Desafios enfrentados pelas mães na amamentação exclusiva de crianças de 0 a 6 meses: uma revisão sistemática de literatura

Abstract

Exclusive breastfeeding in the first six months is of utmost importance for the health of both the newborn and the mother. However, due to several factors such as personal routine, presence of nipple fissures, and lack of family support, early weaning tends to occur. Therefore, the objective of this study was to identify the hallenges faced by mothers in exclusive breastfeeding of children aged 0 to 6 months. This is a descriptive, exploratory, and documentary study, using a systematic literature review approach. The guiding question followed the PICO strategy: What are the challenges faced by mothers in the exclusive breastfeeding of children aged 0 to 6 months? The review was organized according to the PRISMA recommendation, and the search was conducted in the MEDLINE, BDENF, and LILACS databases, using standardized descriptors from the DESC. Eligibility criteria included studies published in the last five years, in English and Portuguese, excluding theses, dissertations, theoretical essays, and studies not available in full. The selection of studies was carried out independently by two reviewers. Data were extracted using an adapted form, and methodological quality was assessed based on the GRADE system, with the risk of bias evaluated using the Rob2 tool. Eleven studies were selected for the systematic review, most of which employed a qualitative methodological design and observational study, published in nursing journals. Regarding the risk of bias, the studies presented low risk; however, many studies had uncertain bias due to the lack of information. The main difficulties related to exclusive breastfeeding highlighted by the studies were socioaffective problems, breast engorgement and nipple injuries, low milk production, poor latch, need to work outside the home, nipple type, and difficulty in executing the breastfeeding technique. Thus, it is emphasized that the breastfeeding process should involve the entire family, especially the partner, as exclusive breastfeeding has a significant impact on the child's health, promoting benefits for the newborn's development.