CARE FOR LACTATING MOTHERS IN PUERICULTURE CONSULTATIONS : INTERVENTION IN THE WAITING ROOM CUIDADO

Objective: to report the experience of educational sessions for mothers about infant care in a waiting room for child care consultations. Method: qualitative, descriptive study, type of experience report, in which the educational sessions took place in a Primary Health Care Unit, whose data collection occurred from August 2015 to March 2017. Results: six educational sessions were carried out verifying the pre-knowledge -existing, implementing health education strategies and, later, verifying knowledge. We highlight the topic "positioning of the child at the time of breastfeeding and the characteristics of the correct handgrip". It was verified that, of the mothers, 40% (pre-test) already knew the subject and after the explanations, the percentage increased to 75% (p <0.016). The Another highlight was "Vitamin D"; the number of correct answers was 7.69% (pre-test) to 76.92% (post-test), with a significant value (p <0.04). Conclusion: the educational sessions took on a valuable connotation, considering that they enabled to improve the knowledge of the mothers. Descriptors: Infant Care; Health Education; Child Care; Nursing. RESUMEN Objetivo: relatar la experiencia de la realización de sesiones educativas para madres acerca del cuidado al lactante en sala de espera de consultas de puericultura. Método: estudio cualitativo, descriptivo, tipo relato de experiencia, en que ocurrieron las sesiones educativas en una Unidad de Atención Primaria a la Salud, cuya recolección de datos ocurrió de agosto de 2015 a marzo de 2017. Resultados: fueron realizadas seis sesiones educativas verificando el conocimiento pre-existente, implementando estrategias de educación en salud y, posteriormente, verificando el conocimiento. Se destaca el tema "posicionamiento del niño en el momento de la lactancia y de las características del asa correcta". Se verificó que, de las madres, 40% (pre-test) ya conocían la temática y, después de las explicaciones el porcentaje fue para 75% (post-test), presentando significancia de (p <0,016). Otro tema destacado fue "Vitamina D"; el cuantitativo de aciertos fue del 7,69% (pre-test) al 76,92% (post-test), con valor significante (p <0,04). Conclusión: las sesiones educativas asumieron una connotación valiosa, teniendo en vista que posibilitaron mejorar el conocimiento de las madres. Descriptores: Cuidado del Lactante; Educación en Salud; Cuidado del Niño; Enfermería. Enfermeiros (egressos), Universidade da Integração Internacional da Lusofonia Afro-Brasileira/UNILAB. Acarape (CE), Brasil. E-mails: fmardonessb@hotmail.com; cianyleal@hotmail.com; Doutora em Enfermagem, Professor Adjunto da Universidade da Integração Internacional da Lusofonia Afro-Brasileira/UNILAB. Acarape (CE), Brasil. E-mail: emilia@unilab.edu.br; Doutora em Ciências Veterinárias, Professor Adjunto da Universidade da Integração Internacional da Lusofonia Afro-Brasileira/UNILAB. Acarape (CE), Brasil. E-mail: edmaracosta@unilab.edu.br; Doutora em Enfermagem, Professora Visitante, Universidade da Integração Internacional da Lusofonia AfroBrasileira/UNILAB. Acarape (CE), Brasil. E-mail: vanessaemille@gmail.com; Enfermeira, Mestranda em Enfermagem, Universidade da Integração Internacional da Lusofonia Afro-Brasileira/UNILAB. Acarape (CE), Brasil. E-mail: claudiaferreira91@yahoo.com.br; Doutor em Enfermagem, Professor, Universidade da Integração Internacional da Lusofonia Afro-Brasileira/UNILAB. Acarape (CE), Brasil. E-mail: thiagomoura@unilab.edu.br; Acadêmico de Enfermagem, Universidade da Integração Internacional da Lusofonia Afro-Brasileira/UNILAB. Acarape (CE), Brasil. E-mail: diegoferreira@aluno.unilab.edu.br ARTIGO RELATO DE EXPERIÊNCIA Bernardo FMS, Rouberte ESC, Costa EC et al. Cuidado ao lactente para mães em consultas... Português/Inglês Rev enferm UFPE on line., Recife, 11(12):5129-38, dec., 2017 5130 ISSN: 1981-8963 https://doi.org/10.5205/1981-8963-v11i12a25152p5129-5138-2017 A puericultura é considerada uma importante estratégia de cuidado preventivo, sendo um dos eixos das ações desenvolvidas na atenção à saúde da criança. É capaz de orientar e promover ações de promoção da saúde e de bem-estar infantil, além de permitir a detecção precoce de problemas de saúde e oportunizar seu tratamento em tempo hábil. Esse segmento prevê um calendário básico de consultas, que deve ser cumprido corretamente, promovendo a busca ativa dos faltosos. Com a finalidade de possibilitar o acompanhamento do crescimento e desenvolvimento infantil, o Ministério da Saúde prevê que toda criança deve passar por, no mínimo, sete consultas de puericultura no primeiro ano de vida. As consultas de Puericultura, realizadas no âmbito da Estratégia de Saúde da Família (ESF), constituem um momento oportuno para o desenvolvimento de ações voltadas para a promoção da saúde, bem como são ideais para as atividades focadas na prevenção de agravos por meio da educação em saúde. Além disso, são cruciais para garantir um atendimento de qualidade. Por meio das consultas de puericultura, os profissionais de Enfermagem têm a oportunidade de realizar a investigação ou a identificação do perfil das crianças acompanhadas, dessa forma, possibilitando analisar se o padrão de crescimento e desenvolvimento está alinhado com a idade. Além disso, é possível reconhecer e conhecer as afecções presentes ou mesmo aquelas já ocorridas, bem como analisar o calendário vacinal e ampliar o conhecimento de sua população. A puericultura é uma das diversas ações contempladas pela ESF que possuem, como finalidade, fazer o acompanhamento do crescimento e do desenvolvimento de saúde de crianças; proferir orientações acerca da prevenção de acidentes conforme a faixa etária; avaliar o desenvolvimento neuropsicomotor; identificar dúvidas e dificuldades de mães e de outros membros da família, na perspectiva de esclarecê-las; verificar a cobertura vacinal; incentivar a prática do aleitamento materno; orientar quanto à introdução da alimentação complementar. Além disso, está voltada para a prevenção das principais afecções que acometem as crianças no primeiro ano de vida, como a diarreia e as infecções respiratórias. Nesse cenário, a puericultura é tida como uma ferramenta que possui a finalidade de atuar sobre o binômio mãe-filho, com ênfase no período da infância, uma vez que essa é a etapa da vida de maior vulnerabilidade biológica. Nesse contexto, destaca-se que o enfermeiro é fundamental na realização da puericultura, pois esta envolve uma sequência de etapas que direcionam as ações de modo que haja um atendimento eficaz às necessidades da saúde da criança e aos anseios da família. Não se trata apenas de aferir as medidas antropométricas, mas, sim, avaliar a criança na sua integralidade, observando crescimento e desenvolvimento, com ênfase nas orientações de cuidados proferidas para a mãe. Estas orientações de cuidado são dirigidas à mãe, mas, muitas vezes, no momento da avaliação do filho, elas ficam mais preocupadas com o resultado do que se está avaliando do que com as orientações que estão sendo dadas. ● Relatar a experiência da realização de sessões educativas para mães acerca do cuidado ao lactente em sala de espera de consultas de puericultura. Estudo qualitativo, descritivo, tipo relato de experiência por fonte primária, cuja coleta de dados ocorreu de agosto de 2015 a março de 2017, período no qual ocorreram as sessões educativas, realizadas na sala de espera para as consultas de puericultura de uma Unidade de Atenção Primária à Saúde (UAPS) situada na zona urbana no município de Redenção. Redenção localiza-se no interior do Estado do Ceará, no Nordeste brasileiro. Participaram das ações mães de crianças entre zero e dois anos de idade, as quais compareciam à UAPS para as consultas de Puericultura e aceitaram participar das sessões educativas e da pesquisa. As temáticas explanadas nas sessões educativas foram direcionadas ao universo do cuidado à criança, a saber: “Aleitamento materno”; “Alimentação infantil”; “Alterações de pele”; “Higiene da criança”; “Imunização”; “Cuidados com a criança: ambiente em que vive, sono e repouso”. Os temas foram selecionados conforme a relevância e a abrangência no contexto das consultas de Puericultura. Para isso, faz-se necessário compreender que a Puericultura está voltada para aspectos da promoção de saúde infantil, na prevenção de doenças e educação da criança e de seus familiares. Assim, foram realizadas orientações prévias OBJETIVO

Childcare is considered an important strategy of preventive care, being one of the axes of the actions developed in the health care of the child.It can guide and promote actions to promote health and well-being for children, as well as to enable the early detection of health problems and to provide them with timely treatment.2][3] In order to enable monitoring of child growth and development, the Ministry of Health foresees that every child should be minimum, seven childcare consultations in the first year of life. 4e Puericulture Consultations, carried out within the framework of the Family Health Strategy (FHS) constitute an opportune moment for the development of actions aimed at the promotion of health, as well as are ideal for activities focused on the prevention of diseases through health education.In addition, are crucial to ensure quality care. 5rough childcare consultations, the Nursing professionals have the opportunity to carry out the investigation or identification of the profile of the children followed, thus, allowing to analyze if the pattern of growth and development is aligned with the age.In addition, it is possible to recognize and to know the affections present or even those already occurred, as well as makes it possible to analyze the vaccination calendar and to promote the knowledge of its population. 6ildcare is one of several actions contemplated by the FHS, whose purpose, is to monitor the growth and development of children's health; provide guidance on accident prevention according to age; evaluate neuropsychomotor development; identify doubts and difficulties of mothers and other family members, with a view to clarifying them; check vaccine coverage; encourage the practice of breastfeeding; the introduction of complementary feeding.In addition, it is aimed at preventing the major affections that affect children in the first year of life, such as diarrhea and respiratory infections. 2,3,7 this scenario, childcare is considered as a tool that has the purpose of acting on the mother-child binomial, with emphasis on the period of childhood, since this is the stage of life of greater biological vulnerability. 6 this context, it is important to emphasize that nurses are fundamental in the performance of child care, since this involves a sequence of steps that direct actions so that there is an effective attendance to the health needs of the child and the family's wishes..3 These care guidelines are addressed to the mother, but often at the time of the child's assessment, they are more concerned with the outcome of what is being evaluated than with the guidelines being given.
• To report the experience of holding educational sessions for mothers about infant care in a waiting room for childcare consultations.
A qualitative, descriptive study, a type of experience report by primary source, whose data collection occurred from August 2015 to March 2017, during which educational sessions took place in the waiting room for childcare consultations held in a Unit of Primary Health Care (UPHC) located in the urban area of the municipality of Redenção.Redenção is located in the interior of the State of Ceará, in the Brazilian Northeast.
Participating in the actions of mothers of children between zero and two years of age, who attended the UPHC for Child Care consultations and accepted to participate in educational sessions and research.
The themes explained in the educational sessions were directed to the universe of child care, namely: "Breastfeeding"; "Infant feeding"; "Skin changes"; "Child Hygiene"; "Immunization"; "Caring for the child: environment in which he lives, sleep and rest".
The themes were selected according to relevance and comprehensiveness in the context of Childcare consultations.For this, it is necessary to understand that Childcare is focused on aspects of child health promotion, with a view to prevention of diseases and education of children and their families.socialization and cultural stimulation and adaptation of the child in their social environment. 9e educational sessions were developed by an undergraduate student in Nursing at the University of International Integration of Afro-Brazilian Lusophone under the guidance of a teacher of the course.These were carried out at the health institution, in a reserved place, using pens, folders, serial albums, a doll and the printed questionnaire.The average duration of the approaches was approximately 20 minutes, in each educational session, in which they were divided between pre-test probing, and explanation of the theoretical content of the aforementioned points, accomplishment of the educational activities and probing of later knowledge (post-test).It is worth noting that an explanation of each topic was done monthly, totaling six educational sessions.
These so-called pre-test and post-test instruments, were questionnaires that included closed questions, addressing theoretical aspects about the topics studied, and that the participants completed the selfadministered questionnaire.These types of instruments allow a delineation of each educational session, by providing parameters on the level of knowledge of the mothers on the themes, and it is possible to verify the percentage of correct answers.For the organization of the data, was used Microsoft® Excel® 2010.For the analysis, the Program Statistical Package for the Social Sciences (SPSS for Windows®, version 22 -IBM®, Chicago, USA) was used, with the application of the Test Qui -McNemar squared, with significance value established at p <0.500.
Regarding ethical issues, this study obtained a document of consent from the Health Department of the municipality.It is noteworthy that the study respected the ethical principles of research involving human beings, according to Resolution 466/12 of the National Health Council. 10 In addition, the study was approved by the Ethics and Research Committee of the University of International Integration of Afro-Brazilian with issue number 1,363,872.
The number of mothers per educational session varied from nine to twenty who agreed to participate in the meetings in which the objectives of the session were given before the mothers entered the Child Care clinics.Regarding the education of the subjects of the educational sessions, two mothers had incomplete elementary education; four, complete elementary school; two, incomplete high school; six, complete high school; one had a college degree and five mothers did not report schooling.
Six educational sessions were held and, during these sessions, it was possible to verify the pre-existing knowledge, as well as to implement health education strategies, and later, the knowledge was verified after the explanations.
Regarding the topics covered in each meeting, the following were held: in the first educational session "Breastfeeding"; in the 2nd educational session -"Infant food"; in the 3rd educational session -"Skin alterations"; in the 4th educational session -"Child Hygiene"; in the 5th educational session -"Immunization"; in the 6th educational session -"Caring for the child: environment in which he lives, sleep and rest".
It should be highlighted that the themes were interrelated with the context focused on prevention and health promotion, aimed at informing mothers about the factors that influence the health of their children, as well as ways to prevent health changes, in addition to it is important to emphasize that the consultations of Childcare aim to increase the knowledge of the mothers about the care with the child.
In the first educational session, whose theme was "Breastfeeding", the following topics were explained: "What are the advantages for the baby?";"What are the advantages for the mother, the father and the family?";"Avoid the use of a bottle, pacifiers, dummy or nipple protector with intermediate nozzle"; "Myth of weak milk; Will I breastfeed in what way? -positioning and gripping"; "I will breastfeed in what way? -technical"; "How to do milking (removing milk from the breast) and storage"; "EXCLUSIVE BREASTFEEDING"; "What are the most common breastfeeding problems"; "Clarifying and demystifying myths and taboos that cause harm to breastfeeding" and "Rights guaranteed by legislation on breastfeeding".
One of the topics that aroused great attention of the mothers was in relation to the positioning of the child at the time of breastfeeding, as well as the main characteristics regarding the correct handle.It was verified that 40% of the mothers already knew these aspects, and that, after the explanations, there was an increase to 75%, presenting significance (p <0.016).With this, it stands out, as valid the educational sessions in the sensitization of the participants regarding the theme.

RESULTS
English/Portuguese J Nurs UFPE on line., Recife, 11( 12):5129-38, Dec., 2017 5132 Still with regard to the first educational session, it is noteworthy that the mothers mentioned doubts as to the storage form of milked milk, however, it was verified that the educational sessions contributed to the aforementioned remedy the doubts regarding the topics explained.In addition, the mothers were instructed to donate the surplus milk.To this end, there was a warning about possible donation sites.Many reported producing too much milk, and were interested in practicing the act of giving milk.
With regard to the second educational session, the theme of which was" Infant feeding", it considered the following approaches:" "Recommended practices", "Hand hygiene practices", "Care during food preparation", "Complementary feeding for young children of two years", "What are the characteristics of adequate complementary feeding", "Feeding before six months in situations where breastfeeding is not practiced or is practiced partially" "Complementary feeding -scheme for introduction of complementary foods" "Feeding of the child from six months to two years"," Child feeding from six months to two years (food groups)", "Fruit Pope", "Potato of vegetables (salty potato)"," Guidelines on diet management for six-month-old infants in exclusive breastfeeding";" Breastfeeding supplemented for infants who continue to breastfeed"; "Guidelines on dietary management for seven-and nine-month-old children"; "Suggestions for different combinations of salted potatoes"; "Dietary management guidelines for children between ten and 18 months"; "Foods that should not be offered to the child"; "Examples of natural seasonings that may be used"; "Recommendations"; "The ten steps for healthy eating of children under two years" and" Examples of menus for children in the second year of life and recommendations.
One of the topics that generated great curiosity for the mothers was the fact that the bottle was considered an important source of contamination. 11At that time, it was explained that they should avoid using the bottle.And the mothers, who fed the children, said they found it difficult to clean the utensil.The referred mothers were also surprised to learn that children, who have tried the bottle, may have difficulty breastfeeding.The mothers were worried about this information, which generated apprehension about this.
Another topic that aroused the interest of the participants was about the characteristics that foods should have in the composition of complementary food.Mothers were unaware of the aspects related to the variety of food components, which gave rise to many doubts regarding the composition of food combinations, such as potatoes and salted potatoes.Doubts were healed at the time of the educational sessions.In addition, a folder was provided with sugestions of savory babyfood.
Another aspect that was contemplated, was regarding the foods that should not be offered the child.This topic has led to an intense discussion about the consumption and the harm of certain foods for health.The mothers were interested in the subject, because there were doubts about which foods should be avoided in the child's diet.
The educational session, whose theme was "Skin alterations", it contemplated the following approaches: "Characteristics of the skin of the newborn"; "To protect the skin, you should avoid unfavorable environmental conditions"; "Skin care"; "D vitamin"; "Protection against ultraviolet rays"; "In skin changes, were covered: Milium sebaceous; Mongolian stains; Erythema toxicus; Miliaria "shoots"; Intertrigo; Diaper area dermatitis; Candidiasis or moniliasis in the diaper area; Impetigo; Atopic dermatitis or atopic eczema; Seborrheic dermatitis; Pityriasis versicolor; Scabies; Prevention and care to prevent skin changes.
In the explanations, it was verified that a great part of the mothers understood the questions related to the characteristics of the skin of the newborn.The contents covered included information related to the specificities of the child's skin.
Regarding diaper area dermatitis, it was observed that the mothers did not know the factors related to the onset of the disease.Those mothers concerned had doubts about how to prevent and treat the condition.During the explanations, the participants made several questions that were resolved throughout the exhibition.
In the educational sessions, the low level of knowledge of the mothers regarding the role of the sun in the synthesis of vitamin D was verified, being 7.69% (pre-test), to 76.92% (post-test), presenting significant (p <0.04).With this, it is highlighted that, after the explanations, the quantitative of correct answers increased, which, establishes the activity as a source promoting knowledge.
The fourth educational session, whose theme was "Child Hygiene", contemplated the following approaches: "Hygiene of the skin of the newborn at term (zero to 30 days): bath"; English/Portuguese J Nurs UFPE on line., Recife, 11(12):5129-38, Dec., 2017 5133 "Hygiene of the skin of the term newborn (zero to 30 days): care with the umbilical stump"; "Hygiene of the skin of the newborn: care with the area of the diapers"; "Child care: oral hygiene"; "Guidelines for child hygiene care related to: lice, ear, eyes, mouth, nose, hands, genitals, feet and hand hygiene".
The fifth educational session, whose theme was "immunization", the following approaches were considered: "What are vaccines?";"Whyvaccinate?";"NationalVaccination Calendar"; "Tuberculosis Vaccine (BCG)";"Hepatitis A Vaccine"; "Hepatitis B vaccine"; "Pentavalent vaccine (DTP + Hib + Hep.B)"; Oral poliomyelitis vaccine (OPV);"Human rotavirus vaccine (VORH)";"Meningococcal vaccine C"; "Vaccine against measles, mumps and rubella (threefold virus)","Vaccine adsorbed against (diphtheria, tetanus and pertussis) threefold bacterial (DTP)";"Tetravirus vaccine (measles, mumps , rubella and chickenpox)." Of the topics discussed, the item that dealt with "What are vaccines?"Generated great curiosity for the mothers, since some did not know the meaning of the term.With this, it has been explained that most immunizing agents can be produced from strains or strains of bacteria or viruses. 12en asked about Vaccinate?",They reported that vaccines work to prevent disease.The participants also stressed the importance of keeping the immunization schedule up to date, given the innumerable benefits related to the protection of the child against certain pathologies.
It was verified that 22,22% (pre-test) of the mothers already knew the purpose of VORH, and after, the educational sessions, this percentage passed to 66.67% (post-test), presenting significance (p <0.125).At the time of the activity, the participants asked questions related to the vaccine.They reported not having received information about the purpose of the immunobiological, which shows a knowledge gap with emphasis on this topic.
In relation to the mothers' knowledge about the first vaccines administered to the child in the first days of life soon after the maternity, namely BCG and Hepatitis B, it was found that the number of correct answers increased from 44.44% (pre-test) to 77.78% (post-test), presenting a significance level (p <0.250).
The sixth educational session, whose theme was "Childcare: environment in which you live, sleep and rest," contemplated the following approaches: "Major Accidents Involving Children"; "What are the most common accidents in the home environment?";"Preventivemeasures for intoxications"; "Preventive measures for asphyxiation"; "Preventive measures for burns"; "Preventive measures for falls and traumas"; "Caring for toys"; "Caring for children in the kitchen"; "General care"; "Sleep in newborns and infants"; "Sleep in children between two and six and six and 12 years of age".
It was observed that the mothers already knew several aspects regarding the measures for the prevention of accidents in children.At that moment, some presented personal reports of situations that involved some kind of risk to the child, a fact that enabled the sharing of knowledge and experiences.It was noticeable to note the concern of all to promote the safety of the infant, since the reports signaled that it is necessary to redouble the attention to the child, both in the environment of home and abroad.
In the topic on preventive measures for intoxications, these have reported concern about the domestic environment, because the house contains numerous cleaning products and contain medicines.The theme provided an intense discussion on ways to avoid children's contact with toxic products and medications.In addition, the discussions made it possible to exchange experiences among participants.
Another concern was regarding burns.In this sense, participants reported being very careful with children in the domestic environment, especially, in the kitchen, because it is one of the most dangerous places in the house, according to reports.In addition, care was taken in other spaces of the house, for example, the place where the iron is, the sockets, among others.
Regarding the first educational session, that covered one of the topics related to the positioning at the time of breastfeeding and the characteristics of the correct handgrip, it was observed that some mothers had doubts about this, demonstrating a great interest in observing the technique that was demonstrated using a doll at the time of the educational sessions.
In this sense, it was crucial to show the correct positioning and picking technique, emphasizing that the recommended breastfeeding position is that the child's face is in an intimate juxtaposition, that is, in line with the maternal contour, and that the alignment and the mouth well are some

DISCUSSION
English/Portuguese J Nurs UFPE on line., Recife, 11( 12):5129-38, Dec., 2017 5134 indications of the correct technique for the act of breastfeeding. 13out the milking process, it was apparent that the mothers were unaware of the technique of milk withdrawal by manual milking, as well as the main indications of this procedure.To make the process more playful, images of the stages were shown to facilitate the understanding of the technique using the serial album.Besides, at the end of the exhibition, was set aside a moment to heal possible doubts in relation to the theme.It is worth mentioning that mothers already had knowledge about many topics worked out.
In relation to milking, another study recommends manual milking and milk donation, as well as directing nurses about milking ways and storing milk. 13In doing so, the benefits that milking provides were reinforced, as well as emphasizing the act of generosity with being close to giving the gift to those in need.It was pointed out how the explanations given in the educational sessions were of great value, in addition to emphasizing that the use of the serial album was of great importance for the provision of the actions, considering that it made possible the learning.

Regarding
the topic of exclusive breastfeeding, it was observed that mothers considered it to be of utmost importance to practice exclusive breastfeeding, since it contributes to the growth and development of the child.About breastfeeding, the literature 14 emphasizes that breast milk already has a balanced nutritional composition, which includes all the essential nutrients and factors that contribute to the child's growth and development.
Regarding the second educational session, the topic that contemplated the use of the bottle aroused the mothers' interest, given their surprise when knowing that this utensil could contribute as an important source of contamination, and, could negatively influence the breast-feeding.In addition, it was emphasize that, after trying the bottle, the child may present difficulty when breastfeeding, which is known in the literature as "confusion of nozzles", due to the great difference between the suctioning of the breast and the baby bottle. 11After explaining the contents, the mothers recognized that the use of wood is harmful to the child.
Regarding the characteristics of foods contained in complementary food, it was advised that these should: contain specific nutrients that are essential for growth and developments, such as iron and vitamin A; own varieties of food offered; contain energy density of food and preparations, as well as the absence of ultraprocessed food products. 15garding the foods that should not be offered to the child, during the second educational session, the participants were advised not to offer foods that contained large quantities of sugar, canned foods, fried foods, soft drinks, snacks, coffee, filled cookies and candy.In addition, they were advised to avoid in natura honey consumption in children younger than 12 months for the prevention of botulism. 11 In the third educational session, the interest of mothers with an emphasis on content that included information related to the specificities of the child's skin was perceptible.They did not know the structure of the skin and, in this sense, they were shown figures with the layers (epidermis, dermis, hypodermis), besides emphasizing that it has a diminished thickness and that it has a higher water content than the adult skin, which justifies turgor and texture.In addition, mothers were instructed on measures to protect the child's skin, including avoiding contact and absorption of irritants, not rubbing the skin, avoiding dehydration, avoid sunburn and changes in bacterial flora. 16other topic that greatly aroused the interest of the participants, during the third educational session, was regarding diaper rash, as there were many doubts about these in relation to prevention measures.To that end, aspects of the condition were explained and, subsequently, it was oriented how to prevent it, by adopting some measures, namely: use of absorbent diapers and with frequent exchanges; dry the skin without rubbing, ie with light touches, using soft cloth or cotton balls soaked in warm water. 17e third educational session included information regarding vitamin D. With this it was observed a high index of ignorance of the participants in relation to the abovementioned vitamin.Therefore, it was highlighted, in the explanation, that the sun, as the literature ratifies 18 , is of extreme importance in the synthesis of vitamin D. For this, it was explained that the direct exposure of the baby's skin to sunlight is fundamental for the occurrence of synthesis of said vitamin.
About the fourth educational session, it is noteworthy that the mothers showed an interest in the theme, in particular, about the guidelines regarding care with the umbilical stump, because there were doubts related to the cleaning technique that were healed.For this, demonstrations were made using a doll.
English/Portuguese J Nurs UFPE on line., Recife, 11 (12):5129-38, Dec., 2017  5135  In this sense, the use of alcohol was warned to 70%, which literature19 points out as an important protection factor against infections.
0] About the aforementioned conditions, it is noted that they are characterized by the presence of purulent secretion in the stump region, with the onset of edema and hyperemia in the abdominal wall. 9Therefore, it was pointed out that the care given consists in reducing colonization by germs causing diseases and, consequently, neonatal infection.
In the fifth educational session, the subject addressed contributed to increase the number of hits, and, consequently, made it possible to increase the participants' knowledge about immunization.For that, the feature of the serial album, was used that contained information regarding immunobiological.
During the sessions, it was noticed that the mothers came to understand the purpose of the immunization, since the referred ones report that the vaccines act in the prevention of affections.One study 21 emphasizes the conception of mothers who view immunization as a child-directed protection, because it understands that it helps to prevent various diseases.
During the activities, topics were discussed about the main measures to prevent diarrhea.At the time, the mothers showed considerable concern regarding the prevention of diarrhea and, when asked about ways to prevent it, they reported some measures, such as: care and hygiene in the home; the importance of daily child care such as bathing, hand hygiene, nail cleaning and care of keeping animals away from the home environment.In addition, breastfeeding was mentioned as a positive factor in this process.Thus, these findings are similar to those described in the literature. 22 was observed that mothers increased their knowledge about immunization, especially for the topic that dealt with VORH.For this, it was explained to mothers that rotavirus disease is the main preventable cause of diarrhea in children under five years of age. 23It was therefore emphasized that immunobiological acts in the prevention of gastroenteritis caused by rotavirus in children younger than one year of age. 24This highlights the potential of educational action as a source of knowledge.
In relation to BCG and Hepatitis B vaccines, there is a recommendation that the aforementioned vaccines should be administered as early as possible, even at maternity.In the case of BCG, it is preferable that it be within the first 12 hours after birth.  In dition, it is recommended that the Hepatitis B vaccine be carried out within the first 24 hours, preferably within the first 12 hours.  It s verified that only a given portion of mothers knew the recommendation of vaccination of the mentioned immunobiologicals still in maternity.In this sense, the existence of a knowledge gap with an emphasis on the topic is perceptible.It should be noted that, after the explanations, there was an increase in the percentage of correct answers, going from 44.44% to 77.78%.
About the sixth educational session, it was observed that the mothers were sensitized in what concerns the care to avoid accidents with the infant.The concern of the mothers was to promote a safe environment for the child.In that sense, they reported some means such as use of protection grid in windows; use of protectors in outlets, never leave the child alone, among other reports.
As a basis for the above, it should be pointed out that the alignment referring to the conceptions of the mothers is in line with the measures recommended as preventive for accidents, among them, the insertion of protectors in the sockets and in the electric wires; installation of safety nets on windows; use the back of the stove and keep the cookware cables directed towards the center of the stove; keep children away from fire, from heaters and electric irons; keep away, from children, plastic bags, cords and yarns; do not leave children alone near buckets, tanks, wells and pools; keep cleaners and medicines out of the reach of children, indoors and outdoors, among other measures. 4ill in relation to the sixth educational session, the measures to avoid burns stand out.Mothers were cautioned not to handle hot liquids and / or food with the child in the lap; hinder the child's access to iron and appliances; install protectors in the house sockets, among other measures. 27It was observed that, after the explanations, the mothers were more sensitized as to the aspects related to the measures to avoid burns, and these considered of great relevance the information given.
With regard to the educational sessions, it is worth mentioning that these have assumed a valuable connotation, since they allowed to CONCLUSION English/Portuguese J Nurs UFPE on line., Recife, 11(12):5129-38, Dec., 2017 5136 promote the knowledge leverage of the mothers related to the themes worked, being also emphasized the remarkable interaction between the participants in all activities, fact which promoted the sharing of knowledge and experiences in relation to the practice of child care.
The mothers' change in the conception of many of the topics worked out, among them, the ones of greater complexity in the assimilation of the content, was perceptible, and that, through the educational sessions, it was possible to enhance the knowledge of the mothers, a fact that was only possible due to the use of methodologies experienced, among them, the use of the resource of serial albums, folders, as well as moments of practices with demonstration.
As a positive point, we highlight the recognition of mothers and see the significance of learning, which was verified through the instruments, as well as through the observations presented throughout the above, which was shown as a result of this experience of the observations.In sum, it is pointed out that the exchange of experiences lived and proportioned, as well as the knowledge assimilated by both during this process, is the main fruits obtained from this work.
This study made it possible to look at a more sensitive view of Nursing with regard to health education actions, considering that this practice needs to be incorporated and implemented in the most diverse environments.For this, professionals can make use of several methodologies, among them, the use of differentiated educational technologies.