Ações de promoção e proteção ao aleitamento materno realizadas na atenção primária

Abstract

Introduction: The Breastfeeding and Feeding Strategy Brazil (EAAB) was established in the Unified Health System (SUS) in 2013, with the aim of promoting and protecting breastfeeding (BF) and complementary feeding, through continuing education of health professionals who work in Primary Health Care (PHC). Among EAAB's APS certification requirements are compliance with the Brazilian Norm for the Marketing of Food for Infants and Young Children, Teats, Pacifiers and Bottles (NBCAL) and the monitoring of breastfeeding indicators, which can be carried out through data from the National Food and Nutrition Surveillance System (SISVAN). The implementation of the EAAB is not homogeneous in Brazilian municipalities. Therefore, the detailed analysis of which actions to promote and protect breastfeeding (BF) are carried out in the PHC, the identification of which recommendations are based on their conduct, as well as the knowledge of health professionals about important components of the EAAB is necessary. Objectives: To analyze BF promotion and protection actions carried out by health professionals in PHC in Uberlândia-MG. Material and methods: Cross-sectional study with a sample of 215 PHC professionals, including 29 coordinators and 186 health professionals (nurses, doctors, nutritionists, nursing technicians). The data collected were: professional training; knowledge of NBCAL and its application in PHC; BF promotion and management actions; and knowledge and use of SISVAN. These data were collected through two questionnaires, one for health professionals and the other for PHC coordinators. For data analysis, the chi-square test was used to compare the frequencies of responses according to professional training and care model (with and without a family health team). A significance level of p<0.05 was considered. Results: Only 12.4% of professionals claimed to know the NBCAL and, of these, 30.4% described their objectives. No advertisements for children's products and visits by company representatives to the units were identified. As for knowledge of SISVAN, 100.0% of coordinators and 77.7% of professionals said they knew it, while 86.2% and 45.7% of them knew how to describe its objective, respectively. Only 27.6% of coordinators use SISVAN data to develop actions in the unit. BF management was carried out by 76.0% of the professionals, with the main guidelines being the correct grip and position of the baby when breastfeeding (65.0%) and the importance of breastfeeding (29.2%). The BF promotion action most reported by professionals was carrying out groups of pregnant women (82.3%). Compliance with the NBCAL, BF management and its promotion actions were similar in PHC with and without a family health team, with the exception of carrying out childcare groups, which was more present in the care model without family health. Conclusion: Most professionals did not know the NBCAL and the use of SISVAN for population diagnosis and support for actions is insufficient. Actions on BF management seem to be punctual and variable among professionals, requiring better systematization.