Determinantes do sucesso e do insucesso do aleitamento materno em gestações múltiplas: uma revisão narrativa

Abstract

This narrative review, involving a structured literature search, analyzed the determinants of breastfeeding success and failure in multiple pregnancies, focusing on clinical, technical, and psychosocial aspects. The search was conducted between September 2025 and May 2026 across the PubMed, Web of Science, Scopus, and LILACS databases, covering studies published between 2015 and 2026. Ten studies were included, comprising a total of 2,393 mothers of multiples. A lower prevalence and duration of exclusive breastfeeding were observed in this group compared to singleton pregnancies. Clinical factors—such as prematurity, low birth weight, and neonatal hospitalization—were negatively associated with breastfeeding. Key psychosocial determinants included maternal fatigue, emotional distress, and the perception of insufficient milk supply. Conversely, social and family support, qualified professional guidance, higher maternal education levels, prior experience, and participation in prenatal educational activities were associated with better outcomes. Technical strategies, such as the use of adapted positioning and simultaneous or consecutive breastfeeding, proved relevant for sustaining breastfeeding. Maternal self-efficacy and mental health emerged as central factors in this process. The review concludes that breastfeeding in multiple pregnancies is determined by various interrelated factors, requiring an individualized approach, multidisciplinary support, and the strengthening of public policies, alongside the need for studies focused on specific interventions for this population.