Breastfeeding Management Research Articles

The questionnaire survey about 0-24 months infantile breastfeeding and service requirement of child care clinic in Tianjin Binhai district

Objective To investigate 0-24 months infantile breastfeeding and service requirement of child care clinic in Tianjin Binhai district. Methods A total of 350 cases from June 1,2014 to June 1, 2016 were adopted by questionnaire method about breastfeeding and service requirement. Results In the survey, all of them were breastfeeding, and the 0-6 months breastfeeding rate was 84.4% (295/350). They were divided into three groups: urban, rural and external population, the main of population was urban(64.0%, 224/350). The breastfeeding rate was closely relate to the education of mother, graduate and above almost above 63.7%(223/350); exclusive breastfeeding of three groups were 25.4%(57/224), 25.8% (16/62), 34.4%(22/64) in urban, rural and external population respectively. Generally lower the national level because of the food supplement,4-5 months was 31.8%(21/66), 6-9 months was 65.4%(34/52),10-12 months was 85.0% (51/60). Insufficient breastmilk, mother was ill, working mother, think should be the four main reasons in the weaned process. Conclusions There are still some problems for the ideas and methods of breastfeeding in child care clinic, still need to strengthen the nursing management of breastfeeding. Key words: Breast feeding; Questionnaires; Nursing services needs and demand; Infants and young children

THE CHILDBIRTH SERVICES ASPECT THAT INFLUENCE PATIENT SATISFACTION

Pregnant women have higher expectations of the care providers attitude in order to have childbirth satisfaction. This study aims to analyze the relationship between childbirth services and birth satisfaction in Roemani Muhammadiyah Semarang hospital. We used a cross sectional design and used an interview to collect the data, it was conducted from July to August 2016. A total of 79 women were enrolled in the study that fulfill the inclusion and exclusion criteria. The childbirth services and patient satisfaction were measured using survey instruments which wed measured the reliability and validity previously. The linier regression were applied. The majority of the patients (94,9%) were 21-40 years old, 67,1% were university graduate, 40,5% were housewife, 62% were multigravida, and 57% were delivered by cesarean section. There were significant effect between interpersonal relationship (p=0,0001), patient decision choice (p=0,001), and breastfeeding management (p=0,021) and birth satisfaction. The strongest predictor of birth satisfaction was interpersonal relationship.

A capacitação dos profissionais de saúde que atuam na área do aleitamento materno

Objective: To evaluate the training of health professionals about breastfeeding. Method: Exploratory and descriptive field study with 614 professionals who were part of the multidisciplinary team of basic care network and two hospitals in the city of Marilia / SP. The collected data were stored and analyzed using the EPI INFO vs.6.02. Results: It was found that 22.6% received no information during training; 51.0% had no training for their professional performance. Most of the professionals assess the situation to identify the problem experienced by a woman, but there are still professionals who support the decision of the breastfeeding mother to stop breastfeeding and suggest the early introduction of other foods. In addition, 50.0% of professionals consider the knowledge about breastfeeding for decision making to be important. Conclusion: This confirms the need for ongoing instruction of our team, through training for the control and management of breastfeeding.

Impact of Educational Materials on the Duration of Exclusive Breastfeeding Assured by Women Who Delivered at the Souissi Maternity Hospital in Rabat

Background: The practice of exclusive breastfeeding (EB) in Morocco has witnessed a worrying decline in recent decades, contrary to the recommendations of the World Health Organization (WHO) which advocates it during the first six months as a significant public health tool. The present study aims to assess the impact of educational materials on mothers’ behaviour with regard to keeping up EB as long as six months, at least. Methods: This is a cohort study with a prospective collection of data over a period of one year, through a questionnaire-based survey of 500 women who delivered at the Souissi Maternity Hospital in Rabat. The subjects were divided into an intervention group sensitized, during the medical visit, by means of information delivered orally about breastfeeding and a booklet containing instructions on breastfeeding management and the benefits of EB, especially when extended for the first six months; and a control group attending the same operation with no awareness-rising through educational materials. To assess EB rates, the subjects had been followed for six months through telephone. Results: 372 women who delivered were followed, 194 from the intervention group and 178 from the control group. The remaining 128 women not followed were lost sight of. A higher percentage of mothers in the intervention group exclusively breastfed their babies up to the age of six months compared to the control group, 55.2% against 38.8% (p = 0.002). The main reason produced by most mothers who ceased to exclusively breastfeed their babies is milk insufficiency. Conclusion: The postnatal nutritional education strategy based on the distribution of educational materials has considerably raised the number of women who exclusively breastfed their babies until the age of six months.

Systematic Review of Evidence for Baby-Friendly Hospital Initiative Step 3

The Ten Steps to Successful Breastfeeding outline maternity practices that protect, promote, and support breastfeeding and serve as the foundation for the Baby-Friendly Hospital Initiative. Research aim: This systematic review describes interventions related to Step 3 of the Ten Steps, which involves informing pregnant women about the benefits and management of breastfeeding. Our main objective was to determine whether prenatal clinic- or hospital-based breastfeeding education increases breastfeeding initiation, duration, or exclusivity. The electronic databases MEDLINE and CINAHL were searched for peer-reviewed manuscripts published in English between January 1, 2000, and May 5, 2016. Bibliographies of relevant systematic reviews were also screened to identify potential studies. Thirty-eight studies were included. The research studies were either randomized controlled trials or quasi-experimental studies conducted in developed or developing countries. Findings suggest that prenatal interventions, delivered alone or in combination with intrapartum and/or postpartum components, are effective at increasing breastfeeding initiation, duration, or exclusivity where they combine both education and interpersonal support and where women's partners or family are involved. However, varying study quality and lack of standardized assessment of participants' breastfeeding intentions limited the ability to recommend any single intervention as most effective. Future studies should test the strength of maternal breastfeeding intentions, assess the role of family members in influencing breastfeeding outcomes, compare the effectiveness of different health care providers, and include more explicit detail about the time and full cost of different interventions.

Breastfeeding Curricular Content of Family Nurse Practitioner Programs

IntroductionHealth care provider support is essential for breastfeeding success. Family Nurse Practitioners (FNP) are in a unique position to promote and manage breastfeeding. There is a gap in the literature regarding the amount and type of breastfeeding curricular content in FNP programs. MethodAn online survey of FNP programs was conducted. Data collection included program descriptors, didactic breastfeeding coursework, and clinical breastfeeding opportunities available to students. ResultsNo programs offered courses specific to breastfeeding: 82% of programs devoted 1 to 2 hours of didactic lactation content. More than three quarters of the programs offered students breastfeeding counseling opportunities; no programs, however, identified specific breastfeeding clinical competencies. DiscussionFNPs can play an integral role in breastfeeding promotion and counseling. There appears to be a lack of education provided to FNPs regarding breastfeeding management. Creative approaches that incorporate lactation education into FNP programs may increase FNPs' breastfeeding knowledge and enhance their ability to provide support to breastfeeding families.

Clinical management of breastfeeding: axiological value from women's perspective

Objective: To analyze the axiological value of nurturing women regarding the clinical management of breastfeeding. Methods: This is a phenomenological qualitative study based on the theory of Max Scheler's values, conducted between May and June 2014 in the joint quarters of two university hospitals in Niteroi/RJ and Santa Maria/RS. Twenty nursing mothers participated in the study and The data was organized, subjected to the comprehensive analysis technique and was interpreted according to the value theory and the specific policies of breastfeeding. Results: Two thematic units emerged in the study: breastfeeding clinical management and its vital value and the health network to support breastfeeding care: a utility value. Conclusion: The management of breastfeeding enables a health care that goes beyond the interests, intentions and views of health professionals and institutions; human and existential questions must be seized by rational experiences, linked to those relating to the perception of the nurturer. This perception provides a reframing that is centered in the care provided to women, children and the family.

Medications, "Natural" Products, and Pharmacovigilance during Breastfeeding: A Mixed-Methods Study on Women's Opinions.

In cases of pharmacotherapy, mothers are confronted with the dilemma of breastfeeding and giving up the medication or discontinuing breastfeeding in order to take the drug, thus avoiding any potential risk for the infants. This study aimed to describe women's opinions on the use of medications and "natural" products during breastfeeding, pharmacovigilance and phytosurveillance, and the management of breastfeeding. This was a mixed-methods study with a sequential exploratory design. In the first qualitative phase, we conducted focus groups and in-depth interviews with 25 mothers attending community services. Coding and content analysis were carried out using NVivo9. We identified 4 main categories, and on this basis, we built a questionnaire administered to 248 pregnant women and new mothers attending 2 third-level hospitals. We conducted a descriptive and bivariate analysis (P ≤ .05) using Epi-Info v.7. Women show 3 main attitudes: (1) to discontinue breastfeeding in order to take the medication, (2) to "endure the pain," or (3) to use so-called natural products, perceived safer than drugs. Women expressing an "endure the pain" opinion and women who considered natural products to be safer than medications had a higher probability of knowing that babies should be exclusively breastfed for the first 6 months (respectively, odds ratio [OR] = 2.24; 95% confidence interval [CI], 1.26-3.97; OR = 4.77; 95% CI, 2.56-8.88). In the dilemma of the mothers needing drug treatment, health professionals play a crucial role. They should convey evidence-based information on the compatibility of drugs with breastfeeding and provide individualized treatments, tailored to the single mother-baby case.

Breastfeeding Twins: A Qualitative Study

The purpose of this qualitative research was to explore the needs and difficulties of mothers who had multiple babies at Sakarya County by focusing on their breastfeeding experience. Ten mothers who gave birth to multiple infants participated in the study voluntarily. The framework method of data analysis was applied systematically both within and across cases, with categories and themes identified by reading transcripts of interviews. Major themes generated from focus narrative interviews are described. These themes are: willingness of mothers to breastfeed and continue, management of breastfeeding, use of pacifier, daily life, instructions of healthcare personnel, and advices from practice of experienced mothers. This study showed that women were aware of the importance of mother's milk for their babies. They all, somehow, made intensive efforts to breastfeed their twins. Women who expect and/or have multiple babies need much more support and guidance, which may include advice for nutritional and daily care.

The prevalence of breast variations among women of reproductive age in an Iranian community

Received: August 2015, Accepted: September 2015 Background: Breast variations play an important role in breastfeeding success. It seems that this issue has not gained enough attention. The present study was designed to measure the prevalence of breast variations among women of reproductive age in an Iranian community. Materials and Methods: In this cross-sectional study, a sample of 402 pregnant women who were referred to the only maternal hospital of Rafsanjan county, Iran, was randomly recruited for the study. There were 20 items on the checklist in two sections including 14 demographic and 6 specific items. Trained physicians recorded the data in the checklist through interviewing the mothers and using their physical examination after receiving respondents’ consent. Data were analyzed using SPSS software. In addition to descriptive methods, the level of risk of breastfeeding failure with 95% CI was calculated. Normally distributed continuous variables were compared using the independent t-test and the Mann-Whitney U test was used to compare discrete variables and those continuous variables that were not normally distributed. Results: Of 402 mothers who accepted to participate, 51 mothers were detected with at least one type of breast variation giving a prevalence of 127 per 1000 mothers. The most common type of breast variation was “flat nipple” (n = 34). The existence of at least one type of breast variation among mothers increased the risk of failure in the breastfeeding process 14.1 times. Having “flat nipple” increased the risk of breastfeeding failure 11.6 times. Conclusions: In addition to the high prevalence of breast variation among the study population, our findings illustrated its significant negative effect on breastfeeding success. Thus, health professionals’ skills must be developed in the management of breastfeeding among mothers with this problem and mothers need to be given appropriate advice on how to counteract resulted breastfeeding difficulties. More investigations are strongly recommended.

Baby-Friendly Hospital Initiative: evaluation of the Ten Steps to Successful Breastfeeding

OBJECTIVE: To asses the performance of the Ten Steps to Successful Breastfeeding in an university hospital. METHODS: Descriptive and quantitative research, in which 103 people were interviewed in the outpatient prenatal clinic, in the maternity-ward and in the Neonatal Intensive Care Unit of a university hospital in Vitória, Southeast Brazil. The "Institutional Self-Evaluation Questionnaire" of the Baby Friendly Hospital Initiative was applied. Using this tool, the outcome was measured by the concordance index (CI) proposed by the World Health Organization and by the United Nations Children's Fund. RESULTS: Although the hospital does not have a policy that addresses promotion, protection and support for breastfeeding, 93.3% of the mothers had contact with their babies immediately after birth (step 4), 83.3% of the professionals guided mothers how to breastfeed (step 5), 86.6% of the neonates did not receive any food or drink other than breast milk (step 6), 100% of babies were housed together with their mothers (step 7), 83.3% of the women were encouraged for breastfeeding on demand (step 8) and 100% of the infants did not use bottles or pacifiers (step 9). CONCLUSIONS: 60% of the steps were completed by the hospital. The greatest difficulty was to inform pregnant women about the importance and the management of breastfeeding (step 3). Therefore, visits to pregnant women are recommended, in order to prepare them for breastfeeding and to explain about the infants' healthy feeding habits.

Motivational interviewing improves exclusive breastfeeding in an Australian randomised controlled trial

To increase maintenance of breastfeeding through improved primary care support. A cluster randomised controlled trial recruited 15 rural family doctor's offices and 330 women who were currently breastfeeding took part. Eight practices formed the intervention group (154 women) and seven formed the control group (176 women). The practice nurses who provided the intervention used a specially designed motivational flowchart to speak to the mothers when they brought their child for immunisation at 2, 4 and 6months. The nurses also attended preparatory workshops on breastfeeding management, counselling skills, motivational interviewing and reflective practice and were given resources and support. Breastfeeding rates were measured at 4 and 6months. Randomisation equally distributed all measured variables except prenatal intentions to rejoin employment within 12months (70% intervention, 56% control, p<0.05). After adjustment, the 4-month figures showed significantly higher rates of exclusive breastfeeding (OR 1.88; 95%CI 1.01-3.50; p=0.047) and full breastfeeding (water/juice allowed) (OR 1.95; 95%CI 1.03-3.69; p=0.04) in the intervention group. There were no differences at 6months. A motivational interviewing intervention by primary care health professionals who have undertaken a replicable training programme is feasible and effective in increasing exclusive breastfeeding and full/predominant breastfeeding at 4months.

Pet-saúde na identificação do conhecimento de gestantes sobre aleitamento materno

The objective was to identify the knowledge about breastfeeding of 20 pregnant women in prenatal care in primary health care at Uberaba, Minas Gerais. It was a cross-sectional descriptive study developed in July 2011 through structured interviews, which analysis was based on descriptive statistics. Issues related to the recommendations widespread in the media and health services, as the ideal time to first feeding, the recommended duration of exclusive breastfeeding and use of artificial pacifiers and bottles had more hits than errors. Issues related to the management of breastfeeding as the feeding duration, interval between feedings and the maintenance and increasing of milk production had more errors than hits. Most women could not answer questions relating to the management of complications and problems like breast engorgement and nipple fissures, which also showed no incorrect answers. This situation reflects the lack of ability of health professionals to promote breastfeeding. In this context the work of Programa de Educacao pelo Trabalho para a Saude - PET-Saude is highlighted.

114 Strategies for Increasing Breastfeeding Success

Breast milk is the preferred nutritional source for all newborns and infants through the first six months of life and is widely recommended through the first year. It has significant...

Management of breastfeeding for mothers, nursing professionals, which work in a maternity

ABSTRACT Objective : to k now the decision, time and management of breastfeeding mothers, nursing professionals, which work in a maternity. Methodology: study of quantitative approach, descriptive and exploratory. It was performed in a municipal maternity, which received the award as Hospital Iniciativa Amigo da Crianca (HIAC), situated at the North of Rio de Janeiro, Brazil. The research was conducted from June to August 2011, with 58 members of the nursing team. In this study were included nurses, technical and nursing assistants who had biological children and breastfed them. The data were analyzed using the proposal methodology for Content Analysis. The research project was submitted to the Research Ethics Committee of the Municipal Secretary of Health from Rio de Janeiro, Brazil, and approved under protocol n. o 0259.0.314.000-10. Results: the analysis of the interviews allowed us the construction of single analytical category : Managements of breasts at home : the gaze of professional nursing and cultural influence . Conclusion : it was possible to verify even being a nursing professional and mother, who is knowledgeable about the benefits of breastfeeding and appropriate management of breast to reverse possible complications, the cultural question influences in its management of the breasts in breastfeeding . Descriptors : breastfeeding; nursing; women’s health. Resumo Objetivo: conhecer a decisao, o tempo e manejo do aleitamento materno das maes profissionais de enfermagem. Metodologia: estudo de abordagem qualitativa, descritivo e exploratorio, realizado numa maternidade com o titulo Hospital Iniciativa Amigo da Crianca, da rede municipal na zona norte do Rio de Janeiro, Brasil. A pesquisa foi desenvolvida de junho a agosto de 2011, com 58 membros da equipe de enfermagem. Foram incluidas as enfermeiras, tecnicas e auxiliares de enfermagem, que tinham filho biologico e o amamentado. Os dados foram analisados segundo proposta metodologica da Analise de Conteudo. O projeto de pesquisa foi submetido ao Comite de Etica e Pesquisa da Secretaria Municipal de Saude do Rio de janeiro e aprovado sob no 0259.0.314.000-10. Resultados: A analise das entrevistas possibilitou a construcao de unica categoria analitica: Manejos das mamas no domicilio : o olhar da profissional de enfermagem e a influencia cultural. Conclusao : foi possivel verificar que mesmo a nutriz sendo uma profissional de enfermagem, que tem conhecimento sobre os beneficios do aleitamento materno e o adequado manejo das mamas para reverter possiveis intercorrencias, a questao cultural influencia no seu manejo das mamas no aleitamento materno. Descritores: aleitamento materno; enfermagem; saude da mulher. RESUMEN Objetivo: este articulo se centra en la decision , el tiempo y manejo de la lactancia las madres que trabajan los profesionales de enfermeria en una sala de maternidad con el titulo de Baby - Iniciativa Hospital Amigo. Metodologia: se utilizo un enfoque cuantitativo , descriptivo y exploratorio . A medida que el escenario de la investigacion fue una maternidad municipal situado en el norte de Rio de Janeiro . La encuesta se realizo entre junio y agosto de 2011 con 58 miembros del equipo de enfermeria . Resultados : a partir del analisis de las entrevistas fueron presentados en un estudio descriptivo, que permitio la construccion de una sola categoria de analisis : Gestiones de mama en el hogar : la mirada de la enfermeria profesional y la influencia cultural . Conclusion : se observo que aun siendo un profesional de enfermeria la enfermera que esta bien informado acerca de los beneficios de la lactancia materna y el manejo adecuado de las complicaciones posibles de mama para revertir las influencias de la cuestion cultural en el manejo de los senos en la lactancia materna . Descriptores: lactancia materna ; enfermeria; salud de la mujer.

Breastfeeding Knowledge of University Nursing Students

To assess breastfeeding knowledge among senior nursing students and identify the types of breastfeeding knowledge the students have. We also investigated the relationship between the different types of breastfeeding knowledge. An exploratory descriptive design used a convenience sample of 115 students from two schools of nursing in two Midwestern universities. Students who completed maternal/child nursing didactic and clinical courses were eligible to participate. A Breastfeeding Knowledge Questionnaire adapted from Brodribb, Fallon, Jackson, and Hegney (2008) was used. The questionnaire consisted of 24 items covering knowledge about benefits of breastfeeding, physiology of lactation, and breastfeeding management. Content and face validity were considered, and Cronbach's α for internal consistency was 0.70. Eligible students completed the questionnaire in class. Descriptive and inferential statistics were used to describe student knowledge and to test the differences in breastfeeding knowledge. Findings revealed a mean knowledge score of 17 ± 2.9 (total possible score 24). There was a significant difference in the students' knowledge regarding physiology of lactation and benefits of breastfeeding (t = -3.615, p = .000) and between benefits and breastfeeding management (t = 5.255, p = .000). There was a positive relationship between knowledge of physiology of lactation and breastfeeding management (r = 0.369, p = .000). Strategies are warranted to improve breastfeeding education in the nursing curriculum, focusing on breastfeeding management skills.

Promoting Breastfeeding Self-Efficacy: Fear Appeals in Breastfeeding Management

Lactation consultants (LC) often use fear appeals when providing anticipatory guidance to mothers about breastfeeding. We mention that improper positioning or latch-on can lead to sore nipples or fissures, or that inadequate or irregular emptying can lead to plugged ducts, mastitis, or a diminished milk supply. Instead of motivating the mother to practice the recommended preventive measures, fear appeals can lead to lack of confidence and fear of failure. Instead, lactation consultants can increase the mother’s confidence in her ability to breastfeed by helping her envision success, manage self-defeating thoughts, and solve problems. This article explores how the Extended Parallel Process Model can be applied to lactation consultation to increase the probability that the lactation consultant’s message will be heeded rather than rejected.

The effects of Baby Friendly Initiative training on breastfeeding rates and the breastfeeding attitudes, knowledge and self-efficacy of community health-care staff

To evaluate the effects of Baby Friendly Initiative (BFI) community training on breastfeeding rates, staff and mothers in a large Primary Care Trust (PCT). UK Government policy promotes the adoption and implementation of the World Health Organization/United Nations Children's Fund BFI as the best evidence to raise breastfeeding initiation and prevalence. A total of 141 health visitors and nursery nurses were trained on mandatory three-day BFI courses during 2008; 137 staff (100 health visitors, 37 nursery nurses) took part in the evaluation. Breastfeeding attitudes, knowledge and staff confidence in helping mothers to breastfeed were measured using a validated Breastfeeding Questionnaire and a self-efficacy tool at three time points before and after training. Breastfeeding rates at eight weeks increased significantly, and a baby born in 2009 was 1.57 times more likely to be breastfed than one born in 2006. Statistically significant improvements in staff breastfeeding attitudes, knowledge and self-efficacy were seen after attending the course, in addition to increases in the appropriate management of breastfeeding problems.Process evaluation interviews with 43 health visitors, nursery nurses and managers explored views of the training and changes in practice. The response to the course was overwhelmingly positive and felt to be extremely worthwhile. It has led to renewed enthusiasm, improved the consistency of advice among team members and raised confidence levels of all staff who help mothers with breastfeeding. Health visitors felt confident about enabling nursery nurses to take a greater role in breastfeeding support. A small survey of mothers reported increases in exclusive breastfeeding and signs of increased breastfeeding self-efficacy. Making the training mandatory across the whole PCT has improved the consistency of breastfeeding advice and confidence of all health-care staff who help breastfeeding mothers.

Initiating and Sustaining Breastfeeding in African American Women

To explore issues related to initiating and sustaining breastfeeding in African American women. Qualitative design using focus groups, guided by Leininger's theory of culture care diversity and universality. Three different regions of a southeastern state in the United States. Fifteen self-identified African American women who had recently breastfed were recruited by lactation consultants and by word of mouth. Three focus groups were conducted with initial guiding questions. New ideas that emerged were fully explored in the group and included as a guiding question for the next group. Categories identified from the data were reasons to start and stop breastfeeding, advice about breastfeeding that was useful or not useful, and cultural issues related to breastfeeding that were perceived to be unique among African Americans. Three overall themes were identified that cut across categories: perceived lack of information about benefits and management of breastfeeding, difficulties breastfeeding in public, and lack of a support system for continued breastfeeding. Women need to be taught early in their pregnancies about the benefits of breastfeeding and offered continuing support and teaching once breastfeeding is established. Peer support groups for breastfeeding African American women should be established.

Influência da disfunção oral do neonato a termo sobre o início da lactação

OBJETIVO: verificar a associação entre a disfunção oral e os fatores socioeconômicos, variáveis relacionadas à mãe e ao recém-nascido com o desempenho da mamada, durante as primeiras 48 horas de vida. MÉTODOS: estudo transversal, analítico, realizado em uma maternidade pública do Recife-PE. Foram entrevistadas todas as mães de crianças nascidas a termo entre abril e julho de 2008, perfazendo 588 binômios mãe/recém-nascido. A avaliação do sistema sensório motor oral do neonato e avaliação da mamada foram elaboradas, codificando-se como zero quando o item era "esperado/normal" e um quando "não esperado/de risco". A soma total dos itens "não esperados/de risco" resultou em um Índice de Disfunção Oral e um Índice de Avaliação da Mamada. RESULTADOS: verificou-se que 57,3% dos binômios mães/recém-nascidos apresentavam alteração da mamada, 43,9% apresentavam 1 e/ou 2 alterações e 13,4% maior número de alterações. A frequência de disfunção oral foi de aproximadamente 30%. Na análise de regressão logística entre as variáveis incluídas, apenas a disfunção oral manteve-se associada significativamente com o insucesso da mamada. Crianças com maior número alterações da função oral apresentaram chance 4 vezes maior de ter alteração da mamada. CONCLUSÕES: sendo as disfunções orais uma das causas para o não estabelecimento da lactação, estas devem ser identificadas precocemente, visto que podem ser corrigidas, evitando o desmame. As maternidades devem possuir equipe capacitada no manejo do aleitamento, com um profissional que dê atenção especial às alterações do sistema sensório motor oral.