Improving breastfeeding among adolescent mothers: a prospective cohort

Autores

Palavras-chave:

Breast feeding, Prenatal care, Prenatal education, Pregnancy in adolescence, Postpartum period, Antenatal parenthood education, Breastfeeding, Teen pregnancy

Resumo

BACKGROUND: Exclusive breastfeeding is recommended for the first six months, and mother’s age impact early weaning. Educational support and relevant information can increase breastfeeding rates.
OBJECTIVE: To determine whether antenatal education enhances the maintenance, intention, and confidence in breastfeeding among adolescents.
DESIGN AND SETTING: A prospective cohort study involving primiparous adolescents who gave birth at the Woman’s Hospital (CAISM), Universidade Estadual de Campinas, Brazil.
METHODS: Adolescent mothers were categorized into two groups based on the location of prenatal care: those at the Woman’s Hospital (WH) who received antenatal education, and at the Primary Care (PC) who did not receive antenatal education. All adolescents received breastfeeding orientation during their postpartum hospital stay. The groups were compared using the Student’s t-test, Mann–Whitney U test, and chi-squared test. Log-binomial models were used to compare the groups at different time intervals.
RESULTS: The study included 132 adolescents: 59 in the WH group and 73 in the PC group. Six months postpartum, adolescents in the WH group demonstrated higher engagement in breastfeeding (P < 0.005) and exclusive breastfeeding (P = 0.04) than PC group. PC group showed greater lack of confidence in breastfeeding (P = 0.02) and felt less prepared (P = 0.01). Notably, all WH adolescents reported a stronger desire to breastfeed after antenatal education.
CONCLUSION: Antenatal education significantly improves the maintenance, intention, and confidence of breastfeeding among adolescents. This education approach can be implemented across all healthcare levels and should be made accessible to all women throughout the pregnancy and postpartum period.

Downloads

Não há dados estatísticos.

Biografia do Autor

Maira Pinho-Pompeu, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil

PhD. Nutritionist, Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.

Renan Massao Nakamura, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil

MD. Resident Physician, Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.

Erika Zambrano, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil

PhD. Obstetric nurse, Assistent Professor, Faculty of Nursing, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.

Fernanda Garanhani Surita, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil

MD, PhD. Obstetrician, Full Professor of Obstetrics, Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.

Referências

World Health Organization. The optimal duration of exclusive breastfeeding: report of an expert consultation. Geneva: WHO; 2001. Available from: http://www.who.int/child-adolescent-health. Accessed in 2020 (Feb. 16).

Del Ciampo LA, Del Ciampo IRL. Breastfeeding and the benefits of lactation for women’s health. Rev Bras Ginecol Obstet. 2018;40(6):354-9. PMID: 29980160; https://doi.org/10.1055/s-0038-1657766.

Louis-Jacques AF, Stuebe AM. Enabling Breastfeeding to support lifelong health for mother and child. Obstet Gynecol Clin North Am. 2020;47(3):363-81. PMID: 32762923; https://doi.org/10.1016/j.ogc.2020.04.001.

Fair FJ, Ford GL, Soltani H. Interventions for supporting the initiation and continuation of breastfeeding among women who are overweight or obese. Cochrane Database Syst Rev. 2019;9(9):CD012099. PMID: 31529625; https://doi.org/10.1002/14651858.cd012099.pub2.

United Nations Children’s Fund. Infant and young child feeding: Optimal feeding practices are fundamental to a child’s survival, growth, and development, but too few children benefit. New York: UNICEF; 2022. Available from: https://data.unicef.org/topic/nutrition/infant-andyoung-child-feeding/. Accessed in 2023 (May 23).

Thaithae S, Yimyam S, Polprasarn P. Prevalence and predictive factors for exclusive breastfeeding at six months among Thai adolescent mothers. Children. 2023;10(4):682. PMID: 37189931; https://doi.org/10.3390/ children10040682.

Brazilian Society of Pediatrics. Adolescence and the breastfeeding. Documento Científico. 2020;15:1-11. Available from: https://www.sbp. com.br/fileadmin/user_upload/_22265e-DocCient_-_A_Adolesc_e_o_ Aleitamento_Materno.pdf. Accessed in 2023 (May 23).

Suárez-Cotelo MDC, Movilla-Fernández MJ, Pita-García P, Arias BF, Novío S. Breastfeeding knowledge and relation to prevalence. Rev Esc

Enferm USP. 2019;53:e03433. PMID: 30843928; https://doi.org/10.1590/ S1980-220X2018004503433.

Conde RG, Guimarães CMS, Gomes-Sponholz FA, Oriá MOB, Monteiro JCS. Breastfeeding self-efficacy and length of exclusive breastfeeding among adolescent mothers. Acta Paul Enferm. 2017;30(4):383-9. https:// doi.org/10.1590/1982-0194201700057.

World Health Organization. Global nutrition targets 2025: Breastfeeding policy brief. Geneva: WHO; 2014. Available from: https://apps.who.int/ iris/handle/10665/149022. Accessed in 2022 (Feb. 12).

Lima CMAO, Maymone W. Breastfeeding promotion and support policies in Brazil. Pediatr Gastroenterol Hepatol Nutr. 2019;22(4):413-5. PMID: 31338318; https://doi.org/10.5223/pghn.2019.22.4.413.

Melo DS, Oliveira MH, Pereira DDS. Brazil’s progress in protecting, promoting, and supporting breastfeeding from the perspective of the global breastfeeding collective. Rev Paul Pediatr. 2021;39:e2019296. PMID: 32876303; https://doi.org/10.1590/19840462/2021/39/2019296.

Pan American Health Organization. Accelerating progress toward the reduction of adolescent pregnancy in Latin America and the Caribbean. New York: PAHO; 2017. Available from: https://iris.paho. org/handle/10665.2/34493. Accessed in 2022 (Feb. 10).

United Nations Children’s Fund, World Health Organization. Baby-friendly hospital initiative: revised, updated, and expanded for integrated care. New York: WHO; 2009. Available from: https://apps.who.int/iris/ handle/10665/43593. Accessed in 2022 (Feb. 10).

Johnson RA, Wichern DW. The Bonferroni method of multiple comparison. In: Applied multivariate statistical analysis. New York: Prentice-Hall International Inc; 1992. p. 197-9.

Cohen J. A power primer. Psychol Bull. 1992;112(1):155-9. PMID: 19565683; https://doi.org/10.1037//0033-2909.112.1.155.

von Elm E, Altman DG, Egger M, et al. The strengthening of the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495-9. PMID: 25046131; https://doi.org/10.1016/j.ijsu.2014.07.013.

Muelbert M, Giugliani ERJ. Factors associated with the maintenance of breastfeeding for 6, 12, and 24 months in adolescent mothers. BMC Public Health. 2018;18(1):675. PMID: 29855364; https://doi.org/10.1186/ s12889-018-5585-4.

Brandt GP, Britto AMA, Leite CCDP, Marin LG. Factors associated with exclusive breastfeeding in a maternity hospital reference in humanized birth. Rev Bras Ginecol Obstet. 2021;43(2):91-6. PMID: 33465789; https:// doi.org/10.1055/s-0040-1718450.

Piro SS, Ahmed HM. Impacts of antenatal nursing interventions on mothers’ breastfeeding self-efficacy: an experimental study. BMC Pregnancy Childbirth. 2020;20(1):19. PMID: 31906881; https://doi. org/10.1186/s12884-019-2701-0.

Chopel A, Soto D, Joiner B, et al. Multilevel factors influencing young mothers’ breastfeeding: A qualitative CBPR study. J Hum Lact. 2019;35(2):301-17. PMID: 30517824; https://doi.org/10.1177/0890334418812076.

Lewis-Jones B, Nielsen TC, Svensson J, et al. Cross-sectional survey of antenatal education attendance among nulliparous pregnant women in Sydney, Australia. Women Birth. 2023;36(2):e276-82. PMID: 35987732; https://doi.org/10.1016/j.wombi.2022.08.003.

United Nations Children’s Fund. Breastfeeding and the sustainable development goals. New York: WHO; 2016. Available from: https://worldbreastfeedingweek. org/2016/pdf/BreastfeedingandSDGsMessagingWBW2016Shared.pdf. Accessed in 2021 (Jun. 23)

Alianmoghaddam N, Phibbs S, Benn C. “I did a lot of Googling”: A qualitative study of exclusive breastfeeding support through social media. Women Birth. 2019;32(2):147-56. PMID: 29921552; https://doi. org/10.1016/j.wombi.2018.05.008.

Allen E, Rumbold AR, Keir A, et al. Avoidance of bottles during the establishment of breastfeeds in preterm infants. Cochrane Database Syst Rev. 2021;10(10):CD005252. PMID: 34671969; https://doi. org/10.1002/14651858.cd005252.pub5.

Corsack C, Wallenborn JT, Harley KG, Eskenazi B. Parental cohabitation and breastfeeding outcomes among United States adolescent mothers. Breastfeed Med. 2022;17(1):72-8. PMID: 34958231; https:// doi.org/10.1089/bfm.2021.0090.

World Health Organization. WHO Recommendations on antenatal care for a positive pregnancy experience. Geneva: WHO; 2016. Available from: https:// www.who.int/publications/i/item/9789241549912. Accessed in 2023 (Jun. 23).

Dohbit JS, Meka ENU, KV M, et al. High ‘Loss to follow-up’ of adolescent pregnancies in Yaounde. What are the determinants and challenges? J Gynecol Women’s Health. 2018;12(3):555839. https://doi.org/10.19080/ jgwh.2018.12.555839.

This work was presented as an oral presentation during the International

Federation of Gynecology and Obstetrics (FIGO) XXII FIGO World Congress 2018 at RioCentro, Brazil, from October 14 to 19, 2018; and at the XXIV Congresso Paulista de Obstetrícia e Ginecologia 2019, held on August 22–24, at Transamerica Expo Center, São Paulo (SP).

Downloads

Publicado

2025-03-27

Como Citar

1.
Pinho-Pompeu M, Nakamura RM, Zambrano E, Surita FG. Improving breastfeeding among adolescent mothers: a prospective cohort. Sao Paulo Med J [Internet]. 27º de março de 2025 [citado 15º de outubro de 2025];142(3):1-7. Disponível em: https://periodicosapm.emnuvens.com.br/spmj/article/view/3023

Edição

Seção

Artigo Original