Padrão de aleitamento materno no primeiro mês de vida em mulheres submetidas a cirurgia de redução de mamas e implantes

Abstract

Objective: To describe the breastfeeding pattern in the first month of life in women submitted to two types of surgery -breast reduction and augmentation -and to compare it with the pattern exhibited by women who had no surgery. Methods:Controlled prospective cohort with 25 women submitted to reduction surgery, 24 submitted to augmentation surgery and 25 with no breast surgery, who gave birth at Hospital Israelita Albert Einstein, São Paulo, Brazil. The data were obtained from assessments carried out 48 to 72 hours, between the 5th and 7th days, and 30 days after delivery. The following tests were used for data analysis: chi-square test, Fisher's exact test, Kaplan-Meier curve and Cox regression. Results:The probability of an infant being on exclusive breastfeeding at the end of the first month of life was 29% in women with reduction surgery, 54% in those with augmentation surgery, and 80% in women who had no surgery. The probability of mixed breastfeeding being adopted during this same period amounted to 68% among women with reduction surgery, 32% in those with augmentation surgery, and only 16% among those without any breast surgery. The risk of an infant being on non-exclusive breastfeeding was five times greater in women submitted to reduction surgery when compared to those women with no surgery (p = 0.002). Among women with augmentation surgery, the risk of an infant being on non-exclusive breastfeeding was 2.6 times greater than that observed in infants whose mothers had no breast surgery (p = 0.075). No conflicts of interest declared concerning the publication of this article. ConclusionSuggested citation: de Andrade RA, Coca KP, Abrão AC. Breastfeeding pattern in the first month of life in women submitted to breast reduction and augmentation.

A influência das cirurgias plásticas mamárias no processo de amamentação: Uma revisão integrativa

“…Do ponto de vista fisiológico, para que a mulher consiga produzir leite em quantidade adequada para suprir as necessidades de seu filho, é preciso que tenha uma estrutura mamária (alvéolos, ductos e ampolas lactíferas) íntegra, que permita um estímulo à produção e sua consequente excreção (Andrade, 2010).…”

“…Tais benefícios como: nutricionais, imunológicos, cognitivos, econômicos e sociais são aproveitados em sua plenitude quando a amamentação é praticada por pelo menos 2 anos, sendo oferecida como forma exclusiva de alimentação do lactente até o sexto mês de vida. Os índices de aleitamento materno no Brasil estão muito abaixo dos considerados ideais pela Organização Mundial da Saúde (OMS) (Andrade et al, 2010).…”

Fatores associados à mamoplastia de aumento e o aleitamento materno

“…An American study used the Lactina electric pump with simultaneous extraction to evaluate milk production of two puerperal women with breast implants with periareolar incision from the 4 th day after delivery, demonstrating a significant reduction in milk production over time in both cases; however, they were women with premature births (one of them triplets) and with hospitalization of the newborns in the intensive care unit, which may have influenced the results encountered (5) . Other studies used different ways of measuring production such as manual milking (21) , weight gain (15,22) and the report of women (23)(24) , concluding that breast augmentation surgeries negatively interfere with milk production (15,22) , especially those with periareolar incision (15,22) . Only one study stated that the surgical procedure did not affect the ability to produce milk (24) .…”

Controversies in Breastfeeding

“…Whatever the reason for undergoing mammoplasty, breastfeeding after breast reduction surgery might be challenging, although certain surgical techniques can help preserve the mother's ability to breastfeed. Studies conducted in Brazil ( 14 , 15 ) suggest that breast reduction surgery is associated with negative breastfeeding performance: compared to controls, women who underwent reduction mammoplasty interrupted exclusive breastfeeding after a median duration of only 5 days and were less disposed to exclusively breastfeed at 4 months (22 vs. 4%) after childbirth.…”