Maternal representations about health and breastfeeding of the premature child in hospitals with and without baby and mother friendly hospital initiative certification

BACKGROUND: Breastfeeding in preterm infants in Mexico has a low prevalence despite being an affordable low-cost strategy recommended by WHO. One of the factors of abandonment is the maternal perception of low milk production. OBJECTIVE: Comparing the maternal representations on the health of the premature child and breast-feeding, in two hospitals, one of them with Baby and Mother Friendly Hospital Initiative certification. MATERIAL AND METHODS: A qualitative study was carried out in two reference hospitals, one of them certified as a friend of the child and the mother (17 mothers and 1 father of premature babies) and one without a certificate (13 mothers). Collection instrument: Semi-structured interview guide, interviews were conducted face-to-face by trained personnel. Thematic contents analysis was applied to the communications to apprehend the maternal representations according to the objective. Approval was obtained from the ethics committees of each hospital and informed consent was signed by the participants. RESULTS: Three representations were aprehended: 1. The health related corporeality of the premature child hospitalized; 2. Selecting the best food, breast milk versus formula for the premature child; and 3. The information received on breastfeeding. CONCLUSIONS: The health of the premature child is represented in the corporeality, mainly the weight. Breast milk was represented as "good" food, which helped to initially choose to breastfeed her child. The perception of insufficient production, belief about maternal milk that damages, maternal labor activity and the prescription of substitutes give the possibility of abandonment of breastfeeding. The certified Baby and Mother Friendly Hospital denotes systematization for breastfeeding, with personnel and infrastructure assigned to that work and in the non-certified hospital only verbal or graphic informative actions are denoted.