Razões médicas para a prescrição de fórmulas infantis no pós parto imediato e fatores associados

Abstract

Exclusive breastfeeding (EBF) has several benefits for the mother-child binomial and is widely recommended by the World Health Organization (WHO) until six months of life. However, the use of infant formula (IF) in the immediate postpartum period is a common practice, even in a hospital environment and in situations without adequate indication. This study aimed to identify the reasons for prescribing IF as a substitute for breast milk during the immediate postpartum period and associated factors. This is a quantitative and cross-sectional study carried out in a maternity hospital in Santa Cruz/RN, with a sample of 87 mother-child binomials. Data were collected through questionnaires applied in interviews with the puerperal women and consultations of the physical records and the pregnant woman's booklet. Sociodemographic, clinical and obstetric variables were presented descriptively and the associations were analyzed using the chi-square, Fisher's exact and post hoc tests. The findings indicate that breastfeeding difficulties were the main justification for the use of IF (49.4%) - which is considered unacceptable by the Baby-Friendly Hospital Initiative (BFHI) -, followed by neonatal hypoglycemia (26.4%), hypogalactia/agalactia (14.9%) and other reasons (9%). Significant associations were observed between the use of supplements due to breastfeeding difficulties and parity (p=0.007) and breastfeeding in the first hour of life (p=0.024), with newborns who were not breastfed in the first hour being more likely to receive IF under this justification. It is concluded that the use of IF in the hospital context in the immediate postpartum period is a practice that occurs in maternity wards, often motivated by reasons that are unacceptable according to the BFHI guidelines. This reality represents a challenge to be overcome, reinforcing the need for effective strategies, such as educational actions and training for health professionals, to support breastfeeding and prevent the unnecessary use of supplements, in order to promote maternal and child health, helping to promote EBF from the first hour of the newborn's life.