title: [Identification of difficulties at the beginning of breastfeeding by means of protocol application].
abstract: OBJECTIVE
  To assess a group of mothers/newborns with the necessity of special support at the beginning of breastfeeding by means of protocol application recommended by UNICEF and to verify assisting practices associated with difficulties of breastfeeding.\par
  
  
  METHODS
  In this descriptive study, the sample comprised 50 mother/newborn pairs randomly selected in a maternity where low risk deliveries are cared by SUS (Brazilian Unified Health System). The breastfeeding observation protocol was used to record the behavior of each pair, including the frequency of negative behavior regarding breastfeeding. Next, each aspect was scored as good, regular or poor. The association between negative scores and particular assisting practices was also investigated. A critical level of p < 0.05 was used.\par
  
  
  RESULTS
  The frequency of pairs presenting evidence of severe problems (poor score) at the beginning of breastfeeding ranged from 2% to 22% according to the aspects assessed. The most frequently observed difficulties were mother and infant's bad positioning during breastfeeding and inappropriate mother/newborn interaction. These problems were significantly more frequent after surgical deliveries (p < 0.05). Milk formula and/or glucose solution was also associated with the worst scores in some breastfeeding aspects. \par
  
  
  CONCLUSIONS
  The protocol application to observe and evaluate breastfeeding identified a high prevalence of mothers/newborn pairs with difficulties to begin breastfeeding, especially when the delivery was surgically performed and when the newborn was offered supplementary liquids.
authors.affiliation: Faculdade de Medicina de Botucatu, UNESP, Botucatu, SP, Brazil. carvalha@fmb.unesp.br
authors.forename: Maria Antonieta de Barros Leite
authors.initials: MA
authors.lastname: Carvalhaes
authors.forename: Cláudia Regina Hostin
authors.initials: CR
authors.lastname: Corrêa
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011187:Posture
vernacular_title: Identificação de dificuldades no início do aleitamento materno mediante aplicação de protocolo.