Researchers from Universidade Federal do Espírito Santo (UFES), in Maruípe (ES), published a study in the Revista Paulista de Pediatria in December 2017 evaluating the perception of mothers of preterm newborns regarding their first six months of life and analyzing topics such as breastfeeding and introduction of pacifier and bottle.
The authors emphasize that premature newborns who require hospitalization in the neonatal intensive care unit (NICU) and feeding through gastric tube may, consequently, present delay in developing sucking function, as well as, in its coordination with breathing and swallowing, depending on the gestational age and weight at birth. For hospital discharge, it is necessary that the newborn, in addition to developing systemic conditions, also recover the sucking activity, so that oral feeding is safe. The stimulation of non-nutritive sucking has been recommended in order to anticipate the onset of feeding by sucking, with the objective of reducing hospitalization time; establishing breastfeeding is also associated with lesser need of complementary non-nutritive sucking use. The offer of pacifiers to stimulate non-nutritive sucking is a cultural phenomenon, though controversial among health professionals. Thus, the study of UFES had the objective of assessing the knowledge and expectations of mothers of preterm infants hospitalized in NICU about breastfeeding and the use of pacifiers, as well as, analyzing the experience of these mothers in dealing with the need for sucking within the first months of life of babies.
Initially, 62 mothers - and 52 after six months — of newborns with gestational age below 37 weeks hospitalized in one public and one private NICUs in the city of Vitória (ES), between February and June 2011, were interviewed.
“The results presented demonstrated that the mothers had previous knowledge on the benefits of breastfeeding, although most of them had difficulties to maintain exclusive breastfeeding after discharge from the neonatal ICU and introduced the bottle”, says Professor Dr. Elaine Cristina Vargas Dadalto, one of the authors of the research. Similarly, the study showed that mother had knowledge on the disadvantages of pacifiers, but they changed their minds given that it might calm down the baby. “On the other hand, the preliminary opinion that pacifiers could bring advantages for both mother and baby did not influence their use in the first six months, once that some babies rejected the pacifier, although it was offered by the mother”, added the professor.
According to Dr. Elaine, it should be noted that the infant’s need for non-nutritive sucking during the breastfeeding process was not always understood by the mothers. “The expression ‘the baby uses my breast as a pacifier’ was often mentioned”. In the group of infants who did not use pacifiers, the phrase had a positive meaning, referring to the fact that the baby would remain in the breast and, therefore, did not need a pacifier. In the group that used pacifiers, the interpretation was that the baby should solely extract the milk, and the mother made it so that the infant would no longer act like this, which occurred after introducing the pacifier. “At this point, the study contributed for the scientific knowledge that the need of infants to perform non-nutritive sucking during breastfeeding becomes popular. Mothers should be instructed about this pattern of less sucking power, especially among preterm infants, which is important for baby satisfaction, who won’t need to resort to additional pacifier sucking”, emphasizes the professor.
The study highlighted the difficulty of mother to establish exclusive breastfeeding after NICU discharge, which could be prevented by implementing public policies to provide homecare follow-up of preterm infants after hospital discharge, once that most mothers do not live near a hospital, which restricts their access to professional help. “In home visits, in addition to detecting problems related to breastfeeding, the motivation of mothers should occur from the alternatives suggestions to deal with the infant’s crying and need for sucking, promoting good mother-baby interaction for a successful breastfeeding”, concludes Professor Dr. Elaine Cristina Vargas Dadalto.
Contact: Elaine Cristina Vargas Dadalto
Universidade Federal do Espírito Santo
(UFES), Maruípe (ES)