Fatores associados à técnica da amamentação no puerpério imediato em uma maternidade pública do Ceará: estudo transversal analítico

Abstract

Breast milk is recognized as the ideal food for infants and should be encouraged from birth due to its nutritional, immunological, and protective benefits for both the newborn and the mother. The present study aimed to evaluate the factors associated with breastfeeding technique in the immediate postpartum period in a public maternity hospital in Ceará. This was an analytical cross-sectional study with a quantitative approach, conducted with 1,108 postpartum women hospitalized in Rooming-In Units.Data collection was carried out through individual interviews in the rooming-in units using a sociodemographic and clinical questionnaire, in addition to the Bristol Breastfeeding Assessment Tool – Brazilian version (BBAT-BV), composed of four domains: positioning, latch, sucking, and swallowing. Data analysis included descriptive and inferential statistics, with nonparametric tests and univariate and multiple linear regression, using SPSS software version 26.The mean total BBAT-BV score was 6.68 (SD = 1.47) on a scale ranging from 0 to 8, with a median of 7 points and a concentration of scores at higher values, indicating a predominance of good breastfeeding technique skills among the participants. In the univariate analysis, some variables showed a significant association with breastfeeding technique performance. In the adjusted multiple model (adjusted R² = 0.067; p < 0.001), the following remained as independent predictors: age over 19 years (β = 0.291; p = 0.04), presence of comorbidity prior to pregnancy (β = 0.320; p < 0.001), and breastfeeding within the first hour of life (β = 0.347; p < 0.001), the latter being the factor with the greatest positive magnitude. A significant negative association was observed in the adjusted model for: flat nipples (β = -0.600; p = 0.008), presence of colostrum (β = -0.313; p = 0.019), “housewife” occupation compared to formal employment (β = -0.267; p = 0.028), and mixed breastfeeding compared to exclusive breastfeeding (β = -0.768; p < 0.001), the latter presenting the greatest negative magnitude. Variables such as gestational comorbidity and guidance to breastfeed within the first hour lost significance after adjustment, suggesting mediation by other factors. The findings showed that breastfeeding technique performance in the immediate postpartum period is associated with prior maternal factors and early care practices, particularly breastfeeding within the first hour of life and the type of breastfeeding. It is concluded that the systematic evaluation of breastfeeding technique using standardized scales allows the early identification of difficulties in performance, reinforcing the need for qualified nursing interventions in the immediate postpartum period, focusing on technical support and the promotion of exclusive breastfeeding from the first hours of life.