Navegando por Palavras-chave "Breastfeeding"

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    Aleitamento materno e alimentação complementar de crianças em um município da Amazônia Ocidental Brasileira
    (Universidade Federal de São Paulo (UNIFESP), 2019-03-28) Silva, Vanizia Barboza Da [UNIFESP]; Abrao, Ana Cristina Freitas De Vilhena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To assess supplementary feeding and breastfeeding of children from 0 to 23 months, born in Cruzeiro do Sul, a city located in the Brazilian Western Amazon region. Method: A cross-sectional study was carried out during national immunization campaigns in 2016 and 2017. Cluster sampling size calculation was applied in the methodology, resulting in the number of 856 children. The research tool was based on the questionnaire provided by the II Health Ministry Breastfeeding Prevalence Research, which was adapted according to the study needs. Data collection was carried out with mothers or chaperones who showed up at the basic health unit on the campaign day, or prior and after. For analyzing early weaning, Chi-square, Kolmogorov-Smirnov, and Hosmer-Lemeshow tests were used. For total weaning, Kaplan-Meier survival analysis and Cox Model were utilized. The Poisson regression model with robust variance was applied to analyze supplementary feeding. For all statistical tests, a 5% level of confidence and IBM SPSS 20.0 and Stata 12 statistical software were used. Results. The prevalence of exclusive breastfeeding was 34.7% (CI 31.1 – 38.4) and mixed breastfeeding was 65.3% (CI 62.0 – 69.2). Factors associated with early weaning were paternal education and previous breastfeeding experience. Factors associated with total breastfeeding were: length of the previous breastfeeding experience lower than 6 months, lack of breastfeeding during the first hour, and use of pacifiers and bottles. The assessment of supplementary feeding indicators identified that only 11.7% of the sample had a timely introduction to solid food, and only 9.0% had minimum food diversity, whereas 42.3% practiced the minimum frequency and adequate consistency. The consumption of food rich in iron was 85.5% and vitamin A was 58.7%. Ultra-processed foods were consumed by 98.9% of the children and the consumption of sweetened beverages was 72.7%. The main factors associated with inadequate food intake were: poor maternal and paternal education, low income, living in the countryside, age of children between 6 and 11 months, whereas income between 1 and 2 minimum wages or more was inversely associated with the outcome. Conclusions: Eating habits in children under two years of age lag behind the WHO and the HM recommendations. There is a need to improve health public policies in this area to optimize the quality of life of these children.
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    Aleitamento materno e alimentação complementar no contexto da pandemia de Covid-19: estudo em região de vulnerabilidade social do Município de Santos
    (Universidade Federal de São Paulo, 2023-01-16) Augusto, Giovanna Pukar [UNIFESP]; Santos, Rodrigo Dias dos [UNIFESP]; Devincenzi, Macarena Urrestarazu [UNIFESP]; http://lattes.cnpq.br/9369073345790021; http://lattes.cnpq.br/4436377596895389; Universidade Federal de São Paulo (UNIFESP)
    O aleitamento materno é fundamental para a promoção da saúde das crianças. O início do curso de vida, em especial os dois primeiros anos, é um período delicado para assegurar a segurança alimentar e nutricional. O presente trabalho tem como objetivo identificar situações que interfiram na prática do aleitamento materno e da alimentação complementar no contexto de vulnerabilidade social no período da Pandemia do Covid-19, com o intuito de compreender as estratégias e dificuldades enfrentadas pelas famílias. Foi realizada uma pesquisa com abordagem qualitativa onde os dados foram coletados a partir de entrevistas com uso de roteiro semiestruturado, envolvendo o estudo de múltiplos casos. Foram analisados os casos de 7 mulheres e seus filhos, com idade de até 2 anos, no período da Pandemia, atendidos pelas unidades básicas de saúde da família da Areia Branca e do Piratininga, localizadas na Zona Noroeste de Santos - São Paulo, região de alta vulnerabilidade social. Através do estudo foi possível identificar como o período da Pandemia impactou no cuidado da mulher e dos bebês, agravando o contexto de vulnerabilidade dessas famílias. Foram observados fatores que interferem no aleitamento materno, como ausência, indisponibilidade ou insuficiência de rede de apoio, necessidade de retorno ao trabalho e impossibilidade ou dificuldades de realizar o processo no local do emprego. Os relatos trouxeram questões como: dificuldade financeira, ausência do companheiro, isolamento social, perda do emprego, incompatibilidade entre trabalho e aleitamento, medo da doença, necessidade de auxílios e doações e as dificuldades para retirar e armazenar o leite. Além disso, foi relatada a diminuição da qualidade e quantidade de alimentos disponíveis. Percebeu-se um significativo consumo de alimentos processados e ultraprocessados na alimentação complementar. Logo, para essa parcela da população é imprescindível a ação do poder público por meio de auxílios e políticas públicas que garantam o direito à alimentação adequada e a atuação das equipes de saúde para garantir condições básicas de acesso aos serviços.
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    Aleitamento materno em prematuros: atuação fonoaudiológica baseada nos pressupostos da educação para promoção da saúde
    (ABRASCO - Associação Brasileira de Saúde Coletiva, 2010-03-01) Santana, Maria da Conceição Carneiro Pessoa de; Goulart, Bárbara Niegia Garcia de; Chiari, Brasilia Maria [UNIFESP]; Melo, Adriana de Medeiros; Silva, Érika Henriques de Araújo Alves da [UNIFESP]; Universidade Estadual de Ciências da Saúde do Estado de Alagoas Maternidade Escola Santa Mônica Serviço de Fonoaudiologia; Universidade Federal do Rio Grande do Sul; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Ciências da Saúde do Estado de Alagoas
    This paper reports an experience of a speech-language and audiology (SLP) team based on health promotion and education to contribute for the maintainance of exclusive breastfeeding in premature newborns in a high-risk maternity. In the process, a multiprofessional group and individual strategies were combined, producing dialogic settings along with puerperals and their families. Exclusive breastfeeding increased comparing with the last three years before these approach and greater participation of the team and relatives involved in these activities since the pregnant admission until discharge. The analisys of the strategies used allowed the team to identify the most effective actions to improve longer lasting exclusive breastfeeding and those that ought to be reformulated. From a theoretical and methodological point of view, this experience also allowed to observe the limits and possibilities of the actions that are related to closer areas of scientific knowledge and the effective promotion of exclusive breastfeeding in transdisciplinary activities. Considering health promotion and education as a discipline, it means that the efforts are highly directed to act on the people knowledge and self-care, mainly to contribute to the development of critical judgment and ability to decide what would be better and possible in health care and in managing of their own lives.
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    Análise de fatores individuais e do ambiente alimentar associados à duração da prática de aleitamento materno e ao tempo da introdução de alimentação complementar em crianças menores de dois anos residentes no município de Santos
    (Universidade Federal de São Paulo (UNIFESP), 2013-04-24) Melo, Patricia Ribeiro de [UNIFESP]; Martins, Paula Andrea [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Nutrition in childhood has an important impact on children's health. Breastfeeding’s practices and appropriate complementary feeding time, are extremely important to children under two years old. The study of factors that influence these practices are available in the scientific literature. However, works that analyze the effect of the food environment on the duration of breastfeeding, as well as the use of infant formulas and food thickeners on the inadequacy of the timing of introduction of complementary foods, they are still unknown. Aim: to analyze the food environment´s effects on the duration oexclusive breastfeeding´s duration and the relation between individual factors on time of in troduction of complementary feeding on children under two years old. Methods: this study was part of the research project called "Evaluation of the nutritional environment in the city of Santos" – AMBNUT. It had a dimicile component, for which they were made domicile visits to investigate dietary habits of children under two years old and the environmental component, on which was investigated the availability of food in shops located in the neighborhood´s domiciles. Analysis of exclusive breastfeeding´s duration was performed using the technique of Survival Analysis using the KaplanMeir. Factors associated with the time of introduction of complementary foods were performed by logistic regression analysis. The individual and environmental factors associated with breastfeeding duration were conducted by Cox Regression Analysis. Results: 75.8% of mothers introduced complementary feed to their children at incorrect period, and the liquid foods was those with the highest percentage of inadequacy (49.2% water and tea, fruit juices and 46.7% and 36.8% to cow's milk). In logistic regression models, we observed that mothers with higher educational level (higher education)and those who still breastfeeding their children, had less likely to fail at the time of introduction of complementary foods. The supply of infant formulas served as a risk factor for the outcome. The exclusive breastfeeding median adjusted was 5.5 months. In Cox regression analysis, we found that lower exposure to individual retail shops and stalls open fair, regardless of socioeconomic factors were associated with an increased risk for early weaning. The presence of larger businesses with greater availability of fruits was associated as a protective factor for early weaning. Conclusion: we observed a higher median of exclusive breastfeeding in this study, but a high percentage of inadequate time of introduction of complementary foods. In relation to factors associated with the time of release, it was found that the supply of breast milk and materna l education (higher education) act as protection factor to incorrect feeding practices. The use of infant formula was associated as a risk factor for early introduction of complementary foods in the diet of the child. Regarding the relationship of the food environment with breastfeeding, it was observed that regions with greater availability of fruits and vegetables, were associated with higher rates of exclusive breastfeeding.
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    Aspectos relacionados ao estabelecimento e à manutenção do aleitamento materno exclusivo na perspectiva de mulheres atendidas em uma unidade básica de saúde
    (UNESP, 2010-06-01) Fujimori, Elizabeth; Nakamura, Eunice [UNIFESP]; Gomes, Marcela Melatti; Jesus, Luciana Albuquerque De; Rezende, Magda Andrade; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Hospital Alemão Oswaldo Cruz; Programa de Agentes Comunitários de Saúde
    This qualitative study aimed to investigate the issues involved in establishing and maintaining exclusive breastfeeding from the women's perspective. It was conducted with 12 mothers of infants less than six months of age who were attended at a primary healthcare unit. Semistructured interviews were recorded, transcribed and subjected to content analysis, which revealed the following categories: nipple trauma; free demand; weak breast milk; breastfeeding women's psychological health; previous breastfeeding experience; breastfeeding and women's multiple roles; and influence of close people. Establishment of exclusive breastfeeding was associated with experiences and perceptions about breast milk sufficiency, thereby causing concern and insecurity. Close people, especially family members, influenced the establishment and maintenance of exclusive breastfeeding, as did women's work overload inside and outside home. Knowledge of issues that facilitate or hinder establishment and maintenance of breastfeeding is essential for guiding health professionals' actions.
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    Assessment of swallowing in preterm newborns fed by bottle and cup
    (Sociedade Brasileira de Fonoaudiologia, 2014-02-01) López, Claudia Peyres; Chiari, Brasilia Maria [UNIFESP]; Goulart, Ana Lucia [UNIFESP]; Furkim, Ana Maria; Guedes, Zelita Caldeira Ferreira; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Santa Catarina
    Purpose:To compare the swallowing performance of premature infants using a cup and a bottle during the first offer of food by mouth.Methods:This study was carried out with preterm newborns who presented low weight at birth and no neurological illnesses, genetic syndromes or congenital malformations. The newborns were assessed by videofluoroscopy while using a cup and a bottle, when they reached a post-conceptual age of ≥34 weeks, weight ≥ 1,500 g and showed signs of readiness for oral feeding. All children were fed exclusively by gavage during the period prior to the study.Results:This study included 20 preterm newborns, with average birth weight of 1,356 g and gestational age of 31.3 weeks. The majority of the bottle-fed newborns (68%) presented strong and rhythmic suction and 63% showed good sucking/swallowing/breathing coordination. The same percentage of newborns fed by cup (68%) could not perform the sipping movement and only 32% could suck a minimal amount of liquid contrast. There were no signs of laryngeal penetration and tracheal aspiration in both procedures.Conclusion:At the first oral feeding, preterm newborns showed better swallowing performance with a bottle in comparison to using a cup.
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    Autoeficácia para a amamentação em mulheres com mamoplastia de aumento e redutora
    (Universidade Federal de São Paulo (UNIFESP), 2019-08-29) Eugenio, Daniella Soares [UNIFESP]; Abrao, Ana Cristina Freitas De Vilhena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Women with breast augmentation and reduction mammoplasty have a lower prevalence of exclusive breastfeeding when compared to those without surgery. Considering self-efficacy for breastfeeding one of the modifiable factors in the prevention of early weaning, it is opportune to know the behavior of this variable in this population. Objectives: To analyze the self-efficacy for breastfeeding in relation to the group of women without breast surgery and with mammoplasty. Method: A cross-sectional study was carried out in a private maternity hospital in the city of São Paulo, with 252 women, 100 of the non-surgical group, 83 of the augmentation mammoplasty group and 69 of the reduction mammoplasty group. Data collection was performed between the 5th and 7th day after delivery through the Breastfeeding Self-Efficacy Scale Short Form Brazilian Version. Results: It was verified that the average of self-efficacy scores for breastfeeding was equal between the group of women without breast surgery and that of women with augmentation mammoplasty and greater in relation to the group of women with reduction mammoplasty and this difference was statistically significant ( p = 0.010). Regarding the mean score of the self-efficacy technique for breastfeeding, this was the same among the group of women without surgery and augmentation mammoplasty and was higher in relation to the group of women with reduction mammoplasty and this difference was statistically significant (p < 0.001). The relationship between self-efficacy and the type of breastfeeding, the volume of breast milk extracted and the associated factors are independent of mammoplasty. In this perspective, it was observed that the relationship between self-efficacy and the practice of AME was statistically significant and that for every 1 point increased in the BSES-SFVB global score there was a 16% increase in the chance of AME. It was also identified that women with reduction mammoplasty are 90% less likely to breastfeed exclusively when compared to women without surgery. The relationship between self-efficacy and volume of breast milk extracted was statistically significant and for each 1 point increased in the BSES-SFVB total score there was an increase of 1.36 ml in the volume of milk extracted. It was also found that women with reductive mammoplasty presented 37.2 ml less than the volume of milked milk when compared to those without surgery. Regarding the associated factors, it was identified that vaginal delivery and the perception of adequate milk production favor higher self-efficacy scores for breastfeeding. Conclusion: Self-efficacy for breastfeeding is affected by reductive mammoplasty.
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    Breastfeeding training for health professionals and resultant changes in breastfeeding duration
    (Associação Paulista de Medicina - APM, 2000-11-09) Taddei, Jose Augusto de Aguiar Carrazedo [UNIFESP]; Westphal, Marcia Faria [UNIFESP]; Venancio, Sonia; Bogus, Cláudia; Souza, Sonia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Santo Amaro Maternal and Child Health Graduate Program; State of São Paulo State Health Secretariat Health Institute
    CONTEXT: Promotion of breastfeeding in Brazilian maternity hospitals. OBJECTIVE: To quantify changes in the breastfeeding duration among mothers served by hospitals exposed to the Wellstart-SLC course, comparing them with changes among mothers attended by institutions not exposed to this course. DESIGN: Randomized Institutional Trial. SETTING: The effects of training on breastfeeding duration was assessed in eight Brazilian hospitals assigned at random to either an exposed group (staff attending the Wellstart-SLC course) or a control group. SAMPLE: For each of the eight study hospitals, two cohorts of about 50 children were visited at home at one and six months after birth. The first cohort (n = 494) was composed of babies born in the month prior to exposure to the Wellstart-SLC course, and the second cohort (n = 476) was composed of babies born six months subsequent to this exposure. MAIN MEASUREMENTS: Kaplan-Meier curves were plotted to describe the weaning process and log-rank tests were used to assess statistical differences among survival curves. Hazard ratio (HR) estimates were calculated by fitting Cox proportional hazard regression models to the data. RESULTS: The increases in estimated, adjusted rates for children born in hospitals with trained personnel were 29% (HR = 0.71) and 20% (HR = 0.80) for exclusive and full breastfeeding, respectively. No changes were identified for total breastfeeding. CONCLUSION: This randomized trial supports a growing body of evidence that training hospital health professionals in breastfeeding promotion and protection results in an increase in breastfeeding duration.
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    Características da sucção não-nutritiva em RN a termo e pré-termo tardio
    (Sociedade Brasileira de Fonoaudiologia, 2011-09-01) Kao, Ana Paula D'oliveira Gheti [UNIFESP]; Guedes, Zelita Caldeira Ferreira [UNIFESP]; Dos Santos, Amelia Miyashiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To compare non-nutritive sucking parameters between late preterm and full-term infants. METHODS: Infants were divided into two groups, full-term and late preterm, and were submitted to non-nutritive sucking assessment using a protocol adapted from the Oral Motor Assessment Scale. Statistical analysis was conducted for comparison between the groups. RESULTS: The seeking and sucking reflexes were less frequent in late preterm than in full-term newborns, as well as palmar grip and hands in the midline. Most late preterm infants presented light sleep or drowsiness before the assessment. Late preterm subjects predominantly presented sporadic sucking or blocks of sucking with long pauses and mandibular locking and/or tremors. Tongue retraction and protrusion were mostly present in late preterm infants, and tongue central groove formation, in full-term infants. CONCLUSION: Readiness for feeding, behavioral state, axial tonus, sucking pattern and strength, and tongue movements were the less frequent parameters in late preterm infants, in comparison to full-term infants.
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    Carbamazepine-exposure during gestation and lactation affects pubertal onset and spermatic parameters in male pubertal offspring
    (Elsevier B.V., 2014-04-01) Andretta, Rhayza Roberta [UNIFESP]; Okada, Fatima Kazue [UNIFESP]; Paccola, Camila Cicconi [UNIFESP]; Stumpp, Taiza [UNIFESP]; Oliva, Samara Urban de [UNIFESP]; Miraglia, Sandra M. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Carbamazepine (CBZ) is an anti-epileptic drug that acts on Leydig cells, affecting steroidogenesis and causes fetal malformation. the aim of this study was to investigate the effects of CBZ on male sexual maturation and other male parameters. Rat dams were treated with CBZ during pregnancy and breastfeeding. the anogenital distance (AGD) and the anogenital index (AGI) were obtained. Testicular descent and preputial separation were also evaluated. the offspring was euthanized at PND 41 and 63. the accessory glands were weighed and the testes were collected for histopathological, morphometric and sterological analyses. the numerical density of Leydig cells and hormone dosage were obtained. CBZ caused an increase of AGI and a delay of testicular descent and of preputial separation. CBZ also caused a decrease of testosterone level and of sperm count and an increase of abnormal sperm. These results indicate that CBZ delays puberty onset and affects steroidogenesis and sperm quality. (C) 2013 Elsevier Inc. All rights reserved.
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    Construção de indicadores de estrutura e processo para avaliação da qualidade assistencial em aleitamento materno
    (Universidade Federal de São Paulo (UNIFESP), 2014-12-17) Diaz, Claudia Maria Gabert [UNIFESP]; D'Innocenzo, Maria [UNIFESP]; Abrão, Ana Cristina Freitas de Vilhena [UNIFESP]; http://lattes.cnpq.br/9986621531942283; http://lattes.cnpq.br/8539986249567784; http://lattes.cnpq.br/3373997310868823; Universidade Federal de São Paulo (UNIFESP)
    Essa pesquisa aborda a temática da gestão em aleitamento materno. O objetivo geral foi construir indicadores de estrutura e processo para avaliar a qualidade assistencial em aleitamento materno, na área hospitalar. E, específicos, elaborar um instrumento de avaliação da qualidade assistencial em aleitamento materno, na área hospitalar; validar o conteúdo desse instrumento, por meio da Técnica de Delphi; criar um manual operacional para mensurar a qualidade assistencial. Trata-se de uma pesquisa descritiva, de abordagem metodológica com enfoque quantitativo, que segue a linha de pesquisa ?Gestão, gerenciamento e educação em enfermagem e saúde?. Para a elaboração do instrumento foram identificados os fatores e práticas que repercutem positivamente ou não, na amamentação. Estas variáveis importantes para o cuidado de enfermagem oferecido à nutriz e ao recém-nascido foram pautadas na revisão de literatura científica nacional e internacional sobre a temática, dos últimos dez anos, bem como a experiência e vivências da pesquisadora. A validação de conteúdo do instrumento, por meio da Técnica de Delphi, foi realizada em dois ciclos por experts em aleitamento materno. Dos trinta convidados, dezesseis profissionais devolveram o instrumento preenchido, confirmando a estatística de aproximadamente 50% no primeiro ciclo e treze avaliadores no segundo ciclo. O grau de concordância ou discordância com a opinião expressa pela declaração ocorreu por meio da escala psicométrica tipo LIKERT. O consenso favorável foi de 80%, porém os resultados com percentual de concordância de 75% foram revistos por meio das sugestões e/ou comentários dos experts, agrupados e analisados para serem novamente incorporadas ao instrumento. A maioria das observações foi aceita, tais como: inclusão de referências, adequação do nome parâmetro para itens de referência, o acréscimo ou alteração de palavras nas frases; readequação do cálculo de pessoal, dentre outras. O Manual Operacional contém oito indicadores assistenciais de estrutura e oito, de processo, pautados no modelo Donabediano. Considera-se que este estudo contribui para melhoria das práticas assistenciais relacionadas ao aleitamento materno. Ressalta-se a importância de estudos posteriores para sua aplicação nos cenários assistenciais em AM, consolidando-se futuramente como um importante instrumento de avaliação.
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    O contato pele a pele e amamentação na primeira hora de vida e sua influência na prática da amamentação
    (Universidade Federal de São Paulo (UNIFESP), 2015-08-31) Saco, Marcia Carneiro [UNIFESP]; Abrão, Ana Cristina Freitas de Vilhena [UNIFESP]; Coca, Kelly Pereira [UNIFESP]; Abuchaim, Erika de Sá Vieira [UNIFESP]; http://lattes.cnpq.br/8167230363189115; http://lattes.cnpq.br/9049493842666015; http://lattes.cnpq.br/9986621531942283; http://lattes.cnpq.br/1847440355984493; Universidade Federal de São Paulo (UNIFESP)
    O contato pele a pele e/ou amamentação na primeira hora de vida (CPP/APH) aumenta os índices de aleitamento materno. Objetivos: Os objetivos do estudo em relação a esta prática foram: identificar a sua prevalência e o tipo de aleitamento materno praticado no primeiro mês de vida da criança; verificar sua associação com as características sociodemográficas, obstétricas e neonatais; e analisar sua relação com o tempo de aleitamento materno exclusivo. Método: Estudo descritivo do tipo coorte retrospectivo realizado no Ambulatório de aleitamento materno da UNIFESP ? Centro de Incentivo e Apoio à Amamentação / Banco de Leite Humano CIAAM/BLH - HSP. A população foi composta por 2.060 prontuários clínicos, sendo 1.030 de mulheres e 1.030 de crianças que compareceram à consulta de enfermagem para revisão pós-parto e aleitamento materno entre janeiro de 2004 a dezembro de 2010 no CIAAM. Foram critérios de exclusão: prontuários de mães de crianças gemelares, provenientes de adoção, devido à ausência de dados sobre o parto e aleitamento materno na primeira hora e de prontuários com ausência de informações em relação à maioria das variáveis. Utilizou-se o protocolo de consulta de aleitamento adotado nos atendimentos do CIAAM. A coleta de dados iniciou-se em dezembro de 2014, após a aprovação do Comitê de Ética em Pesquisa da UNIFESP ? CEP: 907.103 e a autorização da Coordenação do CIAAM/BLH e foi concluída em Janeiro de 2015. Para a análise multivariada, foram consideradas significantes as variáveis com valor de p<0,05. Todas as análises foram realizadas por meio da utilização do software estatístico Minitab, versão 16.1. Resultados: A prevalência do contato pele a pele e/ou a amamentação na primeira hora foi de 37,2%. O aleitamento materno exclusivo no primeiro mês de vida esteve presente em 82,1% no grupo que realizou o CPP/APH e 73,9% no grupo que não executou estas práticas e a diferença entre os grupos foi significante. A análise multivariada mostrou que a idade jovem e o parto cesáreo e fórceps foram fatores de risco para a não realização do CPP/APH. Conclusão: O apoio ao aleitamento materno deve ser iniciado no pré-natal, esclarecendo às mulheres sobre seus direitos desde o momento do nascimento até a alta hospitalar e seu seguimento no pós-parto. Uma rede de apoio ambulatorial, como o CIAAM, favorece as práticas relacionadas à continuidade do aleitamento materno após a alta, oferecendo auxílio à díade e promovendo benefícios à saúde da criança.
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    Correlation between hemoglobin levels of mothers and children on exclusive breastfeeding in the first six months of life
    (Soc Brasil Pediatria, 2016) da Silva Vieira Marques, Rosa de Fatima [UNIFESP]; de Aguiar Carrazedo Taddei, Jose Augusto [UNIFESP]; Konstantyner, Tulio [UNIFESP]; Vieira Marques, Affonso Celso; Pellegrini Braga, Josefina Aparecida [UNIFESP]
    Objective: To evaluate the correlation between hemoglobin levels of mothers and their children on exclusive breastfeeding in the first six months of life. Methods: Cross-sectional study with 221 binomials (mother-child) enrolled in a breastfeeding support program, who were stratified into six groups according to the children's age group. The sample consisted of children born at term with normal weight, with no neonatal complications and whose mothers did not have anemia or infectious disease at the time of data collection. Interviews were carried out with the mothers, blood was collected by peripheral venipuncture from mothers and children, and children's anthropometric data were assessed. Pearson's correlation coefficients between the hemoglobin levels of mothers and children were calculated. Six multiple linear regression models were adjusted with regression coefficient estimates, considering as statistically significant associations with p <= 0.05. Results: The correlation coefficients of hemoglobin levels of mothers and children ranged from 0.253, at three months, to 0.601, at five months. The hemoglobin level of mothers was correlated with the hemoglobin level of their children at four months (r = 0.578) and at five months (r = 0.601). In the adjusted multiple linear regression, the regression coefficients were higher at four months (6 = 1.134
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    Diagnóstico de Enfermagem amamentação ineficaz: Estudo de identificação e validação clínica
    (Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2005-03-01) Abrão, Ana Cristina Freitas de Vilhena [UNIFESP]; Gutiérrez, Maria Gaby Rivero de [UNIFESP]; Marin, Heimar de Fatima [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Studies conducted in validation of nursing diagnoses are very useful to the clinical practice. They can precisely establish the patient problems addressing the nursing procedures and the quality of nursing interventions delivered to the patient. The aim of the study was to identify and validate on clinical setting the defining characteristics of the ineffective breastfeeding nursing diagnosis according to North American Nursing Diagnosis Association.This is an analytical descriptive study wich was developed at a puerperium unit and a Nursing Outpatient Unit of the Federal University of São Paulo (UNIFESP) - Brazil. Sample comprises 124 women and their children in breastfeeding process. Data collection was through nursing visit carried out with mother-child binomial by using a previously elaborated and tested tool. Most of the women were single, primiparae, ranged from 20 to 29 years old, and had incomplete 1st Grade of elementary school. The most frequently identified defining characteristics were: unsatisfactory lactation process, sore nipple in the first week and lack of sustained breast sucking. Findings allowed to conclude that defining characteristics proposed by NANDA for ineffective breastfeeding diagnosis were clinicaly validated.
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    Duração do aleitamento materno e seu impacto sobre a variação da massa corporal materna durante o primeiro ano de vida de crianças pertencentes a uma coorte de nascimentos
    (Universidade Federal de São Paulo (UNIFESP), 2021) Marinho, Patricia De Menezes [UNIFESP]; Taddei, Jose Augusto De Aguiar Carrazedo [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Despite the efforts and actions to promote breastfeeding (BF), in Brazil, the estimates on its duration (exclusive and total) remains below the recommended by the World Health Organization, with gaps regarding regional, economic, social, cultural and behavioral determinants of early interruption. Furthermore, although the benefits of breastfeeding in women’s health are widely recognized, its role in post-pregnancy weight control and/or loss is not consensual in the literature, indicating the need for more studies to better understand this complex interaction. Objectives: this dissertation, consisting of two scientific papers aimed to analyze the BF duration and determinants and its impact on the variation of maternal body mass during the first year of life of children belonging to a cohort of live births in Rio Largo, Alagoas. Methods: we used data from the birth cohort “Child Health, Feeding, Nutrition and Development – HFND: a cohort study”, carried out in Rio Largo, AL., composed of children born between February and August 2017 in the only maternity in the city. Socio-demographic, economic, anthropometric and food consumption information, from mother and child, were collected at birth (up to 24 hours post-childbirth), at 3, 6 and 12 months of the child. The considered dependent variables were: (paper 1) duration of EBF and BF, analyzed by Kaplan-Meier survival curves and the risk factors for early weaning through Cox proportional hazards model and; (paper 2) maternal body mass index variation twelve months post-childbirth, the effect of BF duration (≤60/>60days) on this variation was analyzed by linear mixed-effect models. Results: the low duration of EBF and BF was evidenced, with an average of 30 (15-60) and 330 (91-365) days, respectively. The low maternal schooling (HR:1.40 [95%IC:1.04-1.87]) and cesarean section births (HR:1.41 [95%IC:1.04-1.90]) were the risk factors for early EBF weaning, while the use of pacifier (HR:2.37 [95%IC:1.62-3.48]) and child consumption, before the third month, of meals with added salt and sugar (HR:1.63 [95%IC:1.12-2.38]) composed the factors for early BF interruption. Furthermore, in the second study, the results indicate that, in the baseline, the difference between BMI measures, according to BF duration, was 1.37 kg/m² (p=0.146). Breastfeeding for a longer time had a more pronounced effect on lowering BMI at three months. Throughout the analyzed period, the BMI of women who breastfed for more than 60 days went from 26.54 kg/m² (95%IC: 25.78-27.29) to 24.49 kg/m² (95%IC: 23.73-25.25). Conclusions: BF duration was below the international recommendations, identifying risk factor sensible to change with intervention strategies in the different health attention levels. Additionally, it was observed that BF for longer was significantly associated with reduction in maternal BMI twelve months after childbirth, which reinforces the importance of this practice for mother-child health, specially in contexts of high social vulnerability.
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    Duração do efeito analgésico da fotobiomodulação na dor mamilar de puérperas em amamentação
    (Universidade Federal de São Paulo (UNIFESP), 2021) Alves, Maria dos Remedios da Silva [UNIFESP]; Coca, Kelly Pereira [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Low power laser has several benefits, such as: analgesic, antiinflammatory and tissue repair action. The device has shown promise for pain relief in women with nipple injury, but further studies are needed to demonstrate the therapeutic frequency needed to manage nipple pain. Objective: To analyze the duration of the analgesic effect of low-power red laser by comparing the level of nipple pain between women in the control and intervention groups. Method: Pilot clinical trial, double blind, randomized and controlled, carried out in the rooming-in of a low-risk philanthropic maternity hospital. Thirty-one mothers with pain and nipple injury were included, whose babies were born at term and weighed more than 2,500 grams at birth. Women were randomized into groups: control (n=16) and intervention (n=15), in addition to stratified into primiparas and multiparas in each homogenization group. The intervention was laser irradiation (MMOPTICS, Recover) red (660nm), spot area 0.03cm, power of 100mW, 2J, 66.6J/cm², irradiated in contact for 20 seconds, a point centered on the lesion in mode continuous. A numerical verbal scale was used to assess pain immediately before and after 2, 4, 6 and 8 hours of intervention. Student t-tests were used to compare the groups, the nonparametric Friedman test was used to compare pain, and the Variance test for repeated measures and the paired t-test was used for its duration. A significance level of 0.05 was considered. Result: The mean pain before laser irradiation in the Control group in the right breast was 5.2 and in the left breast, 6.3; in the Intervention group, it was 4.1 and 6.6, respectively. The analgesic effect of 4 hours after irradiation differed from the other evaluation times (p = 0.01), however there is no statistical difference in the comparison between the times. The level of pain in women suffered a gradual reduction in both groups, being higher in the experimental group, but without statistical significance. Conclusion: The analgesic effect on the studied parameters seems to last up to 4 hours. This finding may contribute to the construction of protocols with more specific posology in further research with women with pain in the presence of nipple injury.
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    EARLY WEANING and OTHER POTENTIAL RISK FACTORS for OVERWEIGHT AMONG PRESCHOOL CHILDREN
    (Hospital Clinicas, Univ São Paulo, 2010-02-01) Balaban, Geni; Motta, Maria Eugenia Farias Almeida; Pontes Silva, Giselia Alves [UNIFESP]; Univ Fed Ceara; Sch Med Juazeiro Norte; Universidade Federal de Pernambuco (UFPE); Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To investigate whether early weaning constitutes a risk factor for overweight at preschool age and to identify other factors that affect this association.METHODS: This was a case-control study of 366 children aged 2 to 6 years (176 boys and 190 girls) from three cities. the case group comprised overweight children, as defined by body mass index (BMI) for age greater than or equal to the 85(th) percentile. the main exposure analyzed was early weaning (exclusive or predominant breastfeeding for less than four months).RESULTS: Early weaning was a significant risk factor for overweight in univariate analysis (OR = 1.69; 95% CI: 1.10-2.60; p = 0.02), but not in multivariate analysis (OR = 1.42; 95% CI: 0.86-2.34; p = 0.17). Maternal overweight, birth weight >= 3,500 g and sedentarism were the main risk factors for overweight in multivariate analysis.DISCUSSION: in our study, the protective effect of breastfeeding against overweight was only shown in univariate analysis; it did not persist after controlling for other variables. It is possible that breastfeeding has only a small protective role against overweight in comparison with other variables of greater importance.CONCLUSION: Our results suggest that the potential protective effect of breastfeeding against overweight among preschool children is weaker than genetic and other environmental factors.
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    Efeitos da fotobiomodulação na cicatrização de fissuras mamárias e na redução da sensação de dor durante a amamentação entre mulheres puérperas
    (Universidade Federal de São Paulo, 2023-01-06) Parente, Beatriz Coelho Teixeira [UNIFESP]; Aveiro, Mariana Chaves [UNIFESP]; http://lattes.cnpq.br/8912160623559438; Universidade Federal de São Paulo (UNIFESP)
    Introdução: O leite materno é a principal fonte de nutrientes para os recém-nascidos, possui componentes que dão suporte nutricional e imunológico ao bebê, além de promover desenvolvimento cognitivo e vínculo entre mãe e filho. No Brasil, a maioria das crianças são amamentadas exclusivamente no máximo por dois meses, um dos motivos para o desmame precoce são as fissuras mamilares que ocasionam dor nas puérperas na hora da amamentação. A fotobiomodulação tem mostrado efeitos positivos no tratamento deste problema, porém observa-se uma carência de estudos. Objetivo: Sintetizar a evidência sobre a eficácia da fotobiomodulação no reparo tecidual de fissuras mamárias e na redução de sensação de dor durante a amamentação entre mulheres puérperas. Método: A construção desta revisão integrativa de literatura foi realizada em seis etapas: elaboração da pergunta norteadora, definição da estratégia de busca e critérios de inclusão/exclusão, busca na literatura (PUBMED, LILACS/BIREME), seleção dos artigos, análise crítica dos estudos incluídos, discussão dos resultados e apresentação da revisão integrativa. Resultados: Foram selecionados sete estudos que abordavam a temática e a partir dos resultados destes estudos identificou-se as informações relevantes para o uso de laserterapia em traumas mamilares com desfecho de reparo tecidual mamilar ou melhora na sensação da dor no período da amamentação após o uso da fotobiomodulação. Considerações finais: O uso da fotobiomodulação no cuidado e tratamento de trauma mamilar é um tema que apresenta baixa evidência para cicatrização e redução da dor durante a amamentação. Os estudos apresentaram diferentes abordagens quanto ao tipo de luz, dose, intensidade e frequência. A literatura apesar de escassa mostrou que a fotobiomodulação parece contribuir para a cicatrização de fissuras mamárias e redução da dor durante a amamentação, podendo prolongar o período de amamentação dos lactentes.
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    O estado nutricional da mulher em aleitamento materno nos primeiros 6 meses de lactação e sua influência na composição do leite humano
    (Universidade Federal de São Paulo, 2024-08-28) Castro, Lucíola Sant'Anna de [UNIFESP]; Coca, Kelly Pereira [UNIFESP]; Sañudo, Adriana [UNIFESP]; http://lattes.cnpq.br/1676711953464613; http://lattes.cnpq.br/8167230363189115; http://lattes.cnpq.br/2343198115338722
    Introdução: A adequada nutrição materna nos primeiros mil dias de uma criança, em especial da concepção até o sexto mês de vida, tem sido uma janela de oportunidades para diminuir a morbimortalidade da criança nesse período e melhorar o estado de saúde da mulher. Apesar disso, os cuidados com a saúde e nutrição materna são pouco investigados. Objetivo: avaliar a influência do estado nutricional de mulheres em aleitamento materno nos primeiros seis meses de lactação na composição do leite humano. Métodos: coorte prospectiva realizada em um serviço especializado em Aleitamento Materno com mulheres lactantes, adultas e brasileiras, entre 2020 e 2023. Foram coletadas variáveis de caracterização da população estudada, dados antropométricos, composição corporal e de consumo alimentar da mulher. Amostras de 10 ml de leite humano foram coletadas para verificar a energia e os macronutrientes por meio do analisador de leite humano. A coleta de dados foi realizada entre 15 e 30 dias, 2º, 3º, 4º e 6º mês pós-parto. Os dados foram agrupados em eutrofia, sobrepeso e obesidade, de acordo com o IMC pré-gestacional da mulher. Empregou-se as estatísticas ANOVA para as variáveis quantitativas, e teste Exato de Fisher e Qui-quadrado de Pearson para as variáveis qualitativas segundo classificação de IMC pré-gestacional; ANOVA de medidas repetidas para avaliar a evolução das variáveis quantitativas de interesse ao longo dos 180 dias pós-parto; e, correlação de Pearson para avaliar a correlação entre os dados maternos e a composição do leite humano. Para as análises inferenciais foi considerado nível de significância α igual a 5%. Resultados: Um total de 116 mulheres foram incluídas no estudo, 46,6% eram eutróficas, 36,2% sobrepeso e 17,2% com obesidade. A prática do aleitamento materno exclusivo foi de 86,2% na inclusão entre os grupos (p>0,05). A perda de seguimento no estudo variou de 16,4 a 34,5% entre o segundo e sexto mês pós-parto. No período de seis meses, as mulheres eutróficas perderam peso (p<0,001), diminuíram circunferência da cintura (p<0,001), dobra supra ilíaca (p=0,001) e massa gorda (p<0,001); mulheres com sobrepeso apresentaram perda de peso (p=0,045), diminuição da circunferência da cintura (p<0,001) e aumento da braquial (p=0,003); e as mulheres com obesidade aumentaram o peso corporal (p=0,003), circunferência braquial (p<0,001) e massa gorda (p=0,010). As mulheres apresentaram ingestão alimentar de 2537 Kcal, em média, com proporção acima do recomendado para a distribuição de lipídeos, sendo a maior ingestão de calorias pelas mulheres com sobrepeso; e, destas calorias, 24,8% corresponderam ao consumo de alimentos ultraprocessados. A composição nutricional do leite humano não apresentou associação com o estado nutricional pré-gestacional, porém os teores médios de proteínas bruta e verdadeira apresentaram uma diminuição gradativa nos três grupos (p<0,001). Houveram correlações, positiva e negativa, entre os teores de proteína bruta e verdadeira com a porcentagem de massa gorda e o índice de água corporal total da massa magra, respectivamente. E, também, correlação negativa entre a ingestão de energia, carboidrato e proteína da dieta materna e os teores de energia, gordura e carboidrato do leite humano. Conclusões: O estado nutricional pré-gestacional não interferiu na composição nutricional do leite nas mulheres estudadas, mas a composição corporal, por meio da adiposidade corporal e hidratação da massa magra, e a dieta materna apresentaram correlação com os macronutrientes e valor energético do leite humano.
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    Estado nutricional e qualidade da dieta de nutrizes em amamentação exclusiva
    (Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2013-01-01) Tavares, Miriam Paulichenco; Devincenzi, Macarena Urrestarazu [UNIFESP]; Sachs, Anita [UNIFESP]; Abrão, Ana Cristina Freitas de Vilhena [UNIFESP]; Maternidade Pro Matre Paulista; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: Identifying the nutritional status, dietary intake and diet quality of nursing mothers on exclusive breastfeeding. METHODS: Cross-sectional study carried out with nursing mothers on exclusive breastfeeding from day 28 postpartum. Standardized instruments were used, and body mass index, food consumption and diet quality were evaluated. RESULTS: The nursing mothers were overweight, presented energy consumption below the recommended and adequate percentage of macronutrients, except for protein, which was elevated. The diet was classified as needs improvement according to the Healthy Eating Index (HEI). CONCLUSION: The results show that the overweight associated with a diet of poor quality indicated possible deficiencies of micronutrients.