Obstáculos e perspectivas para implementação do aleitamento materno exclusivo: uma revisão integrativa

Abstract

Introduction: Exclusive breastfeeding (EBF) should be offered as the sole source of nutrition for newborns from birth to six months of age. However, despite its numerous benefits, many mothers face challenges in maintaining EBF, which can affect the initiation, continuity, and duration of breastfeeding practices. Objectives: To describe the main obstacles and perspectives regarding the implementation of exclusive breastfeeding. Materials and Methods: This is an integrative review based on the international guideline Preferred Reporting Items for Systematic reviews and Meta Analyses extension for Scoping Reviews (PRISMA-ScR) and the methodology proposed by the Joanna Briggs Institute (JBI). Searches were conducted in the BDENF and PubMed databases. A total of 110 full-text studies, freely available between 2018 and 2023, were selected in Portuguese, English, and Spanish. Results: The findings highlighted key challenges faced by postpartum women, including breast complications, difficulties with latching and positioning, and a lack of breastfeeding knowledge, among others. Nurses' primary interventions have focused on educational actions, with their main difficulties being workload, understaffed teams, and time constraints, as reported by several studies. Conclusion: This study emphasizes that, despite the benefits of EBF, cultural, social, and structural barriers—especially the lack of support for mothers during this process—hinder its continuation. Work overload and inadequate professional training are also significant challenges. Therefore, public policies and educational approaches are essential to promote EBF.