Analysis of social and health-related factors with impact on breastfeeding initiation and consolidation in Primary Care
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Boal Herranz GA, Barrios Mas E. Análisis de los factores sociales y sanitarios que influyen en el inicio y consolidación de la lactancia materna en Atención Primaria. Matronas Hoy 2020; 8(3):15-31.
Authors
1 Gloria Aurora Boal Herranz, 2 Ester Barrios Miras
Position
1 Matrona. Centro Salud San Fernando de Henares (Madrid).2 Pediatra. Consultora IBCLC (International Board Certified Lactation Consultant). Centro Salud San Fernando de Henares (Madrid).
Contact email: gloriaboal@hotmail.com
Abstract
Analysis of social and health-related factors with impact on breastfeeding initiation and consolidation in Primary Care Introduction: in 1981, the World Health Organization (WHO) acknowledged as a world public health problem the protection and support for breastfeeding; since then, many measures have been implemented to this aim. Regardless of this, the figures for initiation and consolidation of breastfeeding (BF) are still low throughout the world: lack of support for mothers and limited political, economic, and social measures leads to a dramatic lowering in the breastfeeding figures after the first four months. The Centro de Salud San Fernando (Madrid) has explicitly supported and protected breastfeeding since 2015; that is why a study has been conducted in order to probe into the reasons and/or circumstances leading to the interruption or, on the contrary, the continuity of breastfeeding, with the objective to improve our consultancy and daily support for mothers. Objectives: 1. To understand the prevalence of breastfeeding initiation and consolidation in the healthcare area. 2. To analyze the strengths and challenges for mothers initiating exclusive breastfeeding. 3. To study the effect of the support by Primary Care professionals on the achievement of exclusive breastfeeding. Materials and method: design: a prospective, cross-sectional, descriptive, observational study. Type of study: correlational. Inclusion criteria: All ≥18-year-old post-partum women attending the health center for consultation. Procedure: It was offered to all mothers, after consent and information, who attended for consultation during the first three/seven days of life of the newborn, and until consolidating the type of diet for the baby (first month of life). They completed a survey, partly self-completed, with items, self-made scale, and validated scales. Results: the exclusive BM rate at hospital discharge was 55.7%, and at the end of the study, the BF rate was 58.8%. No significant differences were observed regarding age, education level, use of intrapartum oxytocin, or skin-to-skin contact. The pairs with the highest difficulty to establish breastfeeding were: primiparous mothers, mothers with non-eutocic delivery and newborns with a lower number of gestational weeks. A mother with good psychophysical health, an adequate breastfeeding technique and a high level of maternal self-efficacy were factors highly associated with breastfeeding consolidation in our setting. Conclusions: after one-month follow-up, the rates of exclusive BF were higher than the rates at hospital discharge, probably due to the intervention of the healthcare staff. In this population, there was similarity in terms of maternal age, education level and family support; moreover, there were no cases of very preterm newborns, and few cases of low weight. The factors more strongly associated with the type of diet for the newborn were: the psychophysical health of the mother, an adequate technique, measured by the LATCH scale, and a high level of maternal self-efficacy, measured by the BSES-SF scale. Sustained support for the pair was essential for breastfeeding consolidation.
Keywords:
breastfeeding; conditioning factors; associated factors; determining factors
Versión en Español
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