Educação em saúde para o aleitamento materno: um novo olhar para as políticas públicas voltadas à amamentação

Abstract

This thesis addresses public health education policies aimed at breastfeeding, focusing on the analysis of their implementation, perception, and experience by both health managers and breastfeeding individuals. The central research question was: "How have public health education policies related to breastfeeding been understood and experienced by managers and breastfeeding individuals, and how do these experiences reveal advances, challenges, and possibilities for improving the implemented strategies?" Accordingly, the main objective was to understand how public health education policies targeting breastfeeding have been implemented, perceived, and

experienced, identifying their potential, challenges, and possibilities for improvement. A mixed- methods (qualitative and quantitative) approach was adopted. A secondary data analysis was

conducted based on the National Survey on Child Nutrition (ENANI-2019) to contextualize current breastfeeding indicators. Additionally, a systematic literature review was carried out using the Methodi Ordinatio method to map public policies in both national and international contexts. The perceptions of health managers were explored through the SWOT matrix and semi-structured

interviews, while the experiences of breastfeeding individuals were investigated through semi- structured interviews. The results indicated that, although well-structured public breastfeeding

policies exist, their implementation faces significant barriers. Most managers pointed to the lack of financial resources and difficulties in adapting policies to local specificities as major obstacles. Furthermore, breastfeeding individuals reported challenges related to insufficient postpartum support, social pressure to breastfeed, and logistical difficulties in balancing work and infant care. Data analysis also revealed a significant gap regarding the personalization of breastfeeding support policies, particularly in regional contexts, as well as the exclusion of new family configurations, such as transgender families and non-maternal caregivers. The study concludes that, although public breastfeeding policies have made notable progress, their implementation still lacks effective adaptation to local realities and personalization that takes into account diverse socioeconomic and cultural conditions. Health education strategies must become more inclusive, considering new family configurations and the diverse identities of those who breastfeed. It is recommended that greater efforts be made to improve coordination across different levels of governance (municipal, state, and federal), and to establish more effective support structures that meet the real needs of breastfeeding individuals. Improving educational strategies with materials that are more sensitive to gender issues and family diversity is also essential to ensure that all people have access to adequate support throughout the breastfeeding process. The research highlights that the continuous adaptation and personalization of breastfeeding policies are crucial for strengthening actions aimed at maternal and child health.