Abstract
To investigate the association between the professionals who attended vaginal delivery and breastfeeding in the first hour of life. This is a cross-sectional study with data from the Nascer no Brasil (Born in Brazil) survey, conducted in the 2011-2012 period. Data from 8,466 puerperae were analyzed using a logistic regression model with a hierarchical approach. The proportion of mothers who breastfed at birth was higher in deliveries attended by nurses (70%). A nurse-assisted delivery was 64% more likely to breastfeed in the first hour of life. Other factors associated with the outcome: residing in the North; age less than 35 years; multiparity; prenatal guidance on breastfeeding in the first hour of life; birth at Baby-Friendly Hospital; companion at birth; and female newborn. Obstetrician nurse/nurse-assisted delivery was a significant independent factor associated with breastfeeding in the first hour of life, suggesting the importance of strengthening the role of the obstetrician nurse.
Highlights
Design, place of study and periodThe leading global initiative for the promotion of breastfeeding in maternal and child services is the Baby-Friendly Hospital Initiative (IHAC)
In 2014, Brazil included in the criteria for qualification to the IHAC the“Women-Friendly Care”(CAM)(6), aiming to promote“Good Delivery and Childbirth Care Practices”(7), since the indiscriminate use of interventions has been a feature of the Brazilian obstetric care model[8]
In Brazil, in the 2011-2012 period, breastfeeding in the first hour of life was performed in 60.9% of vaginal deliveries, higher than that estimated by the 2006 National Survey of Demography and Health (PNDS), with a percentage of 51.1% of children breastfed in the first hour of life in vaginal deliveries[8]
Summary
Place of study and periodThe leading global initiative for the promotion of breastfeeding in maternal and child services is the Baby-Friendly Hospital Initiative (IHAC). Studies indicate that differences in maternity care models may interfere with the early initiation of breastfeeding when mothers’ decision-making power tends to be more limited, making them dependent on the institutional and professional protocols involved in childbirth[4,5]. In 2014, Brazil included in the criteria for qualification to the IHAC the“Women-Friendly Care”(CAM)(6), aiming to promote“Good Delivery and Childbirth Care Practices”(7), since the indiscriminate use of interventions has been a feature of the Brazilian obstetric care model[8]. One of the strategies of the Ministry of Health, based on the humanization of delivery and childbirth, and due to the need to change the current technocratic care model, was the implantation of low-risk normal delivery by the obstetrician nurse, following successful international examples[9]. Obstetrical Nursing Specialization Courses and Residency Programs have been funded since the early 2000s with the aim of training nurses incorporated into the Unified Health System (SUS)(10), along the lines of the Rede Cegonha (Stork Network)(11)
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