Determinantes que influenciam a prática do aleitamento materno em puérperas participantes de um grupo on-line de promoção e apoio à amamentação

Abstract

Introduction: Ensuring breastfeeding (BF) and exclusive breastfeeding (EBF) goes beyond the support and demand for disseminating information; it is influenced by various factors, necessitating support, encouragement, and guidance. Thus, this study aims to evaluate the determinants influencing the practice of BF as perceived by postpartum women participating in a virtual group for promoting and supporting breastfeeding, and to verify the association between breastfeeding practices and maternal, obstetric, socioeconomic, demographic variables, and the intervention provided by the online group. Methods: A randomized clinical trial was conducted at the maternity ward of Lauro Wanderley University Hospital, where data were initially collected. Participants in the intervention group (IG) were included in a virtual environment focused on promoting and supporting breastfeeding. Throughout the study, these women were followed monthly for 6 months through phone calls for data collection. Statistical analyses were conducted using SPSS version 19. Initially, the data underwent the Kolmogorov-Smirnov test to verify the normality of their distribution. Continuous variables were described using absolute and relative frequencies, as well as mean and standard deviation, or median and percentiles, to characterize the intervention and control groups. The evaluation of social support was conducted using the Medical Outcomes Study scale adapted for Portuguese, consisting of five dimensions: affective, emotional, informational, positive social interaction, and material. To assess knowledge about BF, a questionnaire composed of ten questions, developed by the FAO (Food and Agriculture Organization of the United Nations), was implemented by different countries. Results and Discussion: The results indicated that returning to work in the fourth month postpartum (77.3%; p<0.001), as well as primiparity (56.6%; p=0.02), significantly influenced early weaning. Additionally, it was found that women who received prenatal care at the Family Health Strategy (PSF) had a lower number of correct answers on breastfeeding-related questions compared to those who received care at public hospitals (6.57 vs. 7.31; p=0.033). Participants in the virtual group showed better scores in the emotional support dimensions. The discrepancy in emotional support scores between the study groups was statistically significant, with an average score of 90.4 for the intervention group and 84.3 for the control group (p=0.012), highlighting the positive impact of the virtual group on emotional support offered to women during the breastfeeding period. Conclusion: Protective actions for working women, as well as strengthening guidance initiatives, especially for first-time mothers, can help reduce early weaning. The online intervention had a positive impact on the emotional support of women, identifying the need to enhance the tool to reach other dimensions of support.