Prematuridade e hospitalização: possibilidades e atravessamentos na constituição da relação mãe-bebê.

Abstract

This study consists of some research that focus on the constitution of the mother and preterm baby relationship while in a hospital environment. Facing the complexities which are natural to maternity, during the birth of a preterm baby, two factors are observed: hospitalization and prematurity. This birth is categorized by the early separation of baby and mother. The baby is not able to survive on their own and the maternal care given is not enough to allow this survival. Breastfeeding, as part of the process that constitutes the relation between baby and mother, becomes another challenging factor, since the physiological immaturity of the baby, as they are not able to breastfeed directly from the mother when they are born. Breast milk is considered the best food for them and, to be fed early, the mother needs to be milked. However, studies point out difficulties among mothers in the milk production, in the milking process and in breastfeeding. Facing this complex scenario, the purpose of this research was to analyze how the relationship between preterm mother-infant, involving breastfeeding in the hospital context, is constituted. In an attempt to respond to the proposition, we chose Psychoanalysis and the method of observation of the mother-baby relationship of Esther Bick as the theoretical-methodological references. Three mothers and their infants were observed during the three-month period of hospitalization in Recife-PE. As a result, we realize that not only is the new baby a premature one. We reflect that the mother is also premature and needs time to prepare for the arrival of a child who has been crossed by the unexpected and who, at birth, demanded specific hospital care. The hospital, as an institution, becomes an essential element for the survival of the baby. However, this may represent a protective structure, as well as an obstacle between mother and child. In several moments of the observations, the team positioned themselves in an imperative and authoritarian way, with actions based on the medical and institutional power. In this position, what prevailed was the normative dimension of the institution. These acts enhanced the erasure of maternal singularities and their children, as well as ignored the maternal knowledge that was built in the exchange with the baby. The observed mothers, despite their contingencies, were able to appropriate their children and exercise their role in particular. They also have been successful in establishing and maintaining breastfeeding. They revealed to us that regardless the ways the milk was offered, what really mattered was the quality of a pleasurable relationship established in that context. This research therefore points out the need to recognize that in hospital admission, not only a special care is given to the preterm infant in search of their survival, but also a particular relationship between mother and child takes place, legitimized by maternal knowledge in the exercise of its function. In this sense, recognition of these aspects, ethical posture, reception and technical and psychic support, detached from the imperatives of duty and moral judgments, contribute to the process of humanizing the baby and can even collaborate with the goals determined by the hospital protocols.