Feeding development of children with microcephaly: a descriptive study / Desenvolvimento alimentar de crianças com microcefalia: estudo descritivo

ABSTRACT Purpose: to describe feeding characteristics of children with microcephaly, encompassing the feeding route, food consistencies, and utensils used to feed them. Methods: a descriptive study approved by the Research Ethics Committee, including 34 caregivers of children diagnosed with microcephaly. They answered a structured interview on the children's feeding route, breastfeeding, utensils used to feed them, and the food consistencies, besides sociodemographic and overall development data. Descriptive statistical analyses were performed, presenting absolute and percentage frequencies and measures of central tendency and dispersion. Results: the 34 caregivers in the sample were responsible for 34 children born between 2015 and 2018, diagnosed with microcephaly, due to various causes. Of these, 33 (97.02%) were on oral feeding in their first year of life - 26 (76.44%) on breastfeeding, nine of which (26.46%) exclusively so until 6 months old. The children were served food in baby bottles, cups, spoons, and syringes. Pureed food was the consistency most accepted by the children. Conclusions: there was a low prevalence of exclusive breastfeeding until they were 6 months old, delayed progress of consistencies, use of utensils inadequate to their age, and necessary adaptations to feed children, orally.

RESUMO Objetivo: descrever características relacionadas à alimentação de crianças com microcefalia, considerando via de alimentação, consistência e utensílios utilizados. Métodos: estudo descritivo, aprovado pelo Comitê de Ética em Pesquisa. Participaram 34 cuidadores de crianças com diagnóstico de microcefalia. Foi realizada entrevista estruturada com os cuidadores quanto à via de alimentação, amamentação, utensílios para oferta e consistência do alimento, além de aspectos sociodemográficos e de desenvolvimento global. Foi realizada análise estatística descritiva, apresentada por meio de frequências absoluta e percentual, e medidas de posição e dispersão. Resultados: os 34 cuidadores que compuseram a amostra eram responsáveis por 34 crianças nascidas entre os anos de 2015 e 2018 com diagnóstico de microcefalia de causas diversas. Dessas, 33 (97,02%) alimentaram-se por via oral durante o primeiro ano de vida, sendo que 26 (76,44%) foram amamentadas, nove delas (26,46%) de forma exclusiva até o sexto mês. Para oferta do alimento foram utilizados mamadeira, copo, colher e seringa. A consistência alimentar mais aceita pelas crianças foi a pastosa. Conclusões: observa-se baixa prevalência de aleitamento materno exclusivo até o sexto mês, atraso na progressão de consistências, uso de utensílios inadequados para a idade e necessidade de adaptações para as crianças que se mantiveram em alimentação por via oral.

Preschool Children Feeding Patterns And Early Childhood Oral Health Impact In Tanah Merah, Kelantan, Malaysia

@#Introduction: Poor feeding patterns increase risk of Early Childhood Caries (ECC), which can cause negative impacts on oral health-related quality of life (OHQoL) of preschool children and parents. This study aims to assess feeding patterns of preschool children and OHQoL of the children and their parents in Tanah Merah. Methods: A cross-sectional study was conducted involving 134 preschool children aged 5-6 years old from eight private preschools, chosen by multi-staged stratified cluster sampling. Parents answered adopted self-administered questionnaire on feeding patterns and oral health-related impacts. Mann-Whitney U test and Kruskal-Wallis test were used to compare the median between groups of feeding patterns. Results: A total of 122 parents responded. Majority of the children had history of bottle-feeding (97.5%) and being given solid food during infancy (61.2%). Many children were still using bottle to drink (38.5%). Majority were still given formula milk at least three times daily (51.1%) and were feed with bottle to put to sleep (97.9%). The Child Impact Section (CIS), Family Impact Section (FIS) and Overall ECOHIS mean scores were 2.39 (SD=3.41), 0.71 (SD=1.45) and 3.10 (SD=4.41), respectively. Most common impact reported in CIS was ‘oral pain’ (26.2%) whereas in FIS, ‘parents felt guilty’ (7.4%). None of feeding patterns were found significantly different in terms of ECOHIS score median (p-value>0.05). Children OHQoL reporting by proxy should be treated as complementary. Conclusion: Many preschool children were involved in prolonged, frequent and nocturnal bottle-feeding. No significant difference in median ECOHIS scores found according to feeding patterns.

Association between Pacifier Use, Bottle-Feeding, and Pre-Postnatal Variables: A Cohort Study

ABSTRACT Objective: To determine the prevalence and analyze the variables associated with the use of pacifiers and/or bottles by infants up to 6 months of age. Material and Methods: Data on sociodemographic characteristics, intention to offer pacifier and bottle-feeding, pregnancy and breastfeeding (BF) variables were collected at baseline by interviews and a self-administered questionnaire among pregnant women in the 3rd trimester. After delivery, mother-baby binomials were followed by phone calls at the 1st, 3rd, and 6th months of the baby's life (n=467) to gather information on the type of delivery, baby's gender, BF in the first hour of the newborn's life, baby's weight, mother's return to work, and oral habits. Association analyses were performed using logistic regression models with a 5% significance level with the pacifier/bottle-feeding use as the outcome. Results: Most mothers (52.5%) reported their babies used bottle-feeding, 48.2% used pacifiers and 33.4% used both of them throughout the 6 months. Intention to offer pacifier and bottle-feeding was reported by 45.0% and 54.8% of the mothers at the 3rd trimester of the pregnancy, respectively. Not living in one's own residence (OR=1.53; 95%CI: 1.05-2.24) and having the prenatal intention of offering a pacifier (OR=2.50; 95%CI: 1.63-3.83) to the baby were significantly associated with pacifier use. Variables significantly associated with bottle-feeding were mother's return to work (OR=2.48; 95%CI: 1.54-3.97), baby's lower birth weight (OR=1.58; IC95%: 1.07-2.33), and prenatal intention to offer bottle-feeding (OR=2.51; 95%CI 1.56-4.04). Conclusion: About half of the babies used pacifiers or were bottle-fed, which were associated with the mother's prenatal intention to offer them to their babies and socioeconomic factors.

Prevalence and Determinants of Early Childhood Caries among Children Enrolled in Anganwadi Centres in Bhilai of Central India: A Cross-Sectional Study

Introduction: Early childhood caries (ECC), which results in rapid involvement and progression of several teeth, is a growing concern in preschool children. It directly affects a child’s overall health and quality of life. Aim: To assess the prevalence and determinants of ECC among children enrolled in Anganwadi centres in Bhilai city of Chhattisgarh. Methodology: This descriptive cross?sectional study was conducted among 360 children enrolled in Anganwadi of Bhilai. An oral examination and findings were recorded in ‘dmft’ using the WHO oral health assessment form for children 2013. The mothers’ knowledge, attitude, and practice were determined by a professionally administered 10?item pre?tested short questionnaire with Cronbach’s alpha of 0.86. The data were compiled and analysed using Microsoft Excel vs. 2013 and Statistical Package of Social Science (IBM SPSS version 23; Chicago Inc., USA). Results: The prevalence of ECC was 25.83%, out of which 13.33% in boys and 12.50% in girls. Children of middle school?educated mothers have 35.48% ECC, followed by high school and primary school, that is, 24.73 and 23.66, respectively. Mothers who assisted the children in tooth brushing have less prevalence of ECC (8.15%) as compared to non?assisted (17.8%) (P = 0.044). Conclusion: Although mothers’ knowledge was appreciable regarding reasons for tooth decay, still 1/4th of the children were found to be affected by ECC. This necessitates the importance of regular/periodic screening campaigns for the children, implementing institutional preventive programmes, and referral for children to secondary/tertiary healthcare centres.

Violência entre parceiros íntimos, oferta de leite materno, substitutos e uso de mamadeiras no primeiro ano de vida / Intimate partner violence, breastfeeding, breastmilk substitutes and baby bottle use in the first year of life

Resumo O objetivo deste artigo é investigar a relação da violência física entre parceiros íntimos (VFPI) e a oferta de leite materno (LM), os substitutos do leite materno (SLM) e o uso de mamadeiras entre crianças entre 12 e 15 meses. Estudo transversal com mães em unidades de saúde do município do Rio de Janeiro, realizado entre junho de 2005 e dezembro de 2009. A VFPI foi identificada pela versão brasileira da Conflict Tactics Scales 1- Form R e as práticas de alimentação foram identificadas por recordatório de 24 horas. As associações foram verificadas por regressão logística mediante estimativas de razão de chances (RC) e intervalos de confiança de 95%. O leite materno foi ofertado a 58,5% das crianças e os substitutos do leite materno a 88,5%, e 70,5% das crianças usavam mamadeira. A violência física foi observada em 26,7% dos casais. Em lares onde os casais se agridem fisicamente há uma maior chance de não ofertar leite materno, maior chance de ofertar substitutos do leite materno e de usar mamadeira comparado aos lares onde não existe violência física. Os resultados chamam atenção para a necessidade de se investigar as relações intrafamiliares em casos que são identificadas práticas inadequadas de aleitamento, e de capacitar os profissionais de saúde para apoiar as famílias em situações de conflito.

Abstract This article aims to investigate the relationship between intimate partner physical violence (IPPV) and breastfeeding (BF), use of breastmilk substitutes (BMS) and bottle-feeding among children aged 12 to 15 months. This is a cross-sectional study with mothers in primary care facilities of the city of Rio de Janeiro. IPPV was identified by the Brazilian version of the Conflict Tactics Scales 1-Form R and feeding practices were identified by a 24-hour Dietary Recall. Associations were verified by logistic regression with odds ratio (OR) estimates and 95% confidence intervals. BF was offered to 58.5% of the children and BMS to 88.5%. Also, 70.5% of the children used a baby bottle. Physical violence was observed in 26.7% of couples. Households where couples physically abuse each other are more likely to not breastfeed (OR=2.14, p-value=0.030), to use breastmilk substitutes (OR=5.15, p-value=0.03) and bottle-feed (OR=2.71; p-value=0.01), when compared to households without physical violence. The results highlight the need to investigate intrafamily relationships in cases where inadequate breastfeeding practices are identified, and to enable health professionals to support families in conflict situations.

A study to identify knowledge, attitude and practices prevalent amongst the caregivers of children below five years presenting with acute diarrhoea in a tertiary care centre

Background: Diarrhoeal infections are the second leading cause of death worldwide in under-five children covering 9% of the total deaths. The objective of the study was to assess and compare mothers' knowledge, attitude and practice regarding prevention and management of diarrhoea in children.Methods: A cross-sectional hospital-based observational study was conducted in a tertiary centre amongst all 356 children between age group 2 months to 60 months admitted with acute watery diarrhea. A pre-tested questionnaire and face-to-face interviews with the mothers was used as a data collection tool.Results: Most of the mothers 282 (79.2%) were 20-30-year-old, 51.4% were illiterate, 57.3% were unemployed and 27.2% were daily wage labourers. 44.6% people came from rural background and 78.9% belonged to lower socio-economic strata. 30.3% were exclusively breastfed and 69.7% were on top feeds. Animal milk was taken by 62.1%, 46.6% had dilution and 50.6% used bottles for feeding. 70.5% of mothers washed their hands at the time of feeding of their child, 93.8% mother covered food in their houses while only 26.7% of mothers gave freshly cooked food. Mother's outlook on various aspects of diarrhea was sought. Very few mothers considered poor sanitation (2.5%) andcontaminated water (12.6%) as a source of diarrhea. Only 8.7% mothers knew about the role of ORS in diarrhea and maximum (53.4%) considered that diarrhea could not be avoided by any measure.Conclusions: Mother's knowledge regarding causes, management and prevention of diarrhea needs to be upgraded to allow better utilisation of health resources by the families.

Optimal feeding practices in Tamilnadu, breast feeding and complementary feeding: the reality

Background: Optimal feeding of infants under two years of age has the greatest potential impact on child survival of all preventive interventions. This study was done to evaluate feeding practices of infants in first two years of life.Methods: In this cross sectional study, 161 mothers with infants 6 mo to 24 mo of age, attending the well-baby clinic of this hospital were selected for study from April 2014 to March 2015 and interviewed using a structured questionnaire.Results: The prevalence of exclusive breastfeeding for 6 mo was 44% with a median duration of 4.9'1.8 mo. The proportion of infants who received continued breast feeding at 1 year of age (12-15 mo) was 67%. The median duration of any breast feeding was 13.6 mo by survival analysis. Early introduction of cow's milk and bottle feeding were associated with nonexclusive breast feeding under 6 mo and early termination of breast feeding.Conclusions: While rate of exclusive breast feeding was comparable to the state average (48%), there was a higher rate of introduction of cow's milk and bottle feeding which contributed to early termination of breastfeeding before one year of age. This study emphasis the fact that bottle feeding and inappropriate complementary feeding should be tackled to improve IYCF indicators in Tamilnadu.

Exclusive breastfeeding knowledge and attitude among nursing students in Beni-Suef

Background: Previous research conclude small amount of exclusive breastfeeding among the mothers of Egypt and reflect the obvious requirement for appropriate approaches to improve exclusive breastfeeding. The study objective was to evaluate the exclusive breastfeeding attitudes and knowledge among students of nursing in Beni-Suef, Egypt.Methods: A cross-sectional study was performed among 800 undergraduate students in the Faculty of Nursing at Beni-Suef University; convenience sampling was applied in this study, by anonymous self-administered questionnaire composed of 20 items to evaluate the students' knowledge, 17 items to assess attitudes towards breastfeeding and socio-demographics characteristics questions.Results: Overall the majority of study participants (80.2%) had inadequate knowledge, (54.4%) of the participants has negative attitude towards breastfeeding, a statistically significant association between gender and the score of knowledge, p=0.03. and a statistically significant association was found between the score of knowledge and attitude p=0.001.Conclusions: The conducted study illustrated inadequate knowledge and a negative attitude of undergraduate nursing students of University of Beni- Suef to exclusive breastfeeding.

Parents’ Knowledge and Children’s Feeding Patterns in Relation to Caries Experiences

@#This study aims to assess the association of parents’ knowledge, children’s feeding pattern, and other contributing factors with caries experience of a child. This was a cross-sectional study using a validated questionnaire of 145 children aged two to eight years old attending the Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Malaysia. The questionnaires were given to the parents during their children’s dental visit in paediatric clinic and primary care. Dental caries was traced from the patient’s record in the Integrated Dental Records Management System (IDERMS) and clinical examination was done for those who did not have the dental record. Charting was recorded using dentition status and treatment need based on the 1997 World Health Organization (WHO) criteria. Data were analysed using the independent t-test and one-way ANOVA to examine the association of dental caries with two and three or more categorical variables respectively using SPSS 23.0. The study participants were 74 (51%) boys and 71 (49%) girls. The mean dmft score of the participants was 3.31 (4.36). Caries experience was statistically significant with the reason for first dental visit (p < 0.001), the age of the children discontinues bottle-feeding (p < 0.001), habits of leaving bottle-feeding while sleeping (p = 0.011), children wake up for milk at night (p = 0.050) and knowledge of parents on the effect of leaving bottle while sleeping (p = 0.037). Children feeding patterns and parents’ knowledge of the risk factors of dental caries were significantly associated with caries experience among children aged two to eight years old.

Conhecimento de mães sobre formas de aleitamento e hábitos deletérios / Knowledge of mothers about forms of breastfeeding and deleterious habits / Conocimiento de madres sobre formas de lactancia y hábitos deletéreos

Introdução: O aleitamento materno exclusivo é fundamental até os seis meses, pois além de promover a saúde integral para o bebê, auxilia no desenvolvimento craniofacial e nas funções estomatognáticas. Objetivo: Investigar o conhecimento das mães sobre aleitamento materno, hábitos orais deletérios e outros métodos para ofertar a dieta ao bebê. Método: Trata-se de um estudo descritivo de caráter quantitativo. Foi aplicado um questionário semiestruturado com perguntas abertas e fechadas, em 80 mães de uma Clínica Escola de Fonoaudiologia, no período de junho a setembro de 2017. Resultados: 66,3% das mães possui idade entre 18 a 30 anos, 98,8% realizou pré-natal, 63,8% realizou aleitamento materno exclusivo até os seis meses de idade, a maioria (88,8%) demonstrou conhecimento acerca da amamentação exclusiva e 72,5% receberam informações sobre o aleitamento no hospital, 43,8% receberam informações sobre o uso da chupeta e 27,5% quanto ao uso da mamadeira. Observou-se que a mamadeira é a segunda forma mais conhecida para ofertar leite ao bebê, totalizando 52,7%. Em relação ao profissional que mais orientou sobre a amamentação, hábitos orais deletérios e utensílios de alimentação foi o enfermeiro (57,5%) e apenas 16,30% receberam orientações de fonoaudiólogos. Conclusão: Pode-se concluir que há grande adesão do aleitamento materno exclusivo, porém há ainda uma parcela que não realiza desta forma. As mães possuem conhecimento em relação à chupeta, mamadeira, aleitamento materno e outras formas de aleitar, porém, as informações sobre o Sistema Estomatognático estão escassas. Verificou-se que não houve muita atuação do fonoaudiólogo com essa população. Vale ressaltar que há maior número de enfermeiros, em comparação com o número de fonoaudiólogos.

Introduction: Exclusive breastfeeding is essential until six months, because in addition to promoting integral health for the baby, it assists in craniofacial development and stomatognathic functions. Objective: To investigate the knowledge of mothers about breastfeeding, harmful oral habits and other methods to offer the diet to the baby. Method: This is a descriptive quantitative study. A semi-structured questionnaire with open and closed questions was applied to 80 mothers of a Speech-Language Pathology Clinic from June to September 2017. Results: 66.3% of the mothers were between 18 and 30 years old, 98.8%. performed prenatal care, 63.8% performed exclusive breastfeeding until six months of age, most (88.8%) demonstrated knowledge about exclusive breastfeeding and 72.5% received information about breastfeeding in the hospital, 43.8% received information on pacifier use and 27.5% regarding bottle use. It was observed that the bottle is the second best known way to offer milk to the baby, totaling 52.7%. Regarding the professional who advised the most about breastfeeding, harmful oral habits and feeding utensils was the nurse (57.5%) and only 16.30% received guidance from speech therapists. Conclusion: It can be concluded that there is high adherence to exclusive breastfeeding, but there is still a portion that does not perform this way. Mothers have knowledge regarding pacifiers, bottles, breastfeeding and other forms of breastfeeding, but information about the stomatognathic system is scarce. It was found that there was not much performance of the speech therapist with this population. It is noteworthy that there are more nurses compared to the number of speech therapists.

Introducción: La lactancia materna exclusiva es esencial hasta seis meses porque, además de promover la salud integral del bebé, ayuda en el desarrollo craneofacial y las funciones estomatognáticas. Objetivo: Investigar el conocimiento de las madres sobre la lactancia materna, los hábitos orales nocivos y otros métodos para ofrecer la dieta al bebé. Método: Este es un estudio cuantitativo descriptivo. Se aplicó un cuestionario semiestructurado con preguntas abiertas y cerradas a 80 madres de una Clínica de Patología del Habla y Lenguaje de junio a septiembre de 2017. Resultados: 66.3% de las madres tenían entre 18 y 30 años, 98.8%. realizó atención prenatal, 63.8% realizó lactancia materna exclusiva hasta los seis meses de edad, la mayoría 88.8% demostró conocimiento sobre lactancia materna exclusiva y 72.5% recibió información sobre lactancia materna en el hospital, 43.8% recibió información sobre el uso de chupetes y 27.5% sobre el uso de biberones. Se observó que el biberón es la segunda forma más conocida de ofrecer leche al bebé, con un total de 52.7%. En cuanto al profesional que más aconsejó sobre la lactancia materna, los hábitos orales nocivos y los utensilios de alimentación fue la enfermera el 57.5% y solo el 16.30% recibió orientación de los logopedas. Conclusión: Se puede concluir que existe una alta adherencia a la lactancia materna exclusiva, pero todavía hay una porción que no funciona de esta manera. Las madres tienen conocimientos sobre chupetes, biberones, lactancia materna y otras formas de lactancia materna, pero la información sobre el sistema estomatognático es escasa. Se descubrió que no había mucho rendimiento del terapeuta del habla con esta población. Es de destacar que hay más enfermeras en comparación con el número de logopedas.

An Interventional Study to Enumerate the Causes of Lactation Failure, its Prevention and Management

Background: Three quarters of the world’s population living in developing countries migrated from rural to an urban area.Since the health professionals are concentrated in the urban areas, the existing health services cater to only 20% of the ruralpopulation. Hence, there is an increased risk of bottle feeding in both urban and rural areas. There is a sharp decline in thepractice of breastfeeding and an increase in the number of infants being artificially fed. In India, there is a decrease in theincidence of exclusive breastfeeding.Aim: The aim of the study was to study an intensive educational program for mothers in the antenatal period, immediatepostpartum period and during follow-up for 4–5 months in a tertiary care institute, and to achieve an exclusive breastfeedingrate of 80% among the mothers and study the impact of the intervention program.Methodology: A prospective randomized study was done allocating the mothers into two groups – study and control group.Conclusion: Exclusive breastfeeding has shown a definite decline globally. The practice of breastfeeding is downbut definitely not out. Hence, it becomes our duty as health-care providers to teach mothers about the importance ofbreastfeeding. In the present study, even though a majority of mothers had adequate knowledge about breastfeeding,many of them did not practice what they knew. Hence, we should try to analyze the factors which hinder their breastfeedingpractice.

Can moms give up bottle feeding?: retrospective analytic study to promote breast feeding

Background: Bottle feeding is one of the preventable causes of morbidity and mortality in infants and young children. Children admitted in our hospital analyzed at our center and appropriate advice and guidance for cessation of bottle feeding was given. The objective of this study was to analyses the feeding pattern and the reasons for bottle feeding in children and to help mothers to try and give up bottle feeding and initiate breast feeding.Methods: Retrospective analysis of 200 children less than 2 years admitted to Shri B M Patil hospital for various illnesses was done. Children were divided into 2 groups mainly breast-fed children and bottle-fed group. Both groups were analysed with respect incidence of infection, reason for bottle feeding, age of introduction of bottle feeding, time taken by mother to give up bottle feeing and type of compatible feeding at the time of discharge.Results: All the mothers could give up bottle feeding in less than 7 days during the hospital stay. 81 mothers were able to initiate breastfeeding of which 4 mothers were able to exclusively breastfeed at the time of discharge. 66 mothers were not able to initiate breastfeeding.71% of children received help with drip-drip method of feeding. Breast refusal was the cause of bottle feeding in 40.13% (59/147) of babies.Conclusions: Bottle fed children were more prone to infections. All the mothers gave up bottle feeding within 1 week. Drip drop method was the most effective strategy for initiation of breastfeeding.

Feeding Practices of Potential Risk to Dental Caries in Early Childhood and its Relationship with Sociodemographic Variables and Prematurity

Objective: To verify the relationship of feeding practices of potential risk to dental caries in early childhood with sociodemographic variables, prematurity and Neonatal Intensive Care Unit admission (NICU). Material and Methods: Data from medical records of infants and preschool children, including feeding practices (breastfeeding, bottle feeding, feeding during sleep, introduction and frequency of sugar use), sociodemographic variables, prematurity and NICU admission were collected. Chi-square, Fisher and Maximum Likelihood Ratio tests were used. Results: The number of medical records was 222 in the age group of 01-45 months. Breastfeeding was not present in 66.7% of preterm infants (p=0.003) and 66.1% of infants admitted at NICU (p=0.011). The use of feeding bottle occurred in 58.4% of infants whose mothers work / study; 58.4% of preterm infants and 60.9% of children admitted at NICU (p<0.001). Feeding during sleep occurred in 70.5% of infants aged 1-24 months (p<0.001); 51.4% were single children (p=0.010) and 76.7% did not attend daycare centers (p=0.003). The introduction of sugar occurred in 60.6% in the age group of 01-24 months. The use of sugar more than 3x / day occurred in 52.6% of infants aged 25-45 months (p=0.003) and; 51.8% with mothers whose schooling corresponded to elementary school (p=0.039). Conclusion: Among caries-risk feeding practices, there was relationship between breastfeeding and prematurity and NICU admission; use of feeding bottle and mothers who worked and / or studied, prematurity and NICU admission; feeding during sleep and younger children, single child and those who did not attend daycare centers; and higher frequency of sugar use and older infants, and maternal schooling corresponding to elementary school.

Efficacy of Oral Rehabilitation Therapy in Terms of Neonatal Outcomes in Preterm Infants

PURPOSE: To evaluate the efficacy of oral rehabilitation therapy (ORT) in terms of prematurity-associated morbidities in preterm infants born before a gestational age of 33 weeks. METHODS: This was a single-institution retrospective case-control study including 78 high-risk preterm infants born between January 2015 and December 2016, who were administered with ORT for at least 15 minutes, 2 to 5 times/week by an occupational therapist. Various factors associated with feeding progression and neonatal morbidities were compared between the two groups. RESULTS: Seventy-eight subjects, of whom 39 were cases and 39 controls, were included in this study. Infants in the case group achieved a greater total feeding volume (122.9±85.3 mL vs. 48.9±25.7 mL, P<0.001), i.e., 8 times/day with oral feeding only, and showed significantly higher body weight (1,852.1±303.3 g vs. 1,592.3±444.1 g, P=0.003) than those in the control group with complete oral feeding day. The duration from the first day of oral feeding to full enteral feeding, i.e., 150 mL/day, was significantly shorter in the cases than that in the controls (15.4±1.4 days vs. 23.1±1.8 days, P=0.004). The body weight at discharge was higher in the cases than that in the controls (3,102.6± 619.3 g vs. 2,744.6± 436.8 g, P=0.008). Moreover, the incidence of late-onset sepsis was lower in the cases than that in the controls (12.8% vs. 25.6%, P=0.033). Other prematurity-associated morbidities were not different between the two groups. CONCLUSION: ORT in preterm infants facilitated the transition process from tube feeding to full oral feeding and reduced the incidence of late-onset sepsis.

Marcadores de consumo alimentar e baixo peso em crianças menores de 6 meses acompanhadas no Sistema de Vigilância Alimentar e Nutricional, Brasil, 2015 / Marcadores de consumo alimentario y bajo peso en menores de 6 meses, acompañados por el Sistema de Vigilancia Alimentaria y Nutricional, Brasil, 2015 / Food intake and underweight markers in children under 6 months old monitored via the Food and Nutrition Surveillance System, Brazil, 2015

Objetivo: investigar a frequência de aleitamento materno exclusivo, a introdução precoce de outros alimentos e a associação com o baixo peso em crianças brasileiras. Métodos: analisaram-se registros de menores de 6 meses com dados inseridos no Sistema de Vigilância Alimentar e Nutricional em 2015; investigaram-se associações, por regressão de Poisson. Resultados: encontraram-se prevalências de aleitamento exclusivo, 56,1% (IC95% 55,3;56,8), baixo peso para idade, 8,1% (IC95% 7,7;8,5), e baixo índice de massa corporal (IMC) para idade, 5,7% (IC95% 5,3;6,7); agua ou chás e fórmulas infantis foram os alimentos introduzidos mais precocemente; crianças em aleitamento materno exclusivo apresentaram menor prevalência de baixo peso (RP=0,73 - IC95% 0,61;0,87) e de baixo IMC (RP=0,69 - IC95% 0,56;0,85); o consumo de fórmulas infantis se associou ao deficit de peso (RP=1,35 - IC95% 1,15;1,58). Conclusão: reforçou-se a importância do aleitamento materno exclusivo para o adequado crescimento até os 6 meses.

Objetivo: investigar la frecuencia de la lactancia materna exclusiva, la introducción precoz de otros alimentos y su asociación con el bajo peso en niños brasileños. Métodos: se analizaron registros de menores de seis meses con datos insertados en el Sistema de Vigilancia Alimentaria y Nutricional en 2015; se investigaron las asociaciones por medio de la Regresión de Poisson. Resultados: se hallaron prevalencias de lactancia exclusiva, 56,1% (IC95% 55,3;56,8), bajo peso para la edad, 8,1% (IC95% 7,7;8,5), y bajo Índice de Masa Corporal (IMC) para la edad, 5,7% (IC95% 5,3;6,7); agua o tés y fórmulas infantiles fueron los alimentos introducidos más precozmente; los niños en lactancia materna exclusiva presentaron menor prevalencia de bajo peso (RP=0,73 - IC95% 0,61;0,87) y de bajo IMC (RP=0,69 - IC95% 0,56;0,85); el consumo de fórmulas se asoció al deficit de peso (RP=1,35 - IC95% 1,15;1,58). Conclusión: se ha reforzado la importancia de la lactancia materna exclusiva para el adecuado crecimiento has los 6 meses.

Objective: to investigate the frequency of exclusive breastfeeding, early introduction of other foods and association with prevalence of low weight in Brazilian children. Methods: we analyzed records of children under 6 months of age held on the Food and Nutrition Surveillance System for the year 2015; associations were investigated through Poisson Regression. Results: we found prevalence of 56.1% (95%CI 55.3;56.8) for exclusive breastfeeding, 8.1% (95%CI 7.7;8.5) for low weight for age, and 5.7% (95%CI 5.3;6.7) for low BMI for age; water or teas and infant formulas were the earliest foods introduced; underweight prevalence was lower (PR=0.73 - 95%CI 0.61;0.87) as was prevalence of low BMI (PR=0.69 - 95%CI 0.56;0.85) among exclusively breastfed infants; infant formula intake was associated with low weight (PR=1.35 - 95%CI 1.15;1.58). Conclusion: the importance of exclusive breastfeeding for adequate growth in the first 6 months of life was reinforced.

Association Between Early Childhood Caries and Feeding Pattern in 3- to 5-Year-Old Children in Grogol Utara, South Jakarta

Abstract Objective: To evaluate the relationship between the feeding method and early childhood caries (ECC) in children aged 3-5 years. Material and Methods: An observational study using a cross-sectional approach and convenience sampling method was performed on 165 children aged 36-71 months from eight kindergartens in Grogol Utara, Indonesia. Data on feeding and oral hygiene behavior patterns were obtained through interviews using a structured questionnaire, and an oral examination was performed to collect information on oral health using the decayed, extracted, filled surface and plaque indices. The oral examination was performed by two examiners who were calibrated for intra- and interobserver reliability (Kappa = 0.9) Results: The prevalence of dental caries was 83%, with mean values of decayed, extracted, filled teeth (deft) and of defs being 6.2 and 14.8, respectively. The prevalence of children with anterior dental caries was higher than that of children with posterior-only dental caries. The most severely affected teeth were maxillary central incisors (right = 62.4%; left = 61.2%), followed by maxillary lateral incisors (right = 49.1%; left = 44.2%). The caries pattern was almost symmetrical across the arches. There were significant differences between breastfeeding methods with anterior (p<0.05), but not with posterior dental caries. The complementary feeding initiation age was significantly different between anterior and posterior teeth caries groups (p<0.05), but complementary food type after tooth eruption and infant formula frequency were related only to anterior dental caries (p<0.05) Conclusion: The patterns of breastfeeding and complementary feeding were related to dental caries in anterior and posterior teeth. The feeding method that increases the ECC score in anterior and posterior teeth was the age at initiation of complementary feeding.

Association between pacifier use and bottle-feeding and unfavorable behaviors during breastfeeding / Associação entre uso de chupeta e mamadeira e comportamentos desfavoráveis à amamentação durante as mamadas

Abstract Objective: To investigate the association between pacifier use and bottle-feeding and unfavorable behaviors during breastfeeding. Method: A cross-sectional study was conducted with 427 babies/mothers. Socio-demographic, perinatal data, and information about the use of artificial nipples (pacifier and/or bottle) were collected through a questionnaire. The breastfeeding aspects regarding position, affectivity, sucking behavior, baby responses, and breast anatomy were evaluated through observation during breastfeeding. The chi-squared test and the multiple linear regression analysis were used to investigate the association between the variables. Results: The aspects of breastfeeding that showed higher percentages of the category "poor" were sucking behavior (22.5%) and position (22.2%). The group of infants who used pacifiers and/or bottle showed higher percentages in the poor and fair categories when compared with the good category for all five breastfeeding aspects evaluated (p < 0.001). The linear regression analysis revealed that the increase in the number of unfavorable behaviors regarding position, affectivity, sucking behavior, and baby responses were independently associated with both pacifier and bottle use (β positive, p < 0.05), while breast anatomy was independently associated only with bottle use. Conclusion: The findings suggest that the use of pacifiers and/or bottle-feeding may be associated with unfavorable behaviors during breastfeeding, especially the use of bottle-feeding.

Resumo Objetivo: Investigar a associação entre uso de chupeta e mamadeira e comportamentos desfavoráveis à amamentação durante as mamadas. Métodos: Um estudo transversal foi conduzido com 427 bebês/mães. Foram coletados dados sociodemográficos, perinatais e sobre o uso de bicos artificiais (chupeta e/ou mamadeira) através de questionário. Os aspectos de amamentação referentes à posição, afetividade, adequação da sucção, respostas do bebê e anatomia das mamas foram avaliados através da observação durante a mamada. O teste qui-quadrado e a análise de regressão linear múltipla foram usados para investigar associação entre as variáveis. Resultados: Os aspectos de amamentação que apresentaram percentuais mais elevados da categoria ruim foram a adequação da sucção (22,5%) e posição (22,2%). O grupo de bebês que usavam chupeta e/ou mamadeira apresentou percentuais mais elevados nas categorias ruim e regular quando comparados com a categoria bom para todos os cinco aspectos da amamentação avaliados (p < 0,001). A análise de regressão linear revelou que o incremento do número de comportamentos desfavoráveis referentes à posição, afetividade, adequação da sucção e respostas do bebê estavam associados de forma independente tanto ao uso de chupeta quanto ao uso de mamadeira (β positivo, p < 0,05), enquanto que anatomia das mamas estava associado de forma independente apenas com o uso de mamadeira. Conclusão: Os achados sugerem que o uso de chupeta e/ou mamadeira pode estar associado a comportamentos desfavoráveis durante amamentação, em especial o uso de mamadeira.

Preterm birth, pacifier use and breastfeeding: is there a relationship?

Abstract The immaturity of born to preterm infants may predispose to sucking difficulties. This research aimed to evaluate if pacifier use is associated with preterm birth and influenced in type of infant feeding. This comparative cross-sectional study was conducted in Belo Horizonte, Brazil and evaluated 250 children aged 3 to 5 years. As a sample, two groups were established: the normal term children group (n=125) was selected at a day-care centre and the group of preterm children (125) was identified at a public university hospital with a preterm care project from birth to seven years of age. To collect data, a pre-tested questionnaire regarding information on gestational age, infant development, infant feeding and non-nutritive sucking habits was used for both groups. Bivariate and multivariate Poisson regression was used for the statistical analysis. Pacifier use was more prevalent in the preterm group (PR=1.20, 95% CI=1.02-1.42) who used the bottle (PR=1.38, 95% CI=1.15-1.64) and were breastfed for less than six months (PR=1.19, 95% CI=1.01-1.41). The majority of breastfed infants were of normal term birth (PR=1.14, 95% CI=1.04-1.20) and had monthly family income greater than USD 450.28 (RP= 1.10, 95% CI=1.01-1.20). In this study, pacifier use was more prevalent among preterm infants and associated with less than six months of breastfeeding and used of bottle. Monthly family income was associated with a prevalence of breastfeeding.

Resumo A imaturidade no nascimento para pretermos pode os predispor a dificuldades de sucção. Esta pesquisa teve como objetivo avaliar se o uso de chupeta está associado ao nascimento prematuro e ao tipo de alimentação infantil. Este estudo transversal comparativo foi realizado em Belo Horizonte, Brasil e avaliou 250 crianças de 3 a 5 anos. A amostra foi composta por dois grupos: o grupo de crianças nascidas a termo (n = 125) que foi selecionado em uma creche e o grupo de crianças pré-termo (125) que foi contatado em um hospital universitário público vinculado a um projeto de cuidados pré-termo desde o nascimento até os sete anos de idade. Para coletar dados, um questionário pretextado sobre informações da idade gestacional, desenvolvimento infantil, alimentação infantil e hábitos de sucção não nutritiva foram utilizados para ambos os grupos. Análises bivariada e Regressão de Poisson multivariada foram utilizadas para a análise estatística. O uso de chupeta foi mais prevalente no grupo pré-termo (RP = 1,20, IC95% = 1,02-1,42), que usou a mamadeira (RP = 1,38; IC95% = 1,15-1,64) e foram amamentados ao seio por menos de seis meses (RP = 1,19, 95% IC = 1,01-1,41). A maioria das crianças amamentadas ao seio nasceram a termo (RP = 1,14, 95% IC = 1,04-1,20) e com renda familiar mensal maior que USD 450,28 (RP = 1,10, 95% IC = 1,01-1,20). Neste estudo, o uso de chupeta foi mais prevalente entre os prematuros e associado com a amamentação ao seio por menos de seis meses e uso de mamadeira. A renda familiar mensal associou-se a uma prevalência de prática da amamentação ao seio.

Prevalence and risk-factors of early childhood caries among 2–6-year-old Anganwadi children in Nellore district, Andhra Pradesh, India: A cross-sectional survey

The objective of this study is to study the prevalence and associated risk determinants of early childhood caries (ECC) among preschool children. Materials and Methods: A cross-sectional descriptive study was designed to assess the ECC prevalence and associated risk factors among preschool children in Anganwadi of Nellore district using a standardized questionnaire. Results: A total of 550 study participants of age 2–6 years are enrolled in this cross-sectional study. Mean age of the participants was 4.39 ± 0.89 years. Most of the study participants (38%) were in the age of 5 years. When gender wise comparison was made girls represented 62% and boys 38% of the total population. When the risk factors were assessed for their association with caries experience, socioeconomic status, mother's schooling at child's birth, duration of using bottle, and bottle feeding while sleeping and plaque scores showed significant association with caries experience. Conclusion: ECC was more prevalent among 5-year-old children as compared to other age groups and moreover demographic factors such as mother's occupation, education, socioeconomic status, developmental characteristics such as enamel hypoplasia, feeding habits like prolonged and nocturnal bottle feeding and clinical parameters like plaque scores showed significant correlation with ECC.

Tempo de transição alimentar na técnica sonda-peito em recém-nascidos baixo peso do Método Canguru / Intervention time until discharge for newborns on transition from gavage to exclusive oral feeding

RESUMO Objetivo Verificar o tempo despendido na transição da alimentação por gavagem para via oral exclusiva, na técnica sonda-peito, comparando RNs baixo peso, considerando suas intercorrências clínicas/médicas, submetidos ao peito exclusivo com aqueles que, além do peito, receberam complemento por copo/mamadeira. Método Estudo de coorte, analítico e longitudinal, com 165 RNs, divididos quanto à gravidade de intercorrências clínicas (G1 e G2) e quanto à via de dieta (A e B). Todos RNs eram baixo peso, do Método Canguru, estimulados no peito, conforme prescrição médica e rotina hospitalar. Pertenciam ao subgrupo A: RNs estimulados exclusivamente no peito, que mantiveram peito exclusivo no momento da alta, e ao subgrupo B: RNs que utilizaram copo/mamadeira em algum momento da internação hospitalar em complementação ao peito. Foi registrado o número de dias que o RN permaneceu em cada etapa da transição. Resultados O histórico de intercorrências médicas influenciou significativamente o tempo total de transição. Subgrupos G1-A (10 dias), G1-B (9 dias) e G2-A (12 dias), quando comparados ao grupo G2-B(16 dias), evidenciaram maior chance de alta antecipada. Conclusão RNs sem intercorrências clínicas importantes apresentaram chance de alta mais breve. RNs com intercorrências clínicas, que fizeram a transição da gavagem exclusivamente no peito, tiveram tempo de transição menor que aqueles que utilizaram complementação por copo/mamadeira. A transição alimentar pela técnica sonda-peito é importante para ser preconizada na atuação fonoaudiológica em Neonatologia.

ABSTRACT Purpose Measure the intervention time required for transition from gavage to exclusive oral feeding, comparing newborns exposed exclusively to the mother's breast with those who, in addition to breastfeeding, received supplementation using a cup or baby bottle. Methods Analytical, longitudinal, cohort study conducted with 165 newborns (NB) divided into groups according to severity of medical complications (G1-with no complications; G2-with significant complications), and into subgroups according to feeding mechanism (A and B). All NBs were low birth weight, on Kangaroo Mother Care, and breast stimulated according to medical prescription and hospital routine. Regarding feeding pattern, subgroup A comprised NBs exclusively breastfed at hospital discharge, whereas subgroup B was composed of NBs fed through cup/bottle at some time during hospitalization. The number of days spent in each stage of transition was recorded for each NB. Results History of clinical complications significantly influenced total intervention time. Study participants in subgroups G1-A (10 days), G1-B (9 days), and G2-A (12 days) displayed greater chances of early discharge compared with those in subgroup G2-B (16 days). Conclusion NBs with no important history of clinical complications displayed greater chances of early hospital discharge. NBs with significant history of clinical complications that underwent gavage to exclusive breastfeeding transition presented smaller intervention time than those that required supplementation using cup/bottle. Feeding transition using the gavage-to-exclusive oral feeding technique is recommended for Speech-language Pathology practice in Neonatology.