ISSN: 1981-8963
Dodt RCM, Javorski M, Nascimento LA do et al.
DOI: 10.5205/reuol.3960-31424-1-SM.0705201329
Album series about breastfeeding…
CASE REPORT ARTICLE
ALBUM SERIES ABOUT BREASTFEEDING: BREASTFEEDING MOTHERS WITH
EDUCATIONAL INTERVENTION IN IMMEDIATE POSTPARTUM
ÁLBUM SERIADO SOBRE ALEITAMENTO MATERNO: INTERVENÇÃO EDUCATIVA COM
NUTRIZES NO PÓS-PARTO IMEDIATO
ALBUM SERIES DE LACTANCIA MATERNA: LACTANCIA MATERNA CON INTERVENCIÓN EDUCATIVA
EN POSPARTO INMEDIATO
Regina Cláudia Melo Dodt1, Marly Javorski2, Ludmila Alves do Nascimento3, Ádria Marcela Vieira Ferreira4,
Milena Colares Tupinambá5, Lorena Barbosa Ximenes6
ABSTRACT
Objective: to report the experience of using a flipchart on breastfeeding in mothers with an educational
intervention. Method: study type reporting experience with application of the album titled "Can I breastfeed
my son." Portrays the educational sessions with 100 mothers in the period from February to May 2011.
Results: visualization of figures allowed nursing mothers to identify real situations, simulated on the album,
and from them, discuss coping strategies. It was found that most of the situations brought their own
knowledge to the context exposed by the figures; the technology used was configured as a space in which
questions about the management of breastfeeding could be raised and discussed. Conclusion: the use of the
album was considered a suitable tool in the promotion of breastfeeding, as facilitated communication
between health professional and nurturing, encouraging the learning process from the needs of nursing
mothers. Descriptors: Health Promotion; Teaching Materials; Breastfeeding; Nursing.
RESUMO
Objetivo: relatar a experiência da utilização de um álbum seriado sobre amamentação, em uma intervenção
educativa com nutrizes. Método: estudo do tipo relato de experiência, com aplicação do álbum intitulado “Eu
posso amamentar o meu filho”. Retrata as sessões educativas com 100 nutrizes, no período de fevereiro a
maio de 2011. Resultados: a visualização das figuras possibilitou às nutrizes identificar situações reais,
simuladas no álbum, e a partir delas, discutir estratégias de enfrentamento. Verificou-se que a maioria das
situações trazia seu próprio conhecimento para o contexto exposto pelas figuras; a tecnologia utilizada se
configurou como um espaço no qual as dúvidas sobre o manejo da amamentação puderam se colocadas e
discutidas. Conclusão: a utilização do álbum foi considerada uma ferramenta apropriada na promoção do
aleitamento materno, pois facilitou a comunicação entre profissional de saúde e a nutriz, favorecendo o
processo de aprendizagem a partir das necessidades da nutriz. Descritores: Promoção da Saúde; Materiais de
Ensino; Aleitamento Materno; Enfermagem.
RESUMEN
Objetivo: presentar la experiencia de usar un rotafolio sobre la lactancia materna en madres con una
intervención educativa. Método: estudio del tipo de informes con experiencia de aplicación el disco titulado
"¿Puedo amamantar a mi hijo¿" Retrata las sesiones educativas con 100 madres en el período de febrero a
mayo de 2011. Resultados: la visualización de las cifras permitidas las madres lactantes para identificar
situaciones reales, simulados en el álbum, y de ellos, discutir estrategias de afrontamiento. Se encontró que
la mayoría de las situaciones aportaron su conocimiento del contexto expuesto por las cifras, la tecnología
utilizada se configura como un espacio en el que las preguntas sobre el manejo de la lactancia materna
podrían plantearse y discutirse. Conclusión: la utilización del álbum fue considerado una herramienta
adecuada en la promoción de la lactancia materna, ya que facilita la comunicación entre los profesionales de
la salud y nutrición, fomentando el proceso de aprendizaje a partir de las necesidades de las madres
lactantes. Descriptores: Promoción de la Salud; Materiales de Enseñanza; Lactancia Materna; Enfermería.
1
Nurse, PhD in Nursing, Associate Professor VII of the Metropolitan College of Grande Fortaleza / FAMETRO. Fortaleza (CE), Brazil. E-mail:
[email protected]; 2Nurse, PhD in Nursing Doctoral Program Interinstitutional DINTER Federal University of Ceará, Pernambuco
Federal University, Professor at the Federal University of Pernambuco/UFPE. Recife (PE), Brazil. E-mail: [email protected];
3
Student, Graduate Nursing, Federal University of Ceará/UFC, Scholarship PIBIC/CNPq. Fortaleza (CE), Brazil. E-mail:
[email protected]; 4Nurse, Federal University of Ceará/UFC. Fortaleza (CE), Brazil. E-mail: [email protected];
5
Student, Graduate Nursing, University of Fortaleza/UNIFOR. Fortaleza (CE), Brazil. E-mail: [email protected]; 6Nurse, PhD,
Associate Professor at the Federal University of Ceará/UFC, CNPq Researcher. Fortaleza (CE), Brazil. E-mail: [email protected]
English/Portuguese/Spanish
J Nurs UFPE on line., Recife, 7(5):1469-75, May., 2013
1469
ISSN: 1981-8963
DOI: 10.5205/reuol.3960-31424-1-SM.0705201329
Dodt RCM, Javorski M, Nascimento LA do et al.
INTRODUCTION
The practice of exclusive breastfeeding
until six months positively impacts the health
of infants. The promotion of breastfeeding is
considered an effective intervention in
reducing infant morbidity and the formation
of the bond between mother and child.1
However, the low prevalence of exclusive
breastfeeding, demonstrated in the Second
Survey
of
prevalence
of
maternal
2
breastfeeding , worries researchers. Recent
studies assert that the belief of nurturing that
breast milk is weak and/or insuficient3
associated with the unpreparedness for
breastfeed factors are interrelated to early
weaning.
A significant number of children are
weaned from causes that can be addressed
with educational interventions. Guidelines
with objective information and enlightening
may give more confidence to women about
the potential for breastfeeding. Thus,
education, inherent to the work of nurses, put
up as an important tool in promoting
breastfeeding.
Health education is understood as a
resource through which scientific knowledge
produced in the area of health, is shared with
the intention of reaching the daily life of the
people, since the understanding of the
determinants of the disease process provides
grants to adopt new habits and health
behaviors.
Every action on health is considered as an
educational action, but this cannot be
understood only as the transmission of
content, but rather characterized as a
combination of opportunities that promote
health maintenance and promotion, from the
adoption of educational practices that seek
autonomy. In this perspective, health
education is understood as the full exercise of
citizenship construction.
The effectiveness of the interventions of
the process requires the health professional to
know the reality of the individuals to whom
the action is intended educative.7 Moreover,
embrace dialogue and listening as tools for
action, allows the educator to view the user
of health services as subject bearer of
knowledge, which although distinct from
technical knowledge and scientific knowledge,
have any legitimacy. Thus, the goal is not to
inform health promotion, but transform
existing knowledge. 8
It is important that the professional values
the popular knowledge that the educational
process is a space for sharing knowledge, the
individual should be recognized as a subject
English/Portuguese/Spanish
J Nurs UFPE on line., Recife, 7(5):1469-75, May., 2013
Album series about breastfeeding…
acting in their own health and their ability to
intervene in reality.6
Ensuring positive outcomes in educational
activities to promote breastfeeding is not an
easy task. Research of new strategies
combining the scientific knowledge to popular
knowledge are necessary, however, these
nursing mothers should be seen as active in
the process of breastfeeding.
Analyzing the issue of breastfeeding and
dialogical
aspect
of
the
educational
intervention was designed to promote this
practice. The operation took place through
individual counseling strategy, using as a tool
album series, consisting of 8 figures and 7chip roadmaps, which was based on the
concept of self-efficacy of the mother to
breastfeed her child.
The self-efficacy theory of Bandura has
been used by research nurses trying to help
women who want to breastfeed. The results
already show the adequacy of the theory in
addressing the phenomenon, as demonstrated
in a study conducted in Australia. On occasion
we used an educational intervention that
consisted of a notebook of instructions, the
contents of which were based on the concept
of self-efficacy tailored for breastfeeding,
showing that the proposed intervention were
significantly
associated
with
exclusive
breastfeeding in the fourth month of life
babies.
Whereas the use of the theory of selfefficacy
is
suitable
for
educational
interventions in promoting breastfeeding and
that the concept of it guided the construction
of the flipchart titled "Can I breastfeed my
son," the study aims at describing the use of
this album educational intervention with
mothers.
METHOD
The study is an experience report on the
use of a flipchart on breastfeeding
educational intervention as applied to nursing
mothers in a rooming in a teaching hospital in
the city of Fortaleza.
The album, produced and validated11, is
composed of two parts: the illustration that
the verse is getting exposed for the group,
and the plug-script anteverse oriented
professional. The same has eight characters,
namely: Maria (the infant); Felipe (nurse),
José (father), Little João (Maria's firstborn),
Francisca (friend of Maria), Melo (grandfather
of Maria), Lina (grandmother of Maria) and
Rebeca (the nurse). In the construction and
naming of the characters, the author took
care to which they are put close to the reality
experienced by nursing mothers in the study.
1470
ISSN: 1981-8963
Dodt RCM, Javorski M, Nascimento LA do et al.
The reflection of the items Breastfeeding
Self-Efficacy - Shot Form (BSES-SF), the
assumptions of Self-efficacy theory, besides
literature on breastfeeding, underlies the
construction of figures and chips script. This
educational technology underwent evaluation
by ten judges, resulting in the Content
Validity Index of 0.92 compared to 0.97 and
figures about the chip-script.
The
hundred
individual
educational
interventions lasted 20-30 minutes, from
February to May 2011, the wards with the
women that were in the immediate
postpartum period, together with a newborn,
with at least 6 hours post-delivery.11
DOI: 10.5205/reuol.3960-31424-1-SM.0705201329
Album series about breastfeeding…
The study was approved by the Ethics
Committee of the Maternity School Assis
Chateaubriand - MEAC/UFC under Opinion No.
42/08.
RESULTS AND DISCUSSION
Before
starting
the
educational
intervention with hundred nursing mothers,
the researcher explained the purpose of that
meeting and the importance of their
participation and interaction. The meeting
individual was used flipchart "I can breastfeed
my son", presented in Figure 1.
Figure 1. Flipchart "I can breastfeed my son." Fortaleza, 2011. Source: Own elaboration
With the presentation of the album cover,
which shows a newborn (NB) looking forward
to the breast, gave up early dialogue with
mothers. On being questioned about what is
visualized in the figure, nursing mothers used
to verbalize that nurses (including his own
son-daughter), initiated breastfeeding wide
awake and active, responsive to stimuli.
The alert is considered ideal for contact
with parents or to initiate breastfeeding. The
graphical representation of the album cover
allowed participants to symbolize the
appropriate situation between the nurse and
the baby in the early feeding. It is considered
that the symbols, as well as being the carrier
of thought, allow individuals to store
information for guiding and shaping behavior.
In
script
form,
Maria
Felipe
is
breastfeeding, especially when the handle of
the womb. Right now questioned how Mary
was feeling, and most emphasized the
English/Portuguese/Spanish
J Nurs UFPE on line., Recife, 7(5):1469-75, May., 2013
expression of binomial satisfaction. Then
began the dialogue with the nurse about her
understanding about proper latch, demand
and enough milk. Faced with answers,
information was provided and reinforced the
positive aspects. They identified the
alignment of the body of the newborn with
the mother's body and mouth wide open, as
signs of the correct technique for
breastfeeding.
The positions of feeding recommended by
Nutrition Biological are defined as in which
the front face of the infant's body is in close
juxtaposition with the breast contour.
The basic argument regarding the role of
self-efficacy beliefs in human functioning is
that the level of motivation, affective states
and people's actions are based more on what
they believe than on what is objectively true.
However, any degree of confidence can
determine success in an action in the absence
1471
ISSN: 1981-8963
Dodt RCM, Javorski M, Nascimento LA do et al.
of necessary skills and knowledge. Knowledge
of mothers about breastfeeding technique, as
well as discussion from chip roadmaps album,
can increase the belief of these, in their
ability to breastfeed.
Given the form script 2, the mothers were
surveyed regarding the procedure of Mary
before emptying of the left breast, and even
having answered that Mary should offer both
breasts, reported that their children were
satisfied with only one breast. With such
statements, was discussed switching the
breasts, as well as the concepts of milk before
and after. The mothers were also reassured
about nurse satisfaction with just one breast,
being warned about the possibility of
engorgement, and the importance of hand
milking and milk donation, if production was
beyond the need of the baby.
The opportunity to observe other women
facing the situation shown in the schedule
script 2 configured as vicarious experience for
mothers. People form their self-efficacy
beliefs also through this kind of experience,
which is to observe other people executing
tasks. However, even experienced individuals
increase their self-efficacy if they are taught
better ways of doing things.12
The screenplay Sheet 3 represents Felipe
being heavy, gaining weight, dropping the
breast spontaneously, presenting bladder
removal and reconciling sleep; participants, to
look at the illustrations, could identify the
signals of satiety and baby compared with
their own children. Some pointed out the
difficulty in recognizing when their children
finished nursing, and the feeling of emptying
the breast was the most cited evidence.
The recognition of signals of satiety by the
mother of the baby is important for
breastfeeding success. Thus, it is necessary to
inform it about the pattern of deletions RN,
noting that diuresis is common, with small
volume, 6-8 voids per day. This pattern, in
most cases, indicates an adequate intake of
milk.13
Confidence in breastfeeding is revealed in
the belief or expectation of the woman, that
she has sufficient knowledge and skills to
successfully breastfeed her son. Healthcare
professionals
may
increase
maternal
confidence with what has been theoretically
conceptualized
by
self-efficacy
for
breastfeeding, defined as the woman's
confidence in her ability to breastfeed her
baby.17
The self-efficacy beliefs help determine
how much effort people will devote to an
activity, how long they will persevere when
confronted with obstacles and be as resilient
in the face of adverse situations.15,17
English/Portuguese/Spanish
J Nurs UFPE on line., Recife, 7(5):1469-75, May., 2013
DOI: 10.5205/reuol.3960-31424-1-SM.0705201329
Album series about breastfeeding…
It is observed in screenplay form, Felipe
crying too. However, Maria remains calm and
investigates the reason for crying, after
renewing his diaper hygiene, reassured Felipe
and offers his chest. The analysis of this
figure, the hunger, "cramping pain" dirty
diaper and were cited by participants as
reasons for crying Felipe, adding that the cry
of insecurity occasioned their children and it
was hard to keep calm in this situation.
Calm the baby before taking him to the
breast facilitates your organization, providing
reassurance to the mother to position it
properly. Other ways to reassure the baby
should be presented as the music, the voice of
parents, changing positions, the warmth, the
momentum, is to see whether cold or heat
because they can reduce the stress level of
the binomial. Using the information from the
visual script file, each nurse was advised on
the need to identify the cause of the crying
child to be able to comfort her.
To cope with the low rates of breastfeeding
duration, health professionals need to identify
risk
factors
amenable
to
supportive
interventions and a possible modification of
the variables is the maternal confidence in
breastfeeding.
Somatic and emotional states such as
anxiety, stress and arousal, also provide
information about the beliefs of self-efficacy.
The baby's crying can trigger or potentiate
stress situation. Nursing mothers struggling to
identify the cause of the crying infants may
have negative thoughts and doubts about their
ability
to
breastfeed,
with
frequent
association of crying with hunger and
insufficient milk.
The plug script 5 represents Mary in their
family context, performing activities of daily
living, and nursing Felipe. In this figure the
mothers verbalized that the activities
performed by Mary portrayed their lives;
discussed the challenge of reconciling so many
activities with breastfeeding.
Family support is crucial to the success or
failure of breastfeeding. Support means
support, sustain, provide mutual aid, hold,
protect. Regardless of who provides support
women need to be helped during the
breastfeeding period.
The vicarious experience is considered
powerful when observers they see similarities
in some attributes and consider that the
model performance is diagnostic of their own
ability. In this case, the representation of the
figure is capable of reproduce the life of
women studied so that they identify
similarities with its own routine.
The family atmosphere of Maria is
represented in script form, she breastfeeds
1472
ISSN: 1981-8963
DOI: 10.5205/reuol.3960-31424-1-SM.0705201329
Dodt RCM, Javorski M, Nascimento LA do et al.
Felipe, with her husband and parents receive,
Melo and Lina. The participants again
identified themselves with the scene, some
had already received visits or someone in the
ward had been visited.
From the placement of the mothers about
the situation, she wondered how Mary was
feeling when breastfeeding in the presence of
family. The majority held that Mary was
comfortable. When asked about breastfeeding
in
public,
younger
women
reported
embarrassment, especially if they had to
breastfeed in front of men, even if they were
family.
A nursing mother is experiencing deep
emotions related to their experiences in
relation
to
her
own
mother.
Even
unconsciously, she is playing the role of
mother, constructed from his relationship
with his mother or with adults who cared for
her. If she has memories (conscious or
unconscious) to have been well cared for or
abandoned,
having
had
a
mother
predominantly "good" or "bad", it will make a
significant difference in their confidence for
breastfeeding your baby.19
Breastfeeding in public is subject to
judgments and comments positive or negative.
This situation can also influence the beliefs of
efficacy, since results are also social
persuasions. 12
The plug script 7 depicts the interaction of
Mary with the return of Rebecca nurse and
baby to the Basic Health In the drawing there
is the approach of the time of exclusive
breastfeeding (EBF). While recognizing the
importance of exclusive breastfeeding until 6
months old, many had to interrupt it before,
on account of maternity leave is only four
months, despite the recommendation of the
Ministry of health this point was discussed
with the mother’s strategies as milk and store
milk.
Information is critical to increase the
confidence of the women so that they can
overcome adversity. For guidance in the
practice of breastfeeding is satisfactory,
health professionals should have, besides the
knowledge on breastfeeding, ability to
communicate with the nurse. Speaking clearly
and without using difficult words are essential
factors that mothers understand the
guidelines, minimizing future doubts. It is also
important to focus on the guidance for the
father and family, with the goal of supporting
the mother and encourage her always,
avoiding early weaning.
It is known that it is easier to weaken selfefficacy beliefs with negative comments than
strengthen them with positive comments, so it
is important that health professionals be
English/Portuguese/Spanish
J Nurs UFPE on line., Recife, 7(5):1469-75, May., 2013
Album series about breastfeeding…
careful when addressing the nursing mother,
avoiding judgments that may affect your
confidence, even in situations where
breastfeeding is not recommended.
It is worth noting that the technology used
during interventions allowed the nurse to
approach the situations she was experiencing
or could arise in the process of breastfeeding.
The viewing figures in these situations made
opportune verbalization of doubts and
uncertainties, which could be discussed.
It is noteworthy that the technology should
not be seen merely as something concrete,
but as a result of a job that involves a set of
abstract actions with specific purpose, in the
case of the flipchart, the promotion of
breastfeeding.
CONCLUSION
Using the flipchart "I can breastfeed my
son" showed up as a resource in the
appropriate individualized approach of
nurturing, enabling the creation of an
educational space in which dialogue was
possible. With the presentation of the figures
for nursing mothers, followed by questions
about the pictures, gave up early the
communication process, allowing the nurse to
identify their learning needs, indicating the
areas in which enhanced self-efficacy in
breastfeeding was needed.
Moreover, it can be seen that the ease in
handling the flipchart by the researcher,
provided a helpful educational technology in
clinical practice of nurses, then appropriate
that they be able to implement such a tool in
the actions of health education with
postpartum women.
REFERENCES
1. Toma TS, Rea MF. Benefícios da
amamentação para a saúde da mulher e da
criança: um ensaio sobre as evidências. Cad
saúde pública [Internet]. 2008 [cited 2012 Oct
12];24(2):235-46.
Available
from:
http://www.scielo.br/pdf/csp/v24s2/09.pdf
2. Brasil. Ministério da Saúde. Secretaria de
Atenção à Saúde. Departamento de Ações
Programáticas e Estratégicas. Prevalência do
aleitamento materno nas capitais brasileiras e
no Distrito Federal. Brasília: Ministério da
Saúde; 2009.
3. Oliveira JS, Joventino ES, Dodt RCM, Veras
JEGLF, Ximenes LB. Fatores associados ao
desmame precoce em multíparas. Rev Rene
[Internet]. 2010 [cited 2012 Sept 14];11(4):95102.
Available
from:
http://www.revistarene.ufc.br/revista/index.
php/revista/article/view/429/pdf
1473
ISSN: 1981-8963
Dodt RCM, Javorski M, Nascimento LA do et al.
4. Silva MD, Silva KV, Leal LP, Javorski M.
Técnica da amamentação: preparo das
nutrizes atendidas em um hospital escola,
Recife-Pe. Rev Rene [Internet]. 2011 [cited
2012 Jan 13];12(spe):1021-7. Available from:
http://www.revistarene.ufc.br/revista/index.
php/revista/article/view/331
5. Bonilha ALL, Schmalfuss JM, Moreto VL,
Lipinski JM, Porciuncula MB. Capacitação
participativa de pré-natalistas para a
promoção do aleitamento materno. Rev bras
enferm [Internet]. 2010 [cited 2012 Jan
13];63(5):881-6.
Available
from:
http://www.scielo.br/pdf/reben/v63n5/19.p
df
6. Pinafo E, Nunes EFPA, Gonzáles AD,
Garanhani ML. Relações entre concepções e
práticas de educação em saúde na visão de
uma equipe de saúde da família. Trab educ
saúde [Internet]. 2011 [cited 2012 Feb
10];9(2):201-21.
Available
from:
http://www.scielo.br/pdf/tes/v9n2/03.pdf
7. Silva MO. Plano educativo. In: Diabetes
mellitus: clínica, diagnóstico, tratamento
multidisciplinar. São Paulo: Atheneu; 2004.
8. Santana MCCP, Goulart BNG, Chiari BM,
Melo AM, Silva EHAA. Aleitamento materno em
prematuros: atuação fonoaudiológica baseada
nos pressupostos da educação para promoção
da saúde. Ciênc saúde coletiva [Internet].
2010 [cited 2012 Jan 13];15(2):411-7.
Available
from:
http://www.scielo.br/pdf/csc/v15n2/v15n2a1
7.pdf
9. Joventino ES, Freitas LV, Rogério RF, Lima
TM, Dias LMB, Ximenes LB. Jogo da memória
como estratégia educativa para prevenção de
enteroparasitoses: relato de experiência. Rev
Rene [Internet]. 2010 [cited 2012 Mar
11];10(2):141-8.
Available
from:
http://www.revistarene.ufc.br/10.2/html/10
_2_15.html
10. Nichols J, Schutte NS, Brown RF, Dennis
CL, Price I. The impact of a self-efficacy
intervention on short-term breast-feeding
outcomes. Health educ behav [Internet]. 2009
[cited 2012 Mar 11];36(2):250-8. Available
from:
http://heb.sagepub.com/content/36/2/250.f
ull.pdf
11. Dodt RCM, Ximenes LB, Oriá MOB.
Validation of a flip chart for promoting
breastfeeding. Acta paul enferm [Internet].
2012 [cited 2012 Dec 10];25(2):225-30.
Available
from:
http://www.scielo.br/pdf/ape/v25n2/en_a11
v25n2.pdf
English/Portuguese/Spanish
J Nurs UFPE on line., Recife, 7(5):1469-75, May., 2013
DOI: 10.5205/reuol.3960-31424-1-SM.0705201329
Album series about breastfeeding…
12. Bandura A, Azzi RG, Polydoro S. Teoria
Social Cognitiva: conceitos básicos. Porto
Alegre: Artmed; 2008.
13. Carvalho MR, Tavares LAM. Amamentação
bases científicas. 3th Ed. Rio de Janeiro:
Guanabara Koogan; 2010.
14. Colson S. Maternal Breastfeeding
positions: have we got it right? Pract Midwife
[Internet]. 2005 [cited 2012 Dec 10];8(10):247.
Available
from:
http://www.biologicalnurturing.com/assets/a
rticles/Colson%202005%20PM%208%2010%202427.pdf
15. Chezem JC, Friesem C, Boettcher J.
Breastfeeding
Knowledge,
Breastfeeding
Confidence, and Infant Feeding Plans: Effects
on Actual Feeding Practices. J Obstet Gynecol
Neonatal Nurs [Internet]. 2006 [cited 2012 Dec
10];32(1):40-7.
Available
from:
http://onlinelibrary.wiley.com/doi/10.1177/0
884217502239799/pdf
16. Dennis CL. Theoretical underpinnings of
breastfeeding confidence: a self-efficacy
framework. J Hum Lact [Internet]. 1999 [cited
2012 Dec 01];15(3):195-201. Available from:
http://jhl.sagepub.com/content/15/3/195.ful
l.pdf+html DOI: 10.1177/089033449901500303
17. Bandura A. Self-Efficacy: the exercise of
control. New York: W.H. Freeman, 1997.
18. Gonçalves AC, Bonilha ALL. Crenças e
práticas da nutriz e seus familiares
relacionados ao aleitamento materno. Rev
gaúcha enferm [Internet]. 2005 [cited 2012
Oct 12]; 26(3):333-44. Available from:
http://seer.ufrgs.br/RevistaGauchadeEnferma
gem/article/view/4564/2491
19. Assis MBAC. Mãe e Bebê: encontros e
desencontros. In: Del Ciampo LA, Ricco RG,
Almeida
CAN.
Aleitamento
materno:
passagens e transferências mãe-filho. São
Paulo: Atheneu; 2004.
20. Góes FGB, Rangel RO, Borges RLL. Nurse’s
Educational Practices from Pospartum Women
on the Breastfeeding. J Nurs UFPE on line
[Internet]. 2009 [cited 2012 Jan 13];3(1):3843.
Available
from:
http://www.ufpe.br/revistaenfermagem/inde
x.php/revista/article/view/260
21. Joventino ES, Dodt RCM, Araujo TL,
Cardoso MVLML, Silva VM, Ximenes LB.
Tecnologias de enfermagem para promoção do
aleitamento materno: revisão integrativa da
literatura. Rev gaúcha enferm [Internet]. 2011
[cited 1012 Dec 12];32(1):176-84. Available
from:
http://www.scielo.br/pdf/rgenf/v32n1/a23v3
2n1.pdf
1474
ISSN: 1981-8963
Dodt RCM, Javorski M, Nascimento LA do et al.
DOI: 10.5205/reuol.3960-31424-1-SM.0705201329
Album series about breastfeeding…
Submission: 2013/01/16
Accepted: 2013/03/19
Publishing: 2013/05/01
Corresponding Address
Regina Cláudia Melo Dodt
Graduação em Enfermagem
Faculdade Metropolitana da Grande Fortaleza
Rua Conselheiro Estelita, 500 / Centro
CEP: 60010-260 –Fortaleza (CE), Brazil
English/Portuguese/Spanish
J Nurs UFPE on line., Recife, 7(5):1469-75, May., 2013
1475