controlled clinical trial. BMC Womens Health. 2020; 5(20):94. DOI: 10.1186/s12905-020-00947-1.
26.Wu Q, Tang N, Wacharasin C. Factors influencing exclusive breastfeeding for 6 months postpartum: A systematic review. Int J Nurs Knowl. 2022; 33(4):290-303. DOI:10.1111/2047-3095.12360.
27. Piro SS, Ahmed HM. Impacts of antenatal nursing interventions on mothers' breastfeeding self-efficacy: an experimental study. BMC Pregnancy Childbirth. 2020; 20(1):19. DOI: 10.1186/s12884-019-2701-0.
28. Peres JF, Carvalho ARS, Viera CS, Linares AM, Christofell MM, Toso BRGO. Social support and strategies for breastfeeding promotion according to health professionals. Ciênc. cuid. saúde. 2023; 22: e62149. DOI: https://doi.org/10.4025/ciencuidsaude.v22i0.62149.
2.Pretorius CE, Asare H, Kruger HS, Genuneit J, Siziba LP, Ricci C. Exclusive Breastfeeding, Child Mortality, and Economic Cost in Sub-Saharan Africa. Pediatrics. 2021;147(3):e2020030643. DOI:10.1542/peds.2020-030643.
3. Souza CB, Melo DS, Relvas GRB, Venancio SI, Silva RPGVCD. Promotion, protection, and support of breastfeeding at work, and achieving sustainable development: a scoping review. Cien Saude Colet. 2023; 28(4):1059-1072. DOI:10.1590/1413-81232023284.14242022.
4. United Nations Children’s Fund, Division of Data, Analysis, Planning and Monitoring. Global UNICEF Global Databases: Infant and Young Child Feeding: Exclusive breastfeeding, New York, 2024. Disponível em: https://data.unicef.org/topic/nutrition/breastfeeding/.
5. Rio de Janeiro. Universidade Federal do Rio de Janeiro. Aleitamento materno: Prevalência e práticas de aleitamento materno em crianças brasileiras menores de 2 anos 4: ENANI. [Internet]. 2021. Disponível em:https://enani.nutricao.ufrj.br/index.php/relatorios.
6. Wu Q, Tang N, Wacharasin C. Factors influencing exclusive breastfeeding for 6 months postpartum: A systematic review. Int J Nurs Knowl. 2022; 33(4):290-303. DOI:10.1111/2047-3095.12360.
7. Lima MEV, Corrêa L da C, Freitas UC de, Mercês MM das, Pinto JCT, Martins MI da S, et al. Determinantes que influenciam na continuidade da prática do aleitamento materno. REAS 2023; 23(12):e13440. DOI: https://doi.org/10.25248/reas.e13440.2023.
8. Chen Y, Zhao Y, Wang WL, Wang F, Jiang H, Wang L. Factors associated with exclusive breastfeeding during postpartum in Lanzhou city, China: a cross-sectional study. Front Public Health. 2023; 30(11):1089764. DOI:10.3389/fpubh.2023.1089764.
9. Inano H, Kameya M, Sasano K, Matsumura K, Tsuchida A, Hamazaki K, et al. Factors influencing exclusive breastfeeding rates until 6 months postpartum: the Japan Environment and Children’s Study. Sci Rep. 2021; 11:6841. DOI: 10.1038/s41598-021-85900-4.
10. Souza BS, Assunção EG, Guimarães GC. Fatores associados ao desmame precoce no contexto brasileiro. Saberes Plur. 2023; 7(2):e133427. DOI: 10.54909/sp.v7i2.133427.
11. Saavedra SS, Rodríguez-Gallego I, Leon-Larios F, Andina-Diaz E, Perez-Contreras R, Gonzalez-Sanz JD. Influence of Perceived Maternal Self-Efficacy on Exclusive Breastfeeding Initiation and Consolidation: A Systematic Review. Healthcare (Basel). 2024; 12(23):2347. DOI: 10.3390/healthcare12232347.
12. Islam MJ, Broidy L, Baird K, Rahman M, Zobair KM. Early exclusive breastfeeding cessation and postpartum depression: Assessing the mediating and moderating role of maternal stress and social support. PLoS One. 2021; 16(5):e0251419. DOI: 10.1371/journal.pone.0251419.
13. Achike M, Akpinar-Elci M. The Role of Maternal Prepregnancy Body Mass Index in Breastfeeding Outcomes: A Systematic Review. Breastfeed Med. 2021;16(9):678-686. DOI: 10.1089/bfm.2020.0376.
14. Brasil. Ministério da Saúde. E-gestor: Informação e Gestão da Atenção Básica. [Internet]. Relatórios públicos. Cobertura da Atenção Básica. Vigência 07/2020. 2020. [acesso em 03 abr. 2025]. Disponível em: https://relatorioaps.saude.gov.br/cobertura/pnsl.
15. Paraná. Instituto Paranaense de Desenvolvimento Econômico e Social (IPARDES). Paraná em números. [Internet]. 2020 [acesso em 12 jun. 2024]. Disponível em:http://www.ipardes.gov.br/index.php?pg_conteudo=1&cod_conteudo=1.
16. Góes FGB, Ledo BC, Santos AST, Pereira-Ãvila FMV, Silva ACSS, Christoffel MM. Cultural adaptation of Infant Feeding Intentions Scale (IFI) for pregnant women in Brazil. Rev. Bras. Enferm. 2020; 73(4). DOI: https://doi.org/10.1590/0034-7167-2019-0103
17. Salama ES, Hussein M, Fetih AN, Abul-Fadl AMA, Elghazally SA. High-risk pregnancy and risk of breastfeeding failure. J Egypt Public Health Assoc. 2024; 99(1):27. DOI: 10.1186/s42506-024-00172-w.
18. Al-Anazi OM, Heneef MSM, Zafar M, Ahsan M. Association of Maternal Obesity and Diabetes Mellitus with Exclusive Breastfeeding Among Saudi Mothers in Jubail, Saudi Arabia. InT J Prev Med. 2022; 13(68). DOI: 10.4103/ijpvm.IJPVM_61_20.
19. Sokou R, Parastatidou S, Lliodromiti Z, Lampropoulou K, Vrachnis D, Boutsikou T, et al. Knowledge Gaps and Current Evidence Regarding Breastfeeding Issues in Mothers with Chronic Diseases. Nutrients. 2023; 15(13):2822. DOI:10.3390/nu15132822.
20. Wallenborn JT, Perera, RA, Masho SW. Breastfeeding after Gestational Diabetes: Does Perceived Benefits Mediate the Relationship? J Pregnancy. 2017; 2017:9581796. DOI: 10.1155/2017/9581796.
21. Jirakittidul P, Panichyawat N, Chotrungrote B, Mala A. Prevalence and associated factors of breastfeeding in women with gestational diabetes in a University Hospital in Thailand. Int Breastfeed J. 2019; 14:34. DOI: 10.1186/s13006-019-0227-8.
22. Kozhimannil KB, Jou J, Attanasio LB, Joarnt LK, McGovern P .Medically Complex Pregnancies and Early Breastfeeding Behaviors: A Retrospective Analysis. PLoS ONE. 2014; 9(8). DOI: 10.1371/journal.pone.0104820.
23. Cordero L, Stenger MR, Blaney SD, Finneran MM, Nankervis CA. Prior breastfeeding experience and infant feeding at discharge among women with pregestational diabetes mellitus. J Neonatal Perinatal Med. 2020; 13(4):563-570. DOI:10.3233/NPM-19030824.
24. Shi H, Yang Y, Yin X, Li J, Fang J, Wang X. Determinants of exclusive breastfeeding for the first six months in China: a cross-sectional study. Int Breastfeed J. 2021; 17;16(1):40. DOI: 10.1186/s13006-021-00388-y.
25. Shafaei FS, Mirghafourvand M, Havizari S. The effect of prenatal counseling on breastfeeding self-efficacy and frequency of breastfeeding problems in mothers with previous unsuccessful breastfeeding: a randomized controlled clinical trial. BMC Womens Health. 2020; 5(20):94. DOI: 10.1186/s12905-020-00947-1.
26.Wu Q, Tang N, Wacharasin C. Factors influencing exclusive breastfeeding for 6 months postpartum: A systematic review. Int J Nurs Knowl. 2022; 33(4):290-303. DOI:10.1111/2047-3095.12360.
27. Piro SS, Ahmed HM. Impacts of antenatal nursing interventions on mothers' breastfeeding self-efficacy: an experimental study. BMC Pregnancy Childbirth. 2020; 20(1):19. DOI: 10.1186/s12884-019-2701-0.
28. Peres JF, Carvalho ARS, Viera CS, Linares AM, Christofell MM, Toso BRGO. Social support and strategies for breastfeeding promotion according to health professionals. Ciênc. cuid. saúde. 2023; 22: e62149. DOI: https://doi.org/10.4025/ciencuidsaude.v22i0.62149.
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2025-12-11
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Preditores do aleitamento materno exclusivo: estudo longitudinal. (2025). Ciência, Cuidado E Saúde, 24(1). https://doi.org/10.4025/ciencuidsaude.v24i1.73037
