Estudio de la construcción que hacen las madres del soporte necesario para la instauración y mantenimiento de la lactancia materna

Programa Oficial de Doutoramento en Ciencias Sociosanitarias. 512V01[Resumen] La lactancia materna (LM) ha sido históricamente y continúa siendo motivo de interés por parte de numerosas disciplinas, entre ellas, la enfermería. En los humanos, como mamíferos que son, la LM forma parte de su ciclo reproductivo. Sin embargo, a diferencia de éstos, en las mujeres la LM no es un acto exclusivamente biológico. En el ser humano la lactancia es una construcción social y, por lo tanto, depende del aprendizaje, creencias, valores, normas y condicionantes socioculturales que cambian a lo largo de los tiempos y de los individuos que en ellos viven. Es por ello que se hace necesario incorporar en el estudio de la LM la perspectiva de los sujetos implicados, en este caso las madres. La investigación en salud que se presenta en esta tesis se ha realizado como un Estudio Mix- Method Transformativo con una estructura secuencial cuantitativa-cualitativa. Los resultados de esta investigación establecen que la decisión que han de tomar las mujeres sobre la alimentación del RN está condicionada por los beneficios que ellas atribuyen a la LM y a la LA; la estigmatización de la LM en público; y la presión que ejercen los profesionales sanitarios, la sociedad y las propias mujeres, influidos por las normas sociales y culturales del momento. Al tratarse de un estudio transformativo se finaliza con una propuesta de agenda para cambiar o reformar los aspectos que se han desarrollado como resultado de la investigación. Esta agenda transformadora implica, además de a los profesionales sanitarios responsables del cuidado de la mujer gestante, a los gestores de la Xerencia de Xestión Integrada de Ferrol (XXIF).[Resumo] A lactación materna (LM) foi historicamente e segue sendo motivo de interese por parte de numerosas disciplinas, entre elas, a enfermaría. Nos humanos, coma mamíferos que son, a LM forma parte do seu ciclo reprodutivo. Con todo, a diferencia destes, nas mulleres a LM non é un acto exclusivamente biolóxico. A diferenza doutros animais, no ser humano a lactación é unha construción social e, polo tanto, depende da aprendizaxe, crenzas, valores, normas e condicionantes socioculturais que mudan ó longo dos tempos e dos individuos que neles viven. É por iso que se fai necesario incorporar no estudo da LM a perspectiva dos suxeitos implicados, neste caso as nais. A investigación en saúde que se presenta nesta tese realizouse coma un Estudo Mix-Method Transformativo cunha estructura secuencial cuantitativa-cualitativa. Os resultados desta investigación establecen que a decisión que teñen que tomar as mulleres sobre a alimentación do recén nado (RN) está condicionada polos beneficios que elas atribúen á LM e á LA; a estigmatización da LM en público; e a presión que exercen os profesionais sanitarios, a sociedade e as propias mulleres, influídos polas normas sociais e culturais do momento. Ó se tratar dun estudo transformativo finalízase cunha proposta de axenda para cambiar ou reformar os aspectos que se desenvolveron como resultado da investigación. Esta axenda transformadora implica, ademáis dos profesionais sanitarios do coidado da muller xestante, ós xestores da Xerencia de Xestión Integrada de Ferrol (XXIF).[Abstract] Historically and to this day, breastfeeding has been a topic of great interest in many disciplines, among them in the field of nursing. In humans, as mammals that they are, breastfeeding is part of their reproductive cycle. However, unlike the latter, in women breastfeeding is not exclusively and merely a biological act. Differing from other animals, for a human being breastfeeding is a social construct that depends on learning, beliefs, values, norms and sociocultural variables that change in time as well as the individuals that live through them. For this reason, it is necessary to include in the breastfeeding research the perspective of the involved subjects, the mothers. The health research presented in this thesis has been completed as a transformative Mix- Method study with a quantitative-qualitative sequential structure. The results obtained from this research establish that the decision women make in regards to feeding their newborn is conditioned by the benefits they attribute to breastfeeding and to formula; the stigmatization of breastfeeding in public, and pressure from health professionals, society and women as a whole, influenced by the social and cultural norms in the moment. Complying with the research methodology, at the end of the study there is a scheduled proposal to change or improve the aspects developed as a result of the research. Besides the health professionals responsible for the well being during pregnancy, the proposal also involves the management team of the Xerencia de Xestión Integrada de Ferrol (XXIF)

Conhecimentos sobre aleitamento e a relação com a sua prevalência

Objective: Determine the level of knowledge about maternal breastfeeding and analyze to what extent this influences the intention to breastfeed after the introduction of infant feeding at the 6th and 16th weeks and at 6 months postpartum. Method: Prospective descriptive study conducted with pregnant women in Galicia (Spain). By means of a self-filling questionnaire, data were collected on the intention of the woman to feed the newborn and their knowledge about breastfeeding. Pregnant women were also contacted at the 6th and 16th weeks and at 6 months postpartum to know the type of feeding they gave their child. Results: 297 pregnant women participated in the study, of which 90.4% wanted to exclusively breastfeed their baby, however, only 28.2% continued up to 6 months. The level of knowledge about breastfeeding was regular and it was observed that it influences both the intention and the type of feeding of the newborn, thus it is an element to be considered when developing educational strategies aimed at increasing breastfeeding rates. Conclusion: The level of pregnant women’s knowledge about breastfeeding is regular and influences the choice of how to feed their babies and the duration of exclusive breastfeeding. Strategies should be implemented to increase knowledge and improve breastfeeding rates

Knowledge, Attitudes, and Practices of Spanish Midwives and Midwifery Students toward Oral Healthcare during Pregnancy

Pregnancy can affect the mother’s oral health, increasing their susceptibility to oral diseases that have been associated with harmful effects on the newborn. Despite the severity of oral diseases during pregnancy, the demand for dental care during the gestational period is low, which may improve with the participation of midwives in promoting oral health activities. The objectives of this study were: (i) to determine the knowledge, attitudes, and practices of Spanish midwives and midwifery students regarding oral health in pregnant women; and (ii) to identify the barriers faced by these healthcare professionals in addressing oral health promotion during pregnancy. An observational cross-sectional descriptive study was conducted. A total of 128 midwives and/or midwifery students ≥ 18 years old and of both sexes were invited to self-complete a questionnaire between January and April 2020. A total of 85 people participated in the study. Participants had a regular level of knowledge about oral health during pregnancy (overall knowledge score: 6.53), and although they were interested in activities that promote oral healthcare, their oral healthcare practices during pregnancy were limited. As midwives play an important role in promoting health, their training in oral healthcare could help to improve pregnant women’s oral healthS

Infant Feeding Attitudes and Practices of Spanish Low-Risk Expectant Women Using the IIFAS (Iowa Infant Feeding Attitude Scale)

The Iowa Infant Feeding Attitude Scale (IIFAS) has been shown to have good psychometric properties for English-speaking populations, but it has not been validated among low-risk pregnant women in Spain. The aim of this study was to assess the reliability and validity of the translated version of the IIFAS in order to examine infant feeding attitudes in Spanish women with an uncomplicated pregnancy. Low-risk expectant women (n = 297) were recruited from eight primary public health care centres in Galicia (Spain). Questionnaires including both socio-demographic and breastfeeding characteristics and items about infant feeding were administered during the third trimester. Participants were contacted by telephone during the postpartum period to obtain information regarding their infant feeding status. Prediction validity and internal consistency were assessed. The translated IIFAS (69.76 ± 7.75), which had good psychometric properties (Cronbach’s alpha = 0.785; area under the curve (AUC) of the receiver operating characteristic (ROC) curve = 0.841, CI95% = 0.735–0.948), showed more positive attitudes towards breastfeeding than towards formula feeding, especially among mothers who intended to exclusively breastfeed. This scale was also useful for inferring the intent to breastfeed and duration of breastfeeding. This study provides evidence that the IIFAS is a reliable and valid tool for assessing infant feeding attitudes in Spanish women with an uncomplicated pregnancy

Breastfeeding knowledge and relation to prevalence

ABSTRACT Objective: Determine the level of knowledge about maternal breastfeeding and analyze to what extent this influences the intention to breastfeed after the introduction of infant feeding at the 6th and 16th weeks and at 6 months postpartum. Method: Prospective descriptive study conducted with pregnant women in Galicia (Spain). By means of a self-filling questionnaire, data were collected on the intention of the woman to feed the newborn and their knowledge about breastfeeding. Pregnant women were also contacted at the 6th and 16th weeks and at 6 months postpartum to know the type of feeding they gave their child. Results: 297 pregnant women participated in the study, of which 90.4% wanted to exclusively breastfeed their baby, however, only 28.2% continued up to 6 months. The level of knowledge about breastfeeding was regular and it was observed that it influences both the intention and the type of feeding of the newborn, thus it is an element to be considered when developing educational strategies aimed at increasing breastfeeding rates. Conclusion: The level of pregnant women’s knowledge about breastfeeding is regular and influences the choice of how to feed their babies and the duration of exclusive breastfeeding. Strategies should be implemented to increase knowledge and improve breastfeeding rates