Avaliação da técnica de amamentação com puérperas em alojamento conjunto

Abstract

Breastfeeding is the most recommended form of infant nutrition, providing benefits for both the child and the mother. However, its success depends on an adequate breastfeeding technique, since difficulties during this process may cause pain and contribute to early weaning. Nevertheless, there are still limitations in the literature on this topic, including studies with small sample sizes and limited control of variables, which reinforces the need for reliable methods to assess breastfeeding. In this context, the Bristol Breastfeeding Assessment Tool – Brazilian version (BBAT-VB) stands out for enabling a structured assessment of breastfeeding technique, identifying difficulties and supporting interventions. Thus, this study aimed to evaluate the breastfeeding technique of the mother-child dyad in rooming-in care using the BBAT-VB. This was a cross-sectional study with a quantitative approach, involving 503 postpartum women assisted at a public maternity hospital in Fortaleza, Ceará, Brazil. Data collection took place in the rooming-in unit through individual interviews, using a sociodemographic and obstetric questionnaire and the Brazilian version of the BBAT-VB, an instrument that evaluates positioning, latch, sucking, and swallowing. Each item is scored from 0 (poor) to 2 (good), resulting in a total score ranging from 0 to 8 points. Observations were carried out during spontaneous breastfeeding sessions by a previously trained team. Data were analyzed using the Number Cruncher Statistical System 2007, employing means, standard deviations, frequencies, and percentages, with dichotomous categorization of BBAT-VB scores into effective technique (≥7) and ineffective/below ideal technique (≤6). The study was approved by the institution’s Research Ethics Committee. Among the 503 participants, 55.5% were classified as having an effective breastfeeding technique, while 44.5% presented an ineffective technique. According to the BBAT-VB, the domains were classified as good for positioning (48.7%), latch (58.8%), sucking (76.9%), and swallowing (68.4%). Maternal habits and health history showed, for the most part, no significant association with breastfeeding technique, except for alcohol consumption (p=0.046). Significant associations were also observed with the number of living children (p=0.037), feeling obligated to breastfeed (p=0.048), milk production (p=0.015), development of maternal comorbidities (p=0.036), nipple type, especially protruding nipples (p=0.017), and maintenance of exclusive breastfeeding (p=0.025). It was concluded that breastfeeding technique was associated with maternal, reproductive, and clinical characteristics, as well as aspects related to the breastfeeding process itself. Therefore, the need for implementing care protocols, personalized educational strategies, and mother-baby centered care is emphasized, with a focus on preventing early weaning.