Impacto do Método Canguru na autoeficácia da amamentação e nas taxas de aleitamento materno exclusivo pós-alta hospitalar em recém-nascidos de baixo peso

Abstract

Introduction: The premature or low birth weight can result in lower breastfeeding success rates. Physiological immaturity and harmful hospital practices are common causes of this failure. Evidence shows that psychosocial factors, such as the mother's motivation and belief in breastfeeding, are decisive for her to overcome the challenges, and the breastfeeding self-efficacy can act as a protective factor. A strategy of biopsychosocial intervention is the Kangaroo Method, a model of neonatal support aimed at qualifying and humanizing the care for low-weight newborns and their families, developed in three stages. Objective: To compare the self-efficacy of breastfeeding and the rate of exclusive breastfeeding among mothers of low birth weight newborns who participated in the three stages of the Kangaroo Method, with those who participated only in the first stage, after hospital discharge. Method: Prospective Cohort, performed at the Neonatal Unit of a Brazilian university hospital between September 2018 and March 2020. The sample was formed by 114 newborns with weights ≤1800 grams, and their mothers. They were divided into two groups: those who have gone through all the steps of the Kangaroo Method, categorized as the Kangaroo group, and those who have been admitted into the Neonatal Intensive Care Unit and later moved to the Conventional Neonatal Intermediate Care Unit without having been assisted in the second stage (Kangaroo Neonatal Intermediate Care Unit) and, posteriorly, third step (outpatient follow-up), categorized as Conventional Group. This division occurred according to the service routine where the study was performed, considering the criteria of eligibility proposed by the Norm of Humanized Care for Low-Weight Newborns – Kangaroo Method. To evaluate the breastfeeding self-efficacy, the Breastfeeding Self Efficacy Scale - Short-Form was utilized. To compare the rates of exclusive breastfeeding over time, the Kaplan-Meier survival analysis was performed. The risk ratio for abandoning exclusive breastfeeding for groups was obtained from Cox's proportional risk regression analysis. The level of significance adopted was 5%. Results: No relationship was found between breastfeeding self-efficacy and duration of exclusive breastfeeding. The Conventional group was approximately 1.5 times more likely to abandon exclusive breastfeeding than the Kangaroo group (p=0,070). In the sixth month of corrected gestational age, 5% of the sample in the Kangaroo group reported breastfeeding exclusively, while no newborn in the Conventional group had breastfed until that moment. Conclusions: The continuous presence with the child, provided by all stages of the Kangaroo Method promotes greater security and confidence for the woman, positively impacting breastfeeding.