Intervenção Digital na Promoção do Aleitamento Materno Entre Puérperas: Um Ensaio Clínico Randomizado

Myrtis Katille de Assunção Bezerra; Adonay Guedes Cirino; Monica Lopes de Assunção; Haroldo da Silva Ferreira; Marília Conceição de Souza Cáceres; Maria Izabel Siqueira de Andrade; Gabriel Soares Badue

doi:10.36489/saudecoletiva.2025v16i103p18312-18329

Authors

Myrtis Katille de Assunção Bezerra Doutorado em Saúde Pública pela Fundação Oswaldo Cruz (Fiocruz/PE); Instituto Aggeu Magalhães. Docente adjunto em universidade Federal de Alagoas https://orcid.org/0000-0002-4315-9623
Adonay Guedes Cirino Residente Multiprofissional em Atenção em Terapia Intensiva pela Universidade Federal de São Paulo (UNIFESP/SP). https://orcid.org/0000-0002-8642-6680
Monica Lopes de Assunção Doutorado em Saúde da Criança e do Adolescente pela Universidade Federal de Pernambuco (UFPE). Docente adjunto em universidade Federal de Alagoas https://orcid.org/0000-0003-2985-9890
Haroldo da Silva Ferreira Doutorado em Saúde Pública pela Escola Nacional de Saúde Pública (ENSP/Fiocruz). Docente adjunto em universidade Federal de Alagoas https://orcid.org/0000-0002-1789-3138
Marília Conceição de Souza Cáceres Doutorado em Ciências pela Universidad de Cádiz (Espanha). Docente adjunto em Universidade Federal de Alagoas. Docente adjunto em Universidade Federal do Recôncavo da Bahia (UFRB) https://orcid.org/0000-0002-8453-4661
Maria Izabel Siqueira de Andrade Doutorado em Nutrição pela Universidade Federal de Pernambuco (UFPE). Docente adjunto em Universidade Federal de Alagoas https://orcid.org/0000-0003-1087-1320
Gabriel Soares Badue Doutorado em Ensino; Filosofia e História das Ciências pela Universidade Federal da Bahia (UFBA). Docente adjunto em Universidade Federal de Alagoas https://orcid.org/0000-0002-4663-4936

DOI:

https://doi.org/10.36489/saudecoletiva.2025v16i103p18312-18329

Keywords:

Health education, Digital health, Puerperium, Breastfeeding, Controlled clinical trial

Abstract

Objective: The aim of this study was to analyze the effect of digital media on the duration of breastfeeding. Method: This was a clinical trial conducted with 173 postpartum women in a maternity hospital, assigned to intervention and control groups. The intervention group received weekly breastfeeding information via WhatsApp over a three-month period. Breastfeeding practices were assessed through interviews conducted at one and three months postpartum. Result: At 30 days postpartum, the intervention group showed a higher intention to continue breastfeeding compared to the control group (p = 0.017). At three months, the prevalence of exclusive breastfeeding was significantly higher in the intervention group (66.7% vs. 40.6%; p = 0.031; RR = 1.64; 95% CI: 1.01–2.64). No statistically significant differences were observed between groups regarding pacifier or bottle use. Conclusion: The participatory educational intervention, conducted by health professionals using digital media, was effective in increasing the prevalence of exclusive breastfeeding.

References

Brasil. Ministério da Saúde. Sistema de Vigilância Alimentar e Nutricional – SISVAN: relatório do consumo alimentar dos indivíduos acompanhados por período, fase do ciclo da vida e índice. Brasília (DF): Ministério da Saúde; 2022.

Marrs T et al. Gut microbiota development during infancy: impact of introducing allergenic foods. J Allergy Clin Immunol. 2021;147(2):613-21.e9. DOI: https://doi.org/10.1016/j.jaci.2020.09.042 DOI: https://doi.org/10.1016/j.jaci.2020.09.042

Rajagopalan V, et al. Breastfeeding duration and brain-body development in 9-10-year-olds: modulating effect of socioeconomic levels. Pediatr Res. 2025;97(1):378-86. DOI: https://doi.org/10.1038/s41390-024-03330-0 DOI: https://doi.org/10.1038/s41390-024-03330-0

McGowan C, Bland R. The benefits of breastfeeding on child intelligence, behavior, and executive function: a review of recent evidence. Breastfeed Med. 2023;18(3):172-87. DOI: https://doi.org/10.1089/bfm.2022.0192 DOI: https://doi.org/10.1089/bfm.2022.0192

Nuzzi G, Di Cicco ME, Peroni DG. Breastfeeding and allergic diseases: what's new? Children (Basel). 2021;8(5):330. DOI: https://doi.org/10.3390/children8050330. Accessed 2025 Jul 25. DOI: https://doi.org/10.3390/children8050330

Zuurveld M, et al. Specific human milk oligosaccharides differentially promote Th1 and regulatory responses in a CpG-activated epithelial/immune cell coculture. Biomolecules. 2023;13(2):263. DOI: 10.3390/biom13020263. Available from: https://pubmed.ncbi.nlm.nih.gov/36830632/. Accessed 2024 Jan 20. DOI: https://doi.org/10.3390/biom13020263

Souza BS, et al. Fatores associados ao desmame precoce no contexto brasileiro. Saberes Plurais Educ Saúde [Internet]. 2023 Oct 6 [cited 2025 May 2];7(2):e133427. Available from: https://seer.ufrgs.br/index.php/saberesplurais/article/view/133427 DOI: https://doi.org/10.54909/sp.v7i2.133427

Regalo IH, et al. Breastfeeding, introduction of food and use of pacifier on the stomatognathic system of children with mixed dentition. J Health Sci [Internet]. 2020 Dec 21 [cited 2025 May 2];22(4):222-8. Available from: https://journalhealthscience.pgsscogna.com.br/JHealthSci/article/view/7821 DOI: https://doi.org/10.17921/2447-8938.2020v22n4p222-228

Alotiby A. The role of breastfeeding as a protective factor against type 1 and type 2 diabetes and rheumatoid arthritis in mothers: a systematic review. Front Pediatr. 2023;11. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981158/ DOI: https://doi.org/10.3389/fped.2023.1086999

. Accessed 2025 Aug 4.

ENANI. Estudo Nacional de Alimentação e Nutrição Infantil – ENANI-2019: Resultados preliminares – Indicadores de aleitamento materno no Brasil [Internet]. Rio de Janeiro: UFRJ; 2020 [cited 2025 Mar 19]. Available from: https://enani.nutricao.ufrj.br/

Brasil. Ministério da Saúde. II Pesquisa de Prevalência de Aleitamento Materno nas Capitais Brasileiras e Distrito Federal [Internet]. Brasília (DF): Ministério da Saúde; 2009 [cited 2025 Mar 19]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/pesquisa_prevalencia_aleitamento_materno.pdf

Organização Mundial da Saúde (OMS). Infant and young child feeding: Indicators for assessing infant and young child feeding practices. Geneva: WHO; 2021. Available from: https://www.who.int/publications/i/item/9789240018389

Unfried AGC, et al. Neonatal factors associated with early weaning in a municipality in Bahia, Brazil: a cross-sectional study. Rev Esc Enferm USP. 2024;58:e20240091. DOI: https://doi.org/10.1590/1980-220X-REEUSP-2024-0091en . Accessed 2025 Jul 26. DOI: https://doi.org/10.1590/1980-220x-reeusp-2024-0091pt

Wu Q, et al. Effectiveness of WeChat for improving exclusive breastfeeding in Huzhu County, China: randomized controlled trial. J Med Internet Res. 2020;22(12):e23273. DOI: https://doi.org/10.2196/23273 DOI: https://doi.org/10.2196/23273

Dodou HD, et al. Telephone intervention to promote maternal breastfeeding self-efficacy: randomized clinical trial. Rev Esc Enferm USP. 2021;55:e20200520. Available from: https://doi.org/10.1590/1980-220X-REEUSP-2020-0520 . Accessed 2025 Jun 5. DOI: https://doi.org/10.1590/1980-220x-reeusp-2020-0520

Cirino AG, et al. Mídias sociais como ferramenta de apoio e incentivo ao aleitamento materno no pós-parto: uma revisão sistemática. gepnews [Internet]. 31º de agosto de 2023 [citado 6º de novembro de 2025];7(2):220-7. Disponível em: https://seer.ufal.br/index.php/gepnews/article/view/16112

David HMSL, et al. Análise de redes sociais na atenção primária em saúde: revisão integrativa. Acta Paul Enferm. 2018;31(1):108-15. DOI: https://doi.org/10.1590/1982-0194201800016 DOI: https://doi.org/10.1590/1982-0194201800016

Cavalcanti DS, et al. Online participatory intervention to promote and support exclusive breastfeeding: randomized clinical trial. Matern Child Nutr. 2019;15(3):e12806. DOI: https://doi.org/10.1111/mcn.12806 DOI: https://doi.org/10.1111/mcn.12806

Aldana-Parra F, Romero-Álvarez N, Alzate-Yepes M, et al. Effectiveness of a new breastfeeding counselling intervention on breastfeeding prevalence, infant growth velocity and postpartum weight loss in overweight women: a randomized controlled trial. Int Breastfeed J. 2025;20:14. Available from: https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13006-025-00703-x. Accessed 2025 Aug 12. DOI: https://doi.org/10.1186/s13006-025-00703-x

Boutron I, et al. CONSORT Statement for Randomized Trials of Nonpharmacologic Treatments: A 2017 Update and a CONSORT Extension for Nonpharmacologic Trial Abstracts. Ann Intern Med. 2017;167(1):40-7. Available from: https://doi.org/10.7326/M17-0046 . Accessed 2020 Jul 10. DOI: https://doi.org/10.7326/M17-0046

Bezerra MKA, et al. Apoio à amamentação: um guia acolhedor para mães, familiares e profissionais de saúde [Internet]. 1st ed. Maceió (AL): Agência de Produção Editorial de Alagoas (Apeal); 2024 [cited 2025 Mar 19]. Available from: https://apealeditora.com.br/ebooks/202519144632726.pdf

de Souza J et al. Investigating interactive methods in remote lactation support in Brazil: a qualitative study. Front Digit Health. 2023;5. Available from: https://www.frontiersin.org/articles/10.3389/fdgth.2023.1143528/full. Accessed 2025 Aug 2. DOI: https://doi.org/10.3389/fdgth.2023.1143528

Zander LRM et al. Aleitamento materno e hábitos de sucção nutritiva e não-nutritiva: acompanhamento de bebês aos seis meses em um projeto de extensão. Braz J Health Rev [Internet]. 2022 Mar 18 [cited 2025 May 2];5(2):4568-77. Available from: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/45303 DOI: https://doi.org/10.34119/bjhrv5n2-047

Peres JF, et al. Percepções dos profissionais de saúde acerca dos fatores biopsicossocioculturais relacionados com o aleitamento materno. Saúde Debate [Internet]. 2022 Jun 27 [cited 2025 May 2];45(128):141-5. Available from: https://revista.saudeemdebate.org.br/sed/article/view/3500 DOI: https://doi.org/10.1590/0103-1104202112811