ABSTRACT
La alimentación al pecho materno es la mejor opción que podemos y debemos ofrecer a los lactantes durante los primeros meses de vida. Se ha perdido la cultura del amamantamiento, de la crianza natural y, posiblemente, el vínculo afectivo natural entre madres e hijos. En Bolivia, la Lactancia Materna (LM) ha sido reimpulsada desde la década de los 90 y nuevamente ocupa un lugar preferente en la atención de los profesionales y trabajadores en salud, así como de importantes grupos de opinión social, medios de comunicación y autoridades de salud. Con el objetivo de determinar los beneficios nutricionales de la LM en menores de 6 meses y el grado de conocimiento materno, se realizaron encuestas a madres con hijos/as hasta los seis meses de edad, nacidos en el Hospital La Paz que acudieron al servicio de pediatría a control de niño sano. De 380 madres encuestadas, el 84% aseguraron conocer la importancia de la lactancia materna pero únicamente el 34% tenía una información clara; en cuanto a la técnica, un 74% sostuvo que la conocía con exactitud pero al ser valoradas, sólo el 22% demostró una técnica adecuada y completa. De todas las madres, 174 (47%) afirmaron que fue un doctor o una enfermera quien les enseñó la técnica de LM. De los/as lactantes, el 58% pertenecían al sexo femenino, el 77 % recibían lactancia materna exclusiva (LME); de aquellos con LME, el 75.5% se encontraban entre los desvíos standart de 0 a +3 de las tablas peso para talla en menores de 6 meses del AEIPI-Nut, mientras que sólo el 53.2% de alimentados con lactancia materna no exclusiva (LMNE) correspondían a estos mismos desvíos y de todos los lactantes el 50% recibía un número adecuado de tomas diarias. Se ha demostrado que aquellos niños/as que reciben lactancia materna exclusiva presentan mejores curvas de crecimiento. El grado de instrucción académica y la edad materna pueden favorecer la capacidad de la mujer para comprender la importancia de la lactancia materna exclusiva en menores de 6 meses. A pesar de los esfuerzos del personal de salud todavía existen dudas acerca de la técnica adecuada de LM. Debemos fomentar la lactancia materna natural exclusiva hasta los 6 meses y seguir capacitando al personal de salud para mejorar el desarrollo y crecimiento de los niños en Bolivia.
The maternal breast feeding is the best option that we can and we must provide to infants during the first months of life. The culture of breast feeding, natural parenting, and possibly the natural emotional link between mothers and children has been lost. In Bolivia, the maternal lactation (LM) has been relaunched since the early 1990s and again occupies pride of place in the attention of professionals and workers in health, as well as large groups of social opinion, media and health authorities. With the aim of determining the nutritional benefits of the LM in children under age of 6 months and the level of maternal awareness surveys were conducted to mothers with children up to six months of age, born in Hospital La Paz who went to the paediatric Centre healthy child control. 380 Surveyed mothers, 84 per cent claimed toknow the importance of breastfeeding, but only 34% had clear information; as to technique, 74% said that it was known exactly but valued, only 22% demonstrated a technique, appropriate and complete. Of all mothers, 174 (47%) claimed that he was a doctor or a nurse who taught the technique of LM. Of the / ACE nursing, 58% were female, 77 per cent were receiving exclusive breastfeeding (LME); those with SCI, the 75.5 per cent were between diversions standart 0 to + 3 of tables weight for height in children under 6 months of the AEIPI-Nut, while that only 53.2% of fed not exclusive breastfeeding (LMNE) corresponded to these same detours and 50% of all infants received an adequate number of shots . It has shown that those children who are exclusively breastfed have better growth curves. The degree of academic instruction and the maternal age may favour women's ability to understand the importance of exclusive breastfeeding among children under age 6 months. Despite the efforts of health workers, there are still doubts about the proper technique of LM. We must encourage natural exclusive breastfeeding up to 6 months and further training of health personnel to improve the development and growth of children in Bolivia.
Subject(s)
Breast FeedingABSTRACT
The chest radiography is used routinely by the clinician as a tool in the scan of patients with systemic arterial hypertension (SAH) to evaluate the dimensions of the heart. However the highest reported sensitivity for the evaluation of heart growth with this method is 77.3% in contrast to the transthoracic echocardiogram (TTE) that reaches between 90 to 100%. The aim of this study was assess in our population of patients with SAH, the correlation between chest radiography and the TTE in regard to cardiomegaly. PATIENTS AND METHODS: Seventy two patients with SAH and radiological cardiomegaly, graded by measuring the cardiothoracic ratio (CTR), were evaluated by transthoracic echocardiography. The Pearson's and Spearman's correlation coefficients between both methods were assessed. Significance level was set at < 0.05. RESULTS: Forty one (56.9%) patients were women and 31 (43.1%) were men. The age was 62.4 +/- 10 years (43-83 years). Left ventricular concentric hypertrophy (LVCH) was found in 56 (77.8%) patients. In 13 (18%) patients the left ventricular end diastolic diameter (LVEDD) was higher than the normal value. The correlation coefficient between the diastolic ventricular septal thickness (DST) and CTR was 0.285 (p < 0.05) and between the LVEDD and radiological cardiomegaly was 0.203 (p = NS). CONCLUSIONS: In patients with SAH, the radiological evidence of cardiomegaly keeps a correlation with ventricular hypertrophy, but not with ventricular dilation.