(Con) vivendo com o bebê prematuro de muito baixo peso (<1.500g) : a experiência materna durante a internação e após a alta hospitalar

Abstract

The advance in perinatal care allowed the survival of a growing number of very low birth weight (VLBW) infants, creating the need for questioning orientations given to mothers during their babies hospitalization, as well as its repercussion in daily homecare – a theme still insufficiently explored. The aim of this study was to investigate aspects regarding health and nutrition of extreme premature babies, with birth weight less than 1.500g from the mothers´ experiences during hospitalization and after discharge. Thus, the qualitative approach, exploratory-descriptive, along the use of semi-structured interviews intended to access the experience of eleven mothers who delivered their newborns with VLBW in Maternidade Escola Assis Chateaubriand. Interviews took place at the mothers´ domicile between June and October, 2009. Over a comprehensive interpretative analysis, the results pointed to the intersubjective communication difficulties with health care professionals, the large occurrence of early weaning and introduction of porridge and other food that are harmful to the preterm baby health, important differences between the orientations provided at the ward in the maternity hospital (kangaroo method), great difficulty in the role of motherhood after discharge and the existence of an informal support network during the follow up consultations when the other mothers and relatives´ opinions determined the assumed practice of home care. Besides, the lack of communication between the reference and counter-reference systems of the health units compromises the quality of the provided care. Moreover, mothers need to be taken in formal counseling groups while their babies are in the hospital and after, with orientation and mutual listening, receiving structured information about feeding and home care to apply more adequate methods in the care of VLBW neonate. The enlargement of the room intended to manual milking and also the capacity of reception and orientation at the kangaroo ward are relevant changes inside the structure of the maternity hospital that seem to be capable of ensuring better conditions in the maternal care of the VLBW infant.