Tecnologia educacional digital para promoção do aleitamento materno exclusivo: ensaio clínico randomizado

Abstract

Introduction: In promoting breastfeeding, the use of innovative strategies and technological resources can contribute to women's learning in order to encourage the adoption of behaviors aimed at promoting breastfeeding. The use of mobile technologies such as the application called 'SOS Mama', provides information in a playful and illustrative way for mothers who experience difficulties with breastfeeding, favoring the identification of difficulties and how to face them, thus contributing to the promotion and protection of breastfeeding. Objective: To evaluate the effect of the SOS Mama application in promoting maternal self-efficacy and Exclusive Breastfeeding (EBF) up to the sixth month of life. Methods: Randomized Clinical Trial carried out in the Rooming-In (AC) of a maternity hospital of the university hospital in northeastern Brazil. The sample consisted of 270 puerperal women, accompanied by the baby, over 18 years old, literate, who had a smartphone and expressed an interest in breastfeeding. The educational intervention was characterized by the availability of the 'SOS mama' application. Collection was performed in five phases: at baseline, at 30, 60, 120 and 180 days postpartum. Instruments containing questions about socioeconomic, obstetrical and breastfeeding history data were used, and the Breastfeeding Self-EfficacyScale - Short-Form (BSES-SF) was used to assess maternal self-efficacy scores in breastfeeding. Block randomization was performed and blinding was ensured between the puerperal women, the collection team, and the statistician. For the analyses, Chi-square tests and Cochran's Q Tests were performed in the IBM SPSS program at 5% significance. The study was submitted to the research analysis system, Plataforma Brasil, and approved under opinion No. 4,900,065 and Brazilian Registry of Clinical Trials (ReBEC) – RBR-5hm95cw. Results: 270 postpartum women were eligible, 132 from the intervention group (IG) and 138 from the control group (CG). As for the self-efficacy scores for breastfeeding, the results showed that there was no statistically significant difference between the groups. However, the GI showed an increase in self-efficacy scores in the period of 30 (GI: 97%; GC: 94.6%), 60 (GI: 93.9%; GC: 93.8%) and 120 (GI: 100 %; GC: 96%) postpartum days. When analyzing the high self-efficacy scores in breastfeeding between the study groups, it was found that GI was higher at 30, 60 and 120 days postpartum. It was observed that EBF was predominant among the groups in the period of 30 (GI:78.8%; GC: 81.1%) and 60 days (GI: 81.8%; GC:84.4%). When analyzing the period of 120 days, it was found that in IG 50% of the babies were on EBF and the other 50% were on Mixed Breastfeeding (AMM), while in the CG 68% were on EBF and 16% on AMM and one significant reduction in EBF rates at 180 days (GI: 23.1%; GC: 11.8In this sense, it confirms that factors such as vicarious and mastery experience, verbal persuasion and somatic and emotional states that can influence EBF in addition to the use of the mobile application. Conclusions: Thus, SOS Mama is effective in promoting high self-efficacy in breastfeeding. Thus, the importance of using technology mediated by Nursing in the prenatal and puerperium, associated with technology with a behavioral approach, is highlighted in order to promote breastfeeding and maternal confidence to breastfeed.