Actitud hacia las dificultades asociadas a la lactancia materna
Resumen Introducción. A pesar de las recomendaciones promulgadas por la Organización Mundial de la Salud, las tasas globales de prevalencia de lactancia materna son bajas. La actitud y el afrontamiento de la madre hacia diversos factores físicos, sociales y emocionales pueden condicionar la duración de la lactancia. El objetivo de este trabajo es conocer qué factores son críticos a la hora de afrontar con éxito la lactancia, mediante la creación de una escala de actitudes hacia algunas de las dificultades asociadas a la lactancia materna. Material y métodos. Se elaboró un cuestionario basado en comparaciones binarias con siete factores: cansancio, regreso al trabajo, percepción de baja producción de leche, amamantar en público, necesitar asesoramiento o ayuda, dolor asociado a problemas físicos y baja autoeficacia para la conducta de amamantar. Se seleccionaron, por muestreo consecutivo, 30 mujeres en el tercer trimestre de gestación, de las que 22 cumplimentaron correctamente el cuestionario. Finalmente, se llevó a cabo el análisis de datos mediante el Método de Thurstone. Resultados. Se obtuvo una escala de actitud, en la que constan de mayor a menor importancia los factores: dolor físico (Z=0,561), sentido de autoeficacia (Z=0,44), regreso al trabajo (Z=0,105), percepción de baja producción de leche (Z=-0,07), necesidad de ayuda (Z= -0,07), cansancio (Z=-0,17) y amamantamiento en público (Z=-1,13). Conclusiones. El apoyo instrumental y emocional durante la estancia hospitalaria y tras el alta favorece un mejor afrontamiento de las dificultades asociadas a la lactancia materna.
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12. Henshaw EJ, Fried R, Siskind E, Newhouse L, Cooper M. Breastfeeding self-efficacy, mood, and breastfeeding outcomes among primiparous women. J Hum Lact. 2015;31(3):511-8. DOI: 10.1177/0890334415579654
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14. Zubaran C, Foresti K. The correlation between breastfeeding self-efficacy and maternal postpartum depression in southern Brazil. Sex Reprod Healthc. 2013;4(1):9-15. DOI: 10.1016/j.srhc.2012.12.001
15. Haga SM, Ulleberg P, Slinning K, Kraft P, Steen TB, Staff A. A longitudinal study of postpartum depressive symptoms: multilevel growth curve analyses of emotion regulation strategies, breastfeeding self-efficacy, and social support. Arch Womens Ment Health. 2012;15(3):175-84. DOI: 10.1007/s00737-012-0274-2
16. Ahmed S, Taha E, Elsharkawy A. Relationship between exclusive breastfeeding self-efficacy and mothers’ practices. Alexandria Scientific Nursing Journal. 2022;24(3):99-113. DOI: 10.21608/asalexu.2022.267759
17. Fallon V, Groves R, Halford JC, Bennett KM, Harrold JA. Postpartum anxiety and infant-feeding outcomes: A systematic review. J Hum Lact. 2016;32(4):740-58. DOI: 10.1177/0890334416662241
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19. Field T. Postnatal anxiety prevalence, predictors and effects on development: A narrative review. Infant Behav Dev. 2018;51:24-32. DOI: 10.1016/j.infbeh.2018.02.005
20. Dennis CL. The breastfeeding self-efficacy scale: psychometric assessment of the short form. J Obstet Gynecol Neonatal Nurs. 2003;32(6):734-44. DOI: 10.1177/0884217503258459
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27. Dutheil F, Méchin G, Vorilhon P, Benson AC, Bottet A, Clinchamps M et al. Breastfeeding after Returning to Work: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021;18(16):8631. DOI: 10.3390/ijerph18168631
28. Hannula L, Kaunonen M, Tarkka MT. A systematic review of professional support interventions for breastfeeding. J Clin Nurs. 2008;17(9):1132-43. DOI: 10.1111/j.1365-2702.2007.02239.x
29. Gavine A, Shinwell SC, Buchanan P, Farre A, Wade A, Lynn F et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews. 2022;25;10(10):CD001141. DOI: 10.1002/14651858
30. Galler JR, Harrison RH, Ramsey F, Chawla S, Taylor J. Postpartum feeding attitudes, maternal depression, and breastfeeding in Barbados. Infant Behav Dev. 2006;29(2):189-203. DOI: 10.1016/j.infbeh.2005.10.005
31. Scott JA, Kwok YY, Synnott K, Bogue J, Amarri S, Norin E et al. A comparison of maternal attitudes to breastfeeding in public and the association with breastfeeding duration in four European countries: results of a cohort study. Birth. 2015;42(1):78-85. DOI: 10.1111/birt.12138
32. Amir LH. Breastfeeding in public: “You can do it?”. Int Breastfeed J. 2014;9:187. DOI 10.1186/s13006-014-0026-1
33. Quiles del Castillo MN, Morera Bello MD, Rodríguez Torres R. Psicología social: Procesos interpersonales. Madrid: Pirámide; 1998.
34. Thurstone LL. Attitudes can be measured. Am J Sociol. 1928;33(4):529-54. DOI: 10.1086/214483
35. Arce C. Técnicas de construcción de escalas psicológicas. Madrid: Síntesis; 1994.
36. Francis J, Russell B, Lucas R. Exclusive breastfeeding at 6 weeks related to pain self-management, emotion and self-efficacy: A secondary analysis of a pilot randomized control trial. MedRxiv. 2020. DOI: 10.1101/2020.09.28.20195198
37. Lucas R, Zhang Y, Walsh SJ, Evans H, Young E, Starkweather A. Efficacy of a Breastfeeding Pain Self-Management Intervention: A Pilot Randomized Controlled Trial. Nurs Res. 2019;68(2):E1-E10. DOI: 10.1097/NNR.0000000000000336
38. Meedya S, Fahy K, Kable A. Factors that positively influence breastfeeding duration to 6 months: A literature review. Women Birth. 2010;23(4):135-45. DOI: 10.1016/j.wombi.2010.02.002
39. Vilar M, Hernández S, Ancira M, Burrola S, Ferre I, Omaña I, Pérez C. Breastfeeding at workplace: A systematic review of interventions to improve workplace environments to facilitate breastfeeding among working women. Int J Equity Health. 2021;20(1):110. DOI: 10.1186/s12939-021-01432-3
40. Huang Y, Liu Y, Yu XY, Zeng TY. The rates and factors of perceived insufficient milk supply: A systematic review. Matern Child Nutr. 2022;18(1):e13255. DOI: 10.1111/mcn.13255
41. Blixt I, Johansson M, Hildingsson I, Papoutsi Z, Rubertsson C. Women’s advice to healthcare professionals regarding breastfeeding: “Offer sensitive individualized breastfeeding support”- an interview study. Int Breastfeed J. 2019;14(1):51. https://doi.org/10.1186/s13006-019-0247-4
2. Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-90. DOI: 10.1016/S0140-6736(15)01024-7
3. Horta BL, Bahl R, Martines JC, Victora CG. Evidence on the long-term effects of breastfeeding: systematic reviews and meta-analyses. Geneva: World Health Organization; 2007.
4. World Health Organization, the United Nations Children’s Fund. Indicators for assessing infant and Young child feeding practices: definitions and measurement methods. Geneva: World Health Organization and the United Nations Children’s Fund; 2021.
5. Instituto Nacional de Estadística. Determinantes de salud: sobrepeso, consumo de fruta y verdura, tipo de lactancia, actividad física. Madrid: Instituto Nacional de Estadística; 2021.
6. Gianni ML, Bettinelli ME, Manfra P, Sorrentino G, Bezze E, Plevani L et al. Breastfeeding difficulties and risk for early breastfeeding cessation. Nutrients. 2019;11(10):2266. DOI: 10.3390/nu11102266.
7. Dennis CL. Breastfeeding initiation and duration: 1990-2000 literature review. J Obstet Gynecol Neonatal Nurs. 2002; 31:12-32. DOI: 10.1111/j.1552-6909.2002.tb00019.x
8. Brown A, Arnott B. Breastfeeding duration and early parenting behaviour: the importance of an infant-led, responsive style. PloS One. 2014;9(2):1-7. DOI: 10.1371/journal.pone.0083893
9. Buck ML, Amir LH, Cullinane M, Donath SM. Nipple pain, damage, and vasospasm in the first 8 weeks postpartum. Breastfeed Med. 2014;9(2):56-62. DOI: 10.1089/bfm.2013.0106
10. Watkins S, Meltzer-Brody S, Zolnoun D, Stuebe A. Early breastfeeding experiences and postpartum depression. Obstet Gynecol. 2011;118(2 Pt 1):214-21. DOI: 10.1097/AOG.0b013e3182260a2d
11. Dennis CL. Theoretical underpinnings of breastfeeding confidence: a self-efficacy framework. J Hum Lact. 1999;15(3):195-201. DOI: 10.1177/089033449901500303
12. Henshaw EJ, Fried R, Siskind E, Newhouse L, Cooper M. Breastfeeding self-efficacy, mood, and breastfeeding outcomes among primiparous women. J Hum Lact. 2015;31(3):511-8. DOI: 10.1177/0890334415579654
13. Loke AY, Chan LK. Maternal breastfeeding self-efficacy and the breastfeeding behaviors of newborns in the practice of exclusive breastfeeding. J Obstet Gynecol Neonatal Nurs. 2013;42(6):672-84. DOI: 10.1111/1552-6909.12250
14. Zubaran C, Foresti K. The correlation between breastfeeding self-efficacy and maternal postpartum depression in southern Brazil. Sex Reprod Healthc. 2013;4(1):9-15. DOI: 10.1016/j.srhc.2012.12.001
15. Haga SM, Ulleberg P, Slinning K, Kraft P, Steen TB, Staff A. A longitudinal study of postpartum depressive symptoms: multilevel growth curve analyses of emotion regulation strategies, breastfeeding self-efficacy, and social support. Arch Womens Ment Health. 2012;15(3):175-84. DOI: 10.1007/s00737-012-0274-2
16. Ahmed S, Taha E, Elsharkawy A. Relationship between exclusive breastfeeding self-efficacy and mothers’ practices. Alexandria Scientific Nursing Journal. 2022;24(3):99-113. DOI: 10.21608/asalexu.2022.267759
17. Fallon V, Groves R, Halford JC, Bennett KM, Harrold JA. Postpartum anxiety and infant-feeding outcomes: A systematic review. J Hum Lact. 2016;32(4):740-58. DOI: 10.1177/0890334416662241
18. Vieira ES, Caldeira NT, Eugênio DS, Lucca MMD, Silva IA. Breastfeeding self-efficacy and postpartum depression: A cohort study. Rev Lat Am Enfermagem. 2018;6(26):1-8. DOI: 10.1590/1518-8345.2110.3035
19. Field T. Postnatal anxiety prevalence, predictors and effects on development: A narrative review. Infant Behav Dev. 2018;51:24-32. DOI: 10.1016/j.infbeh.2018.02.005
20. Dennis CL. The breastfeeding self-efficacy scale: psychometric assessment of the short form. J Obstet Gynecol Neonatal Nurs. 2003;32(6):734-44. DOI: 10.1177/0884217503258459
21. Britton J. Postpartum anxiety and breast feeding. J Reprod Med. 2007;52:689-95. PMID: 17879829
22. Butler MS, Young SL, Tuthill EL. Perinatal depressive symptoms and breastfeeding behaviors: a systematic literature review and biosocial research agenda. J Affect Disord. 2021;283:441-71. DOI: 10.1016/j.jad.2020.11.080
23. Whitten D. A precious opportunity: Supporting women with concerns about their breastmilk supply. AJMH. 2013;25:112-26.
24. Brown CR, Dodds L, Legge A, Bryanton J, Semenic S. Factors influencing the reasons why mothers stop breastfeeding. Can J Public Health. 2014;105(3):179-85. DOI: 10.17269/cjph.105.4244
25. Callahan S, Séjourné N, Denis A. Fatigue and breastfeeding: an inevitable partnership? J Hum Lact. 2006;22(2):182-7. DOI: 10.1177/0890334406286972
26. Gagnon AJ, Leduc G, Waghorn K, Yang H, Platt RW. In-hospital formula supplementation of healthy breastfeeding newborns. J Human Lact. 2005;21(4):397-405. DOI: 10.1177/0890334405280835
27. Dutheil F, Méchin G, Vorilhon P, Benson AC, Bottet A, Clinchamps M et al. Breastfeeding after Returning to Work: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021;18(16):8631. DOI: 10.3390/ijerph18168631
28. Hannula L, Kaunonen M, Tarkka MT. A systematic review of professional support interventions for breastfeeding. J Clin Nurs. 2008;17(9):1132-43. DOI: 10.1111/j.1365-2702.2007.02239.x
29. Gavine A, Shinwell SC, Buchanan P, Farre A, Wade A, Lynn F et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews. 2022;25;10(10):CD001141. DOI: 10.1002/14651858
30. Galler JR, Harrison RH, Ramsey F, Chawla S, Taylor J. Postpartum feeding attitudes, maternal depression, and breastfeeding in Barbados. Infant Behav Dev. 2006;29(2):189-203. DOI: 10.1016/j.infbeh.2005.10.005
31. Scott JA, Kwok YY, Synnott K, Bogue J, Amarri S, Norin E et al. A comparison of maternal attitudes to breastfeeding in public and the association with breastfeeding duration in four European countries: results of a cohort study. Birth. 2015;42(1):78-85. DOI: 10.1111/birt.12138
32. Amir LH. Breastfeeding in public: “You can do it?”. Int Breastfeed J. 2014;9:187. DOI 10.1186/s13006-014-0026-1
33. Quiles del Castillo MN, Morera Bello MD, Rodríguez Torres R. Psicología social: Procesos interpersonales. Madrid: Pirámide; 1998.
34. Thurstone LL. Attitudes can be measured. Am J Sociol. 1928;33(4):529-54. DOI: 10.1086/214483
35. Arce C. Técnicas de construcción de escalas psicológicas. Madrid: Síntesis; 1994.
36. Francis J, Russell B, Lucas R. Exclusive breastfeeding at 6 weeks related to pain self-management, emotion and self-efficacy: A secondary analysis of a pilot randomized control trial. MedRxiv. 2020. DOI: 10.1101/2020.09.28.20195198
37. Lucas R, Zhang Y, Walsh SJ, Evans H, Young E, Starkweather A. Efficacy of a Breastfeeding Pain Self-Management Intervention: A Pilot Randomized Controlled Trial. Nurs Res. 2019;68(2):E1-E10. DOI: 10.1097/NNR.0000000000000336
38. Meedya S, Fahy K, Kable A. Factors that positively influence breastfeeding duration to 6 months: A literature review. Women Birth. 2010;23(4):135-45. DOI: 10.1016/j.wombi.2010.02.002
39. Vilar M, Hernández S, Ancira M, Burrola S, Ferre I, Omaña I, Pérez C. Breastfeeding at workplace: A systematic review of interventions to improve workplace environments to facilitate breastfeeding among working women. Int J Equity Health. 2021;20(1):110. DOI: 10.1186/s12939-021-01432-3
40. Huang Y, Liu Y, Yu XY, Zeng TY. The rates and factors of perceived insufficient milk supply: A systematic review. Matern Child Nutr. 2022;18(1):e13255. DOI: 10.1111/mcn.13255
41. Blixt I, Johansson M, Hildingsson I, Papoutsi Z, Rubertsson C. Women’s advice to healthcare professionals regarding breastfeeding: “Offer sensitive individualized breastfeeding support”- an interview study. Int Breastfeed J. 2019;14(1):51. https://doi.org/10.1186/s13006-019-0247-4
Muñoz Alba, E. (2023). Actitud hacia las dificultades asociadas a la lactancia materna. Revista De Lactancia Materna, 1(1), e30874. https://doi.org/10.14201/rlm.30874
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