Covid-19: desafios para assistência maternoinfantil e amamentação exclusiva no período neonatal / COVID-19: Challenges for maternal child careand exclusive breastfeeding in the neonatal period / COVID-19: desafíos para la atención maternoinfantil y la lactancia materna exclusiva en el período neonatal

Introdução:O novo coronavírus, denominado SARS-CoV-2, multiplica-se ainda de forma acelerada em alguns países, causando impactos na qualidade de vida da população. A transmissibilidade vertical ou pelo leite materno ainda é uma questão controversa que, dada as incertezas, pode comprometer a interação equipe/família/mãe/recém-nascido e a oferta do aleitamento materno nas primeiras horas de vida, com sua permanência no período neonatal. Objetivo:Discutiros desafios da saúde maternoinfantil e do aleitamento materno no contexto da pandemia causada pela COVID-19. Metodologia:Estudo do tipo descritivo, no qual foram verificados boletins, portarias e manuscritos relacionados ao aleitamento materno e aos cuidados maternos e neonatais para prevenção e transmissão do SARS-CoV-2. Resultados:Osdesafios perpassam pelo pré-natal, parto e puerpério devido às dificuldades assistenciais, medidas de proteção para o binômio, vulnerabilidade social e não cumprimento das recomendações. Conclusões:As dificuldades encontradas na pandemia podem refletir na saúde materna, na promoção do aleitamento materno, e na qualidade da alimentação e nutrição do recém-nascido (AU).

Introduction:The new coronavirus, called SARS-CoV-2, is still multiplying at an accelerated rate in some countries, thereby causing impacts on the quality of life of the population. Vertical or breast milk transmissibility is still a controversial issue, which, given the uncertainties, can undermine the team/family/mother/ newborn interaction, and the provision of breastfeeding in the first hours of life and its continuity in the neonatal period.Objective:To discuss the challenges of maternal and child health and breastfeeding in the contextof the pandemic caused by COVID-19.Methodology:Descriptive study, in which newsletters, ordinances and manuscripts related to breastfeeding and maternal and neonatal care for the prevention and transmission of SARS-CoV-2 were checked.Results:The challenges run through prenatal care, childbirth and the puerperium due to assistance difficulties, protection measures for the binomial, social vulnerability and non-compliance with the recommendations.Conclusions:The difficulties found in the pandemic may reflect on maternal health, on the promotion of breastfeeding, and on the quality of food and nutrition of the newborn (AU).

Introducción: El nuevo coronavirus, llamado SARS-CoV-2, todavía se está multiplicando a un ritmo rápido en algunos países, provocando impactos en la calidad de vida de la población. La transmisibilidad vertical o de la leche materna sigue siendo un tema controvertido, que,dadas las incertidumbres, puede comprometer la interacción equipo/familia/madre/recién nacido, y la oferta de lactancia materna en las primeras horas de vida y su permanencia en el período neonatal. Objetivo: Discutir los desafíos de la salud maternoinfantil y la lactancia materna en el período neonatal en el contexto de la pandemia causada por COVID-19.Metodología: Estudio descriptivo, en el que se verificaron boletines, ordenanzas y manuscritos relacionados con la lactancia materna y la atención maternay neonatal para la prevención y transmisión del SARS-CoV-2. Resultados: Los desafíos pasan por la atención prenatal, el parto y el puerperio por dificultades asistenciales, medidas de protección al binomio, vulnerabilidad social e incumplimiento de las recomendaciones. Conclusiones: Las dificultades encontradas en la pandemia pueden reflejarse en la salud materna, en la promoción de la lactancia materna, en la calidad de la alimentación y nutrición del recién nacido (AU).

Feeding practices and early weaning in the neonatal period: a cohort study

ABSTRACT OBJECTIVE To describe feeding practices and the risk factors for the mixed breastfeeding and early weaning in the neonatal period. METHODS Cohort study, which we collected socioeconomic, demographic, health care and feeding data from 415 mother/child binomials born in four public maternity hospitals in Natal/Brazil. They were followed-up at 48 hours, 7 and 28 days after birth. The association was established using Pearson's Chi-square test and Poisson's regression, after adjusting it to other variables. RESULTS The prevalence of mixed breastfeeding in the first 2 days was 47,2% and early weaning in 7 and 28 days was 8,4% and 16,2% in that order. The main reasons for mixed breastfeeding and early weaning were: colostrum deficiency (33.8%), difficulty in latching/sucking (23.5%) and "little milk" (70.0%). The use of formula/milk/porridge remained associated with maternal age ≤ 20 years (RR = 0.64; 95%CI: 0.47-0.86), age 20-29 years (RR = 0,70; 95%CI: 0,57-0,87), primiparity (RR = 1.37; 95%CI: 1.11-1.60) and cesarean delivery (RR = 1.20; 95%CI: 1.00-1.45) at 2 days; absence of paternal support (RR = 4.98; 95%CI: 2.54-9.79) and pacifier use (RR = 3.21; 95%CI: 1.63-6.32) at 7 days; and only pacifier use (RR = 2.48; 95%CI: 1.53-4.02) at 28 days. CONCLUSIONS Early weaning was associated with maternal and health care factors, thus suggesting the need to readjust good practices and educational actions to achieve the exclusive offer to the maternal breast in the neonatal period.