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

Article excerpt

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.

Keywords: breastfeeding, anxiety, depression, preterm infant.

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.

Palabras clave: amamantamiento, ansiedad, depresión, bebés prematuros.

Breast milk is composed of a unique nutritional combination and provides unquestionable benefits with regard to immunological, psychological and economic aspects (Nascimento & Issler, 2004). Since the 1980s, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) have invested in a series of programmatic activities for the implementation of breastfeeding (Lamounier, 1996; Rea, 1998). Between 1996 and 1997, the American Academy of Pediatrics instituted a work group on breast feeding to assess the scientific evidence on the subject (Rea, 1998). The final report from this task force was based on scientific evidence, which highlighted the advantages of breast feeding and human mother's milk for the health, growth, and development of the child, as well as the benefits of breast feeding for the mother's health. From this report, the American Academy of Pediatrics began recommending that pediatricians and other health professionals support and promote conditions for breast feeding.

In the early 1990's in a meeting organized by WHO and UNICEF, a strategy called the "Baby-Friendly Hospital Initiative" (BFHI) was conceived, which was subsequently implemented in several countries with the goal of supporting, encouraging, and protecting the practice of breastfeeding (Lamounier, 1996). …