Fatores contextuais e psicossociais relacionados ao aleitamento materno

Abstract

Breastfeeding (BF), exclusively recommended for up to 6 months, is a complex practice permeated by several factors that can contribute positively or negatively to its continuity. In addition to biological issues, psychosocial and contextual factors also influence BF, forming aspects to be considered in the study of this topic, especially in view of such low rates of exclusive breastfeeding (EBF). Thus, the objective of this study was to investigate the relationship between EBF, contextual factors (urbanity and region of residence), and psychosocial factors (locus of health control and social support received). Therefore, the present work was structured in two studies. In the first study, secondary data from the Food and Nutrition Surveillance System on the prevalence of EBF, by Brazilian municipality, from 2019 to 2021 were analyzed. Information on region, municipal typology and degree of urbanization was extracted from the Brazilian Institute of Geography and Statistic. The final sample obtained consisted of 223,764 children, distributed in 1603 municipalities. The northeast region was associated with the prevalence of EBF classified as poor/fair (p<0.001). There was an association between a high degree of urbanization and the rate of EBF as good/very good (p<0.026), and also between urban typology and the prevalence of EBF classified as good/very good (p<0.011). The second study was carried out with postpartum women at Hospital do Seridó (Caicó/RN). During hospitalization, the Health Locus of Control Scale was applied and demographic and perception information on breastfeeding was collected. Then, 30 days after delivery, information about BF at the end of the first month of life was collected, and the Multidimensional Scale of Perceived Social Support was applied. The final sample consisted of 75 women. Of these, 69.4% practiced EBF during the 1st month. In these women, support of the “material”, “emotional” and “social interaction” type was significantly higher and the score on the external health locus of control scale was lower. This group of participants also had a more positive perception of breastfeeding. In logistic regression, material support increased the probability of EBF in the 1st month by 1.03, while the external health locus of control score decreased the probability of EBF in the 1st month by 0.55 times. The results obtained in both studies point to the need to consider contextual and psychosocial factors when thinking about actions, policies and strategies involving breastfeeding.