Relação pessoa-a-pessoa e esperança no aconselhamento em aleitamento materno

Abstract

Breastfeeding is one of the fundamental pillars for promoting child and postpartum women's health and should be considered in the agendas of prenatal, perinatal, and child growth and development follow-up care. Breastfeeding counseling emerges as a recommended technology to strengthen this practice. It is structured on a horizontal relationship and dialogue between the professional and the woman/breastfeeding person. Counseling increases breastfeeding rates, strengthens the woman/mother-child bond, contributes to female empowerment, and provides unique care. The counseling professional possesses the ability to welcome, understand, and support the breastfeeding person in the processes involved in the practice. Furthermore, the person always has some expectation regarding the nutritional care of their child. Considering this, this study took as its question 'how are the relationships in breastfeeding counseling characterized, to what extent do they reach subjectivities and establish an interactional process that promotes welcome and hope for women?'. The objectives were to analyze the process of establishing the relationship between postpartum women and nurse breastfeeding counselors in rooming-in, to understand hope in the breastfeeding process from the perspective of women who received breastfeeding counseling, and to analyze the person-to-person relationship between postpartum women and nurses in the context of breastfeeding counseling. This is a cross-sectional, qualitative-interpretative research, supported by Joyce Travelbee's Interpersonal Relation (person-to-person) Theory and Dufault & Martocchio's multidimensional model of hope. Data collection took place from may 2024 to june 2025, through single audio-recorded interviews with four counseling nurses and eleven women who received breastfeeding counseling in the rooming-in facilities of three hospitals affiliated with the Unified Health System, located in Minas Gerais, Rio de Janeiro, and Bahia. Thematic analysis, as proposed by Naeem et al. (2023), was adopted for data appraisal, using Atlas.ti® software for information grouping. The analysis enabled the identification of seven themes: 'Child health and development: desire projected onto breastfeeding', 'Practical management of breastfeeding and the maintenance of hope', 'Presence: an advanced competence and the core of counseling', 'Counseling: openness, freedom, and hope', 'Counseling in Rooming-In: intervening factors', 'Counseling: motivation and transcendence', and 'Counseling: importance and recommendations for longitudinal follow-up'. The person's decision to breastfeed is supported by the intended outcomes for the child – better health and life for the child – as well as the creation of unique and lasting bonds. These are hoped-for objects that keep them pursuing breastfeeding and facing its challenges. The relationship with the counselor contributed to the experience of hope in the process. The effective establishment of the person-to-person relationship was mainly determined by the presence demonstrated by the counselor, highlighting her ability to listen and availability to provide support, adjusting the woman's hopes regarding breastfeeding towards something feasible. This depends on an available and attuned presence, which remains in memory and is reactivated in later times when facing breastfeeding challenges. The person-to-person relationship was central to the achievements of counseling, wherein the interactional elements were essential for the relationship to be qualified as dialogical and horizontal. The relational and behavioral characteristics, as well as the personal hope attributes of the professional, reverberated in the woman's lived experience, favoring overcoming the challenges of mothering and breastfeeding, in order to strengthen the woman's hope and autonomy and the success of breastfeeding. Counseling in the rooming-in period reverberates to times after it, given the memory that the person-to-person relationship built and its effects on the cognitive, affective, and behavioral dimensions of hope. The study endorses breastfeeding counseling as a practice that promotes and protects breastfeeding in the rooming-in context, with the person-to-person relationship and hope-promoting processes at the core of this practice.