A segurança dos alimentos nos Centros de Tradições Gaúchas do Rio Grande do Sul / Food safety in the Centros de Tradições Gaúchas of Rio Grande do Sul

Os Centros de Tradições Gaúchas (CTG) são entidades de divulgação e perpetuação da cultura do Rio Grande do Sul. A produção de refeições nessas entidades ocorre nos ensaios dos grupos de danças tradicionais e nos eventos oferecidos à comunidade, como jantares. Sabendo do impacto das doenças transmitidas por alimentos (DTA) na saúde humana, o objetivo deste trabalho é identificar a adequação dos CTG às boas práticas para manipulação de alimentos (BPM), explorar quem são os responsáveis pelas atividades de manipulação de alimentos e identificar a frequência e o número da produção de refeições servidas nessas instituições. A Portaria SES-RS nº 78/2009 e um questionário de coleta de dados dos grupos de dança e da produção de refeições foram aplicados em 5 CTG do Rio Grande do Sul. Outros 17 CTG do estado responderam a um segundo questionário, semelhante ao primeiro, com adição de perguntas sobre controle sanitário. Obteve-se uma média de adequação às BPM de 38% entre os CTG. Verificou-se que são servidas, em média, 4 refeições por semana entre os ensaios das invernadas artísticas próximos a competições. Em 36% dos CTG, ocorrem de 2 a 3 eventos por trimestre com produção de refeições. Em 45% dos CTG, são servidas de 100 a 200 pessoas nos eventos. Em relação aos trabalhos na cozinha, apenas 23,5% dos CTG têm como responsáveis dessas atividades pessoas devidamente capacitadas. Sendo os CTG instituições sem fins lucrativos, a criação de programas para a garantia do alimento seguro nesses espaços se faz necessária.

Centros de Tradições Gaúchas (CTG) are entities for the dissemination and perpetuation of Rio Grande do Sul culture. The production of meals in these entities takes place in the rehearsals of traditional dance groups and in events offered to the community, such as dinners. Knowing the impact of the foodborne diseases in human health, the objective of this work is to identify the adequacy of CTG to good food handling practices, to explore who are responsibles for food handling activities and identify the frequency and number of meals served in these institutions. The Portaria SES-RS No. 78/2009 and a questionnaire for data collection from dance groups and meals production were applied in 5 CTG in Rio Grande do Sul. Another 17 CTG in the state answered a second questionnaire, similar to the first, with the addition of questions about sanitary control. The average compliance with good practices was 38% among the CTG. It was found that, on average, 4 meals are served per week between rehearsals of the dance groups close to competitions. In 36% of the CTG, 2 to 3 events are held per quarter with production of meals. In 45% of the CTG, the number of people served at the events varies from 100 to 200. Regarding the work in the kitchen, only 23.5% of the CTG have duly trained people for these activities. Given that CTG are non-profit institutions, the creation of programs to ensure food safety in these spaces is necessary.

Evaluación de las conductas de lactancia materna y las prácticas de alimentación complementaria de las madres turcas y las madres refugiadas sirias / Evaluation of breastfeeding behaviors and complementary feeding practices of Turkish and Syrian refugee mothers

Objetivos: el objetivo de este estudio fue comparar la lactancia y los factores relacionados (edad, nivel educativo, edad al momento del primer embarazo, etc.) y las prácticas de alimentación complementaria de las madres refugiadas sirias y las madres turcas. Materiales y métodos: este estudio descriptivo y comparativo analizó las características nutricionales de los bebés de 9 a 60 meses de edad cuyas madres fueran turcas o refugiadas sirias que asistieron al Hospital Público de Kiziltepe entre enero y julio de 2022. Resultados: se incluyó a 204 madres (126 turcas y 78 sirias). La edad promedio de las madres turcas era 27,60 ± 5,17 años y la de las refugiadas sirias, 28,91 ± 5,62 años, sin una diferencia significativa entre ambos grupos (p: 0,091). La lactancia materna posparto fue del 91,3 % y la duración de la lactancia fue de 12 meses (0-24) en las ciudadanas turcas, mientras que, en las refugiadas sirias, fue del 84,6 % y 9 meses (0-24), respectivamente (consumo de leche materna, p: 0,144; tiempo de consumo, p: 0,161; sin diferencias estadísticas). El 23,8 % de las ciudadanas turcas y el 5,1 % de las refugiadas sirias recibieron capacitación sobre la lactancia, con una diferencia significativa entre ambos grupos (p: 0,001). Conclusión: en los grupos de refugiadas, las prácticas de nutrición infantil y materna se ven alteradas. En colaboración con las organizaciones locales e internacionales y los organismos estatales que ayudan a los grupos de refugiados se podrían mejorar las prácticas de nutrición maternoinfantil y reducir las brechas.

Objectives: The purpose of this study was to compare breastfeeding and related factors (age, level of education, age at first pregnancy, etc.), and complementary feeding practices between Syrian refugee and native Turkish mothers. Material and methods: This descriptive-comparative study examined the nutritional characteristics of infants aged 9 to 60 months whose mothers were Turkish or Syrian refugees who attended Kiziltepe State Hospital between January 2022 and July 2022. Results: 204 mothers (126 Turkish and 78 Syrian) who had a child aged 9-60 months were included. The average age of the mothers was 27.60 ± 5.17 years for Turkish citizens and 28.91 ± 5.62 for Syrian refugees, without significant difference between the two groups (p: 0.091). Postpartum breastfeeding was 91.3% and breastfeeding duration was 12 (0-24) months in Turkish citizens; in Syrian refugees, breastfeeding was 84.6% and average breastfeeding time was 9 (0- 24) months (respectively, breast milk intake p: 0.144, uptake time p: 0.161; no statistical difference). Breastfeeding training was received by 23.8% of Turkish citizens and 5.1% of Syrian refugees; there was a significant difference between the two groups (p: 0.001). Conclusion: In refugee groups, infant and maternal nutrition practices are disrupted. Working in conjunction with local and international organizations and state agencies that give help to refugee groups, the appropriate interventions, initiatives, supports, and awareness-raising activities would strive to improve practices in mother and baby nutrition and narrow gaps.

A importância da alimentação e nutrição para indivíduos com enxaqueca / La importancia de la alimentación y nutrición para personas con jaqueca / The importance of food and nutrition for people with chronic migraines

Introdução: As cefaleias são consideradas um importante problema de saúde pública e estima-se que são a segunda queixa mais comum de dor, sendo a enxaqueca uma das mais presentes. O tratamento da enxaqueca pode ser sintomático ou profilático, a fim de reduzir os sintomas em períodos de crise e evitar que novas crises se instalem, destacando a importância da adoção de hábitos saudáveis e uma alimentação equilibrada. Objetivo: O objetivo deste estudo foi realizar uma revisão integrativa da literatura, destacando os principais achados sobre a importância da alimentação e nutrição para indivíduos acometidos pela enxaqueca. Metodologia: foi realizado um levantamento de estudos nas bases de dados: Biblioteca Virtual em Saúde (BVS); Medline, LILACS, SciELO e Google Acadêmico, além de ter sido considerada a lista de referências dos trabalhos consultados, utilizando a estratégia PECO, onde P (population) indica a população, a letra E (exposure) exposição, C (comparison) comparação e a letra O (outcome) se refere aos desfechos esperados, assim gerou a pergunta norteadora do estudo: "Qual é a importância da alimentação e nutrição para indivíduos com enxaqueca?". Resultados: Foram selecionados 15 estudos para a produção do presente trabalho e foi realizada uma síntese descritiva dos resultados obtidos da relação e influência de hábitos alimentares com a enxaqueca. Conclusões: Conclui-se que os hábitos alimentares e a nutrição adequada têm grande influência e importância para indivíduos com enxaqueca, pois dessa forma, podem reduzir os sintomas apresentados e crises, já que as substâncias presentes nos alimentos estão relacionadas com o início e intensificação das crises (AU).

Introduction: Headaches are considered an important public health problem and are estimated to be the second most common pain complaint, with migraines being one of the most common. Migraine treatment is symptomatic and prophylactic to reduce symptoms when an attack starts and prevent new ones from forming, highlighting the importance of adopting healthy habits and a balanced diet. Objective: The purpose of this study was to carry out an integrative review of the literature in order to highlight the main findings on the influence of eating habits and the importance of nutrition for migraine patients. Methodology:A survey study was performed in the following databases: Virtual Health Library (VHL); Medline, LILACS, SciELO, and Google Scholar, in addition to considering the reference list of the consulted works. The PECO P (population) E (exposure) C (comparison) O (outcome) strategy was used, which generated the guiding question of the study: 'How important is food and nutrition for people with chronic migraines?'. Results:A total of 15 studies were selected to analyze in this work and a descriptive synthesis of the results was performed on the relationship and influence of eating habits of people with chronic migraines. Conclusions:It was concluded that eating habits and adequate nutrition have great influence and importance for migraine patients, as they are one of the main culprits of triggering and intensifying attacks (AU).

Introducción: Las cefaleas son consideradas un importante problema de salud pública y se estima que son la segunda queja más común de dolor, siendo la jaqueca una de las más frecuentes. El tratamiento de la jaqueca puede ser sintomático o profiláctico, con el fin de reducir los síntomas en periodos de crisis y evitar que nuevas ocurran, destacando la importancia de una adopción de hábitos saludables y una alimentación equilibrada. Objetivo: El objetivo de este estudio fue realizar una revisión integrativa de la literatura, destacando los principales hallazgos sobre la importancia de la alimentación y nutrición en personas afectadas por la jaqueca. Metodología: Fue realizada una investigación de los estudios en las bases de dados: Biblioteca Virtual en Salud (BVS); Medline, LILACS, SciELO y Google Académico, además de considerar la lista de referencias de los trabajos consultados, utilizando la estrategia PECO, donde P (population) indica la población, la letra E (exposure) exposición, C (comparison) comparación y la letra O (outcome) se refiere a los resultados esperados, así fue generada la pregunta guía del estudio: "¿Cuál es la importancia de la alimentación y nutrición para las personas con jaqueca?" Resultados: Fueron seccionados 15 estudios para la producción del presente trabajo y fue realizada una síntesis descriptiva de los resultados obtenidos de la relación e influencia de los hábitos alimentarios con la jaqueca. Conclusiones: Se concluye que los hábitos alimentarios y la nutrición adecuada tienen gran influencia e importancia para las personas conjaqueca, pues de esta forma, pueden reducir los síntomas presentados y crisis, ya que las sustancias presentes en los alimentos están relacionadas con el inicio e intensificación de las crisis (AU).

Aleitamento materno e o processo de adaptação no contexto familiar: abordagem qualitativa / Breastfeeding and the adjustment process in the family context: a qualitative approach

OBJETIVO: Compreender a adaptação das mulheres ao processo de amamentação e o apoio familiar e dos serviços de saúde. MÉTODO: Estudo qualitativo fundamentado no referencial metodológico da Etnoenfermagem, conforme a Teoria de Enfermagem Transcultural de Leininger. Foi utilizado um roteiro de entrevista semiestruturada. RESULTADOS: Evidenciaram-se três categorias temáticas: "Enfrentando algo inesperado, mutável e desafiador"; "Convivendo com dúvidas, incertezas e desorientação" e "Identificando fontes de apoio para a manutenção da amamentação". CONCLUSÃO: O processo de adaptação do aleitamento materno é permeado por dúvidas, incertezas e desafios. As mulheres apoiam-se em suas experiências prévias e na cultura familiar e sofrem influência direta destas. O papel da atenção básica é essencial nesse contexto.

OBJECTIVE: To understand women's adaptation to the breastfeeding process and the support provided by family and health services. METHOD: A qualitative study based on the methodological framework of Ethnonursing, following Leininger's Transcultural Nursing Theory. A semi-structured interview guide was used. RESULTS: Three thematic categories were identified: "Facing something unexpected, changing, and challenging"; "Dealing with doubts, uncertainties, and disorientation"; and "Identifying sources of support for breastfeeding maintenance". CONCLUSION: The breastfeeding adjustment process has doubts, uncertainties, and challenges. Women rely on and are directly influenced by their past experiences and family culture. The role of primary health care is crucial in this context.

Status of prepackaged food intake and the association with growth and development in school aged children of Chengdu City / 中国学校卫生

Objective@#To determine the association between the intake of five major types of prepackaged foods and the growth and development of school aged children, so as to provide a theoretical basis for guiding school aged children and their parents to make healthy prepackaged food choices.@*Methods@#Based on data from the South West China Childhood Nutrition and Growth Cohort (SCCNG), 381 children (6-11 years of age) were selected by stratified cluster sampling. Dietary intake and pubertal development were collected using questionnaires, and anthropometric measurements were obtained. Children were followed up until November 2022. Binary Logistic regression models were used to analyze the prospective association between prepackaged food intake and the growth and development of school aged children.@*Results@#The total intake of the five major types of prepackaged foods was 316.1 (197.1,501.4) g/d. After 2 years of follow up evaluations, 16.5% of school aged children were shown to be overweight and obese. Early spermarche occurred in 12.6% of boys and early menarche occurred in 15.4% of girls. The following findings were suggested after adjusting for the mothers education level, average gross monthly family income, whether or not the family had one child only, geographic area of residence, body mass index Z score, average duration of daily exercise, and total dietary energy intake: convenience food intake might increase the risk of early spermarche ( OR =9.37); fruit and vegetable intake might decrease the risk of early spermarche and menarche ( OR =0.33,0.17); and fish, poultry, meat, and egg intake might increase the risk of early menarche ( OR =7.59)( P <0.05). Intake of the five types of prepackaged foods was not associated with being overweight or obese after adjusting for confounders ( OR =1.40, 0.57, 0.73, 1.33,1.57, P >0.05).@*Conclusions@#The relationship between intake of the five major types of prepackaged foods and pubertal development is inconsistent and no significant correlation was detected between the intake of prepackaged foods and overweight or obese children. Nutrition education should be strengthened to help children and their parents choose healthy prepackaged foods.

Differences in gut microbiota among primary school students with different levels of sugar sweetened beverage consumption / 中国学校卫生

Objective@#To explore the differences in the gut microbiota of primary school students with different levels of sugar sweetened beverage intake, so as to provide scientific evidence for better identification of health risks in children and the development of targeted health policies.@*Methods@#In June 2022, a total of 192 healthy primary school students from Chengdu were selected using a stratified cluster random sampling method. The sugar sweetened beverage intake was assessed through a dietary frequency questionnaire. Based on the median daily sugar sweetened beverage intake, primary school students were categorized into a low intake group ( n =96) and a high intake group ( n =96). The gut microbiota in fresh fecal samples from the two groups of primary school students was analyzed using 16S rRNA high throughput sequencing, and the diversity and community structure differences in the gut microbiota were compared.@*Results@#Children in the low intake group had a sugar sweetened beverage intake of (21.3±1.6) mL/d, while the high intake group had an intake of (269.6±37.3) mL/d. Diversity analysis results showed that there were no statistically significant differences between the low intake and the high intake group in terms of α diversity metrics: Observed_otus index [298.50 (259.75, 342.25), 305.50 (244.25, 367.75)], Goods_coverage index [1.00 (1.00, 1.00), 1.00 (1.00, 1.00)], Chao index [304.18 (260.75, 348.78), 305.88 (245.68, 370.88)], Shannon index [5.88 (5.29, 6.45), 5.71 (4.89, 6.28)] and Simpson index [0.95 (0.91, 0.97), 0.94 (0.88, 0.97)] ( Z =-0.64, -0.76, -0.54, -1.76, -1.67, P >0.05). Furthermore, no statistically significant difference was observed in β diversity between the two groups ( R 2=0.006, P >0.05). At the genus level, the abundance of Blautia [0.033 (0.018, 0.055)] and Fusicatenibacter [0.009 (0.005, 0.015)] were higher in the low intake group compared to the high intake group [0.024 (0.013, 0.041),0.006 (0.003, 0.011)]and differences were statistically significant ( Z =-2.52, -2.81, P <0.05). LEfSe analysis highlighted intergroup differences primarily in Blautia, Fusicatenibacter and Sarcina( LDA= 3.56,3.12,3.53, P <0.05).@*Conclusions@#There is no significant difference in the diversity and overall structure of the gut microbiota in primary school students with different levels of sugar sweetened beverage intake. However, there are species variations at the genus level. The information can serve as a scientific basis for identifying health risks in primary school students and formulating targeted health strategies.

Prospective effects of dietary intake on lung function of pupils in Chengdu City / 中国学校卫生

Objective@#To investigate the prospective effects of intake of each food group on the development of lung function of pupils,so as to provide theoretical basis for promoting the healthy development of lung function and preventing chronic respiratory diseases in Chinese children.@*Methods@#A cluster stratified sampling method was used to select a total of 893 pupils in grades 2-5 from Chengdu in November 2021. Dietary data of respondents were collected using a food frequency questionnaire within the past year,then the food group intake was categorized into T1, T2 and T3 from low to high by the trichotomous method, and anthropometric measurements including lung capacity were obtained in 2022. Logistic regression models and test for trend were used to analyze the prospective effects of intake of each food group on lung function development of pupils.@*Results@#Among male students, consumption of vegetables [118.6(50.5, 188.2)g/d] and milk and dairy products [200.0(73.3, 250.0)g/d] were higher in the excellent lung capacity group than in the non excellent lung capacity group [90.0(37.1, 192.9), and 178.6(35.7, 250.0)g/d],with statistically significant differences ( Z =-1.98, -2.24); among girls, the group with excellent lung capacity consumed less staple food [391.1(273.6, 511.4)g/d] than the group with non excellent lung capacity [407.4(309.5, 594.3)g/d], and the group with excellent lung capacity consumed more aquatic products [31.2(14.6, 69.8)g/d] and milk and dairy products [215.0(107.1, 250.1) g/d ] than that of the non excellent lung capacity [19.4(10.7, 58.3), 114.3(35.7, 250.0)g/d] ( Z =-2.01, -3.33, -5.10)( P < 0.05 ). After adjusting for energy, body mass index Z score(BMI Z ), mother s education level, averge family income monthly, whether presence of smokers in the living environment, and whether participation in physical activities during the past week, among male students, T3 group of vegetable intake ( OR =0.48, 95% CI = 0.27-0.86), T2 group of bean and soy product intake ( OR = 0.52 , 95% CI =0.27-0.96)，T2 and T3 groups of milk and dairy products intake (T2： OR =0.54, 95% CI =0.31-0.93; T3： OR = 0.52 , 95% CI =0.30-0.90) were negatively associated with non excellent lung capacity ( P <0.05). Among girls, T3 group of aquatic product intake( OR =0.52, 95% CI =0.28-0.97), T2 and T3 groups of milk and dairy product (T2: OR =0.44, 95% CI =0.25- 0.76 ;T3: OR =0.33, 95% CI =0.19-0.59) were negatively associated with nonexcellent lung capacity, whereas the T2 group of red meat intake ( OR =2.51, 95% CI =1.37-4.67) was positively associated with non excellent lung capacity. Non excellent lung capacity was found to be negatively associated with vegetable and milk and dairy product intake in boys by test for trend; in girls, milk and dairy products intake was negatively associated with non excellent lung capacity, whereas red meat intake was positively associated with non excellent lung capacity ( t =-1.13，-0.44；-3.03，1.95, P trend <0.05).@*Conclusions@#Milk and dariy products intakes reduce the risk of non excellent lung capacity in pupils, vegetables intakes reduce the risk of non excellent lung capacity in boys, and the intake of red meat increases the risk of non excellent lung capacity in girls. Promoting rational food choices is necessary for children to improve healthy lung development.

A qualitative study on the feeding methods of Filipino mothers of children with cleft lip and palate aged 0 to 24 months: A pilot study

Background@#One of the early problems that children born with cleft lip and palate encounter is difficulty in feeding. This affects the child’s nutritional needs and the timing of the surgical intervention. Information on the appropriate feeding methods for children with cleft lip and palate will enable mothers to feed their babies properly and facilitate the implementation of appropriate interventions.@*Objectives@#The study described the feeding problems experienced by children with cleft lip and palate (CLP), and cleft palate (CP) ages 0-24 months, the feeding methods most preferred by Filipino mothers, the methods they found most useful, and the mothers’ reactions to the feeding issues their children face. Methods. The research is a pilot study which used a quantitative, cross-sectional, descriptive mixed method design. Thirty-two (32) mothers of children with cleft lip and palate, and cleft palate answered an 11-item online survey and participated in focused interviews from January to June 2022. Inferential statistics was used specifically frequency distribution to describe the data, and Fishers’ Exact Test and Pearson’s Chi-Square Test were used to analyze the data quantitatively to determine the significant association between the variables identified.@*Results@#Results showed that the feeding problems encountered by the children included nasal regurgitation, sucking, aspiration of liquids, latching on nipples, and swallowing. Mothers preferred to use regular feeding bottles (24.3%), specialized feeding bottles for children with cleft (21.6%), breast feeding and dropper (17.6%), syringe (9.5%), cup (6.8%), and spoon feeding (2.7%) methods. They also mentioned that they found the following feeding methods to be the most useful, regular feeding bottles (32.7%), specialized feeding bottles for cleft (23.1%), breast feeding (11.5%), spoon and dropper feeding (7.7%), and syringe feeding (1.9%).@*Conclusion@#The feeding problems experienced by Filipino children with CLP and CP mirror those that have been reported in other studies. The study revealed that mothers still prefer to use the traditional regular feeding bottles in feeding their babies and found this to be the most useful. Maternal reactions of the participants to the cleft condition and its feeding issues are similar to reported studies in other countries. The internet has been the primary source of information on cleft and feeding of the participants in the study.

Food capture and escape behavior of Leposternon microcephalum Wagler, 1824 (Squamata: Amphisbaenia)

Abstract Amphisbaenians are fossorial reptiles that have a cylindrical and elongated body covered with scales arranged in rings, and are all apodal, except for the three species of the genus Bipes. The amphisbaenian diet consists of a variety of invertebrates and small vertebrates. As these animals live underground, many aspects of their natural history are difficult to study. Most feeding studies of amphisbaenians have focused on the composition of the diet and feeding ecology, and the data available on feeding behavior are based on precursory observations. The present study describes the food capture behavior of Leposternon microcephalum Wagler, 1824 in captivity. In this experiment we used non-live bait (moist cat food), which was placed near a burrow opening, on the surface of the substrate. Three animals were monitored visually and filmed using cellphone cameras deployed at fixed points, to capture images from the dorsal and lateral perspectives of the study subjects. Two principal types of behavior were observed: the capture of food and defense mechanisms. The strategies used to capture the food were similar to those observed in other fossorial species. Although the backward movement has already been observed and described, we were able to record this movement being used as an escape strategy. These findings enrich our knowledge on different aspects of the natural history of the amphisbaenians.

Resumo Anfisbênas são répteis fossoriais caracterizadas por apresentarem corpo cilíndrico e alongado coberto por escamas dispostas exclusivamente em anéis e todas são ápodas, com exceção das três espécies do gênero Bipes. Sua dieta consiste em uma variedade de invertebrados e pequenos vertebrados. Por viverem no subsolo, muitos aspectos de sua história natural são difíceis de observar. A maioria dos estudos sobre alimentação em anfisbenas concentra-se na dieta e na ecologia alimentar, enquanto as informações sobre o comportamento alimentar se baseiam em observações preliminares. O objetivo deste artigo foi descrever o comportamento de captura de alimentos exibido por Leposternon microcephalum Wagler, 1824, fora da galeria, em cativeiro. Para o experimento foi utilizada uma isca não viva, ração úmida de gato, que foi oferecida e posicionada próxima a uma das aberturas da galeria, na superfície do solo. Um total de três animais foi analisadopor meio de observações visuais e registros de câmeras de telefones celulares posicionadas em um ponto fixo, captando imagens de suas vistas dorsal e lateral. Foram detectados dois tipos principais de comportamento: captura de recursos alimentares e mecanismo de defesa. As estratégias utilizadas para capturar o recurso alimentar foram semelhantes às observadas em outras espécies fossoriais. Embora o movimento de marcha-à-ré tenha sido observado e descrito, o registramos sendo usado como uma estratégia de fuga. Esses resultados contribuem para enriquecer o conhecimento sobre diferentes aspectos da história natural dos Amphisbaenia.

Trophic ecology of Acestrorhynchus falcirostris Cuvier, 1819 in island lakes on the lower stretch of the Solimões River, Amazon Basin

Abstract The aim objective of this study was to determine the trophic ecology of juvenile and adult Acestrorhynchus falcirostris during the rising and flood (high-water) period in six island lakes adjacent to the Solimões River. As such, we investigated: i) the trophic position, through the fractional trophic niche; ii) the niche breadth; iii) niche overlap and iv) the food strategy of the species. The specimens were collected during the years 2014 to 2017, using gillnets with mesh sizes ranging from 30 to 120mm between opposite knots. Through the analysis of stomach contents, the preference in the consumption of items of animal origin was observed. Juveniles consumed insects in greater proportions (IAi% = 50%), while adults consumed fish (IAi%=99,98%). Despite the large supply of food items available in the high-water period, juveniles were the only ones to consume items of allochthonous origin, such as insects. Juveniles presented a different dietary strategy and dietary composition to adults. Juveniles were omnivores with a generalist strategy, while adults were piscivores with a specialist strategy. Thus, the food composition, niche breadth, trophic position and feeding strategy of Acestrorhynchus falcirostris change due to the stage of development.

Resumo O objetivo deste estudo foi determinar a ecologia trófica de juvenis e adultos de Acestrorhynchus falcirostris durante o período de enchente e cheia em seis lagos de ilha adjacentes ao rio Solimões. Assim, investigamos: i) a posição trófica, através do nicho trófico fracional; ii) a largura de nicho; iii) sobreposição de nicho; iv) a estratégia alimentar. Os espécimes foram coletados durante os anos de 2014 a 2017, utilizando redes de emalhar com malha variando de 30 a 120mm entre nós opostos. Por meio da análise do conteúdo estomacal, observamos a preferência no consumo de itens de origem animal. Os juvenis consumiram insetos em maiores proporções (IAi% = 50%), enquanto os adultos consumiram preferencialmente peixes (IAi% = 99,98%). Apesar da grande oferta de alimentos disponíveis no período da cheia, os juvenis eram os únicos a consumir itens de origem alóctone, como por exemplo, os insetos. Os juvenis apresentaram uma estratégia alimentar e composição alimentar diferente para os adultos. Os juvenis foram considerados onívoros com uma estratégia generalista, enquanto os adultos foram considerados piscívoros com uma estratégia alimentar mais especialista. Assim, a composição alimentar, amplitude do nicho, posição trófica e a estratégia alimentar de Acestrorhynchus falcirostris muda em função do estágio de desenvolvimento.

Dietary patterns and socioeconomic, demographic, and health-related behaviors during pregnancy. A cross-sectional study

ABSTRACT BACKGROUND: The identification and understanding of dietary factors and other characteristics that influence gestational weight gain can contribute to the formulation of strategies to promote healthy eating habits before and during pregnancy. OBJECTIVE: To investigate the association between dietary patterns, sociodemographic and obstetric characteristics, and health-related behaviors in pregnant women. DESIGN AND SETTING: A cross-sectional study was conducted on women undergoing prenatal care in the Unified Health System of Colombo, Paraná, Brazil, from February 2018 to September 2019. METHOD: A weekly food frequency questionnaire was administered, and dietary patterns were identified through factor analysis. Median regression models were constructed to identify the associations between dietary pattern scores and variables. RESULTS: Complete data were obtained from 495 pregnant women. Three dietary patterns were identified: 1) "healthy," with higher factor loadings for the weekly consumption of raw vegetables, cooked vegetables, and fresh fruits; 2) "Western," including soft drinks or artificial juice, candies, milk, and dairy products, and processed cold meat; and 3) "traditional," beans and meat. Pregnant women aged 30 years or older (coefficient [Coef.] 0.86, 95% confidence interval [CI] 0.38-1.33) with moderate/intense physical activity (Coef. 0.32, 95% CI 0.02-0.62) had higher adherence to the "healthy" pattern. Adolescents and smokers adhered more to the "traditional" pattern (Coef. 0.17, 95% CI 0.01-0.33). CONCLUSION: Age, smoking status, and physical activity were associated with dietary patterns in pregnant women.

Relação entre desmame precoce e alergias alimentares / Relationship between early weaning and food allergies / Relación entre el destete precoz y las alergias alimentarias

Objetivo: Analisar a relação entre o desmame precoce e o desenvolvimento de alergias alimentares por meio de uma revisão integrativa. Método:Revisão integrativa da literatura realizada através das bases de dados Pubmed, Mesh e Scielo.Resultados:Através da busca pelos descritores determinados, foram selecionados 25 estudos científicos que atenderam aos critérios de inclusão. Devido sua grande composição, o leite humano é responsável pela promoção do crescimento das bactérias com efeito bifidogênico, estando em quantidades superiores nos lactentes em AME. Conclusão: Apesar de alguns dos estudos não mostrarem resultados significativos em relação ao leite materno ser um fator protetor contra as alergias alimentares, nenhum deles deixoude incentivar o AM ou mostrar os seus benefícios já cientificamente comprovados.

Objective: To analyze the relationship between early weaning and the development of food allergies through an integrative review. Method: Integrative literature review performed through the Pubmed, Mesh and Scielo databases. Results: Through the search for the descriptors determined, 25 scientific studies that met the inclusion criteria were selected. Due to its large composition, human milk is responsible for promoting the growth of bacteria with bifidogenic effect, being in higher amounts in infants in EBF. Conclusion: Although some of the studies did not show significant results regarding breast milk being a protective factor against food allergies, none of them failed to encourage BF or show its scientifically proven benefits.

Objetivo: Analizar la relación entre el destete precoz y el desarrollo de alergias alimentarias a través de una revisión integradora. Metodo:Revisión integradora de la literatura realizada a través de las bases de datos Pubmed, Mesh y Scielo. Resultados: A través de la búsqueda de los descriptores determinados, se seleccionaron 25 estudios científicos que cumplieron con los criterios de inclusión. Debido a su gran composición, la leche humana es responsable de promover el crecimiento de bacterias con efecto bifidogénico, estando en mayores cantidades en bebés en LME. Conclusión:Aunque algunos de los estudios no mostraron resultados significativos con respecto a que la leche materna sea un factor protector contra las alergias alimentarias, ninguno de ellos falló en fomentar la BF o mostrar sus beneficios científicamente probados.

Transição alimentar de prematuros internados na Unidade Canguru: revisão sistemática / Transición alimentaria de prematuros internados en la Unidad Canguro: revisión sistemática / Food transition of premature infants admitted to the Kangaroo Unit: systematic review

Resumo Objetivo Analisar as evidências disponíveis sobre a transição alimentar de sonda orogástrica para aleitamento materno diretamente na mama com prematuros internados em unidades hospitalares. Métodos Revisão sistemática da literatura com busca nas bases de dados PubMed/MEDLINE, Web of Science, EMBASE, Scopus, Cochrane CENTRAL, CINAHL, com os critérios de inclusão: estudos experimentais, sem restrição temporal e nos idiomas português, espanhol e inglês. A avaliação metodológica foi realizada por meio das ferramentas Grading of Recommendations Assessment, Development and Evaluation (GRADE) e Revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0) e consistiu em duas etapas: qualidade metodológica e o risco de viés dos estudos. Resultados Foram identificados 10 artigos, todos ensaios clínicos randomizados. As técnicas utilizadas na transição da dieta dos prematuros encontradas foram: sonda-dedo e seringa, copo e sonda-dedo, copo e mamadeira, colher e sucção não-nutritiva, sucção não-nutritiva, sucção não-nutritiva e estimulação oral, comportamento dos prematuros, cheiro do leite materno. Conclusão As técnicas evidenciadas permitiram a transição da dieta, em um período mais curto, reduzindo o tempo de internação, aumentando o ganho de peso e se mostraram seguras, desde que o prematuro tenha maturidade para ser realizada. Contudo, a mamadeira foi desaconselhada, pela ocorrência de episódios de dessaturação, aumento da frequência cardíaca e confusão de bico.

Resumen Objetivo Analizar las evidencias disponibles sobre la transición alimentaria de sonda orogástrica a lactancia materna directamente de la mama con prematuros internados en unidades hospitalarias. Métodos Revisión sistemática de la literatura con búsqueda en las bases de datos PubMed/MEDLINE, Web of Science, EMBASE, Scopus, Cochrane CENTRAL, CINAHL, con los siguientes criterios de inclusión: estudios experimentales, sin restricción temporal y en idioma portugués, español e inglés. La evaluación metodológica se realizó por medio de las herramientas Grading of Recommendations Assessment, Development and Evaluation (GRADE) y Revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0) y consistió en dos etapas: calidad metodológica y riesgo de sesgo de los estudios. Resultados Se identificaron 10 artículos, todos ensayos clínicos aleatorizados. Las técnicas utilizadas para la transición de la dieta de prematuros fueron: dedo-jeringa y jeringa, vaso y dedo-jeringa, vaso y mamadera, cuchara y succión no nutritiva, succión no nutritiva, succión no nutritiva y estimulación oral, comportamiento de los prematuros, olor de la leche materna. Conclusión Las técnicas observadas permitieron realizar la transición de la dieta en un período más corto, con reducción del tiempo de internación y mejor aumento de peso y demostraron ser seguras, siempre que el prematuro tenga madurez para realizarlas. No obstante, se desaconseja la mamadera por la presencia de episodios de desaturación, aumento de la frecuencia cardíaca y confusión tetina-pezón. Número de registro da revisão sistemática: CRD42021240725 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=240725)

Abstract Objective To analyze the available evidence on the transition from orogastric tube feeding to breastfeeding directly from the breast with premature infants admitted to hospital units. Methods Systematic literature review with search in the following databases: PubMed/MEDLINE, Web of Science, EMBASE, Scopus, Cochrane CENTRAL, CINAHL, with the inclusion criteria: experimental studies, without temporal restrictions and in Portuguese, Spanish and English. The methodological assessment was carried out using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) and Revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0) tools and consisted of two stages: methodological quality and the risk of bias of the studies. Results 10 papers were identified, all randomized clinical trials. The techniques used in transitioning the premature babies' diet were: finger tube and syringe, cup and finger tube, cup and bottle, spoon and non-nutritive sucking, non-nutritive sucking, non-nutritive sucking and oral stimulation, behavior of premature babies, and smell of breast milk. Conclusion The demonstrated techniques allowed the transition of the diet in a shorter period, reducing the length of hospital stay, increasing weight gain 1and proved to be safe, as long as the premature baby is mature enough to undergo the procedure. However, bottle feeding was not recommended due to the occurrence of episodes of desaturation, increased heart rate and nipple confusion. Systematic review registration number: CRD42021240725 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=240725)

Complementary feeding indicators from the World Health Organization and the Ministry of Health: agreement analysis and comparison of estimated prevalence in a cohort of children in southwestern Bahia, Brazil, 2018 / Indicadores de alimentación complementaria de la Organización Mundial de la Salud y del Ministerio de Salud: análisis de concordancia y comparación de prevalencias estimadas en una cohorte de niños del suroeste de Bahía, Brasil, 2018 / Indicadores de alimentação complementar da Organização Mundial da Saúde e do Ministério da Saúde: análise de concordância e comparação das prevalências estimadas em uma coorte de crianças no sudoeste da Bahia, 2018

ABSTRACT Objective To assess the agreement between complementary feeding indicators established by the World Health Organization (WHO) and the Ministry of Health (MOH) and to compare the prevalence of these indicators in the first year of a child's life. Methods : This was a cross-sectional study in a cohort of 286 children from Vitória da Conquista, state of Bahia, Brazil; agreement between indicators and comparison between prevalences were analyzed using the Kappa coefficient and McNemar's test; the prevalence of the indicators "introduction of complementary feeding" (ICF), "minimum dietary diversity" (MDD), "minimum meal frequency" (MMF) and "minimum acceptable diet" (MAD) were calculated. Results : Three indicators showed poor agreement, with only one demonstrating moderate agreement; prevalence of WHO indicators was higher than that of the MOH (ICF, 94.3% vs. 20.7%; MDD, 75.2% vs. 50.7%; MMF, 97.2% vs. 44.8%; MAD, 96.8% vs. 26.9%). Conclusion The majority of indicators showed poor agreement and the prevalence of WHO indicators exceeded that of the Ministry of Health.

RESUMEN Objetivo evaluar la concordancia entre indicadores de alimentación complementaria definidos por la Organización Mundial de la Salud (OMS) y el Ministerio de Salud (MS), y comparar la prevalencia entre estos indicadores en niños de un año. Métodos estudio transversal en una cohorte de 286 niños de Vitória da Conquista, Bahía, Brasil; se calculó la prevalencia de "introducción de alimentos complementarios" (IAC), "diversidad dietética mínima" (DMD), "frecuencia mínima de comidas" (FMR) y "dieta mínima aceptable" (DMA); para evaluar la concordancia y comparar prevalencias se utilizó el índice Kappa y la prueba de McNemar. Resultados cuatro indicadores mostraron un acuerdo pobre y sólo uno moderado; las prevalencias fueron mayores según la definición de la OMS (IAC, 94,3% vs 20,7%; DMD, 75,2% vs 50,7%; FMR, 97,2% vs 44,8%; DMA, 96,8% vs 26,9%). Conclusión la mayoría de las concordancias entre los indicadores fueron deficientes, con prevalencias más altas según las definiciones de la OMS.

RESUMO Objetivo Analisar a concordância entre indicadores de alimentação complementar da Organização Mundial da Saúde (OMS) e do Ministério da Saúde (MS) e comparar as prevalências entre esses indicadores em crianças no primeiro ano de vida. Métodos Estudo transversal em uma coorte de 286 crianças de Vitória da Conquista, Bahia, Brasil; a concordância entre indicadores e a comparação entre prevalências foram analisadas pelo índice Kappa e teste de McNemar; foram calculadas as prevalências dos indicadores "introdução de alimentos complementares" (IAC), "diversidade mínima da dieta" (DMD), "frequência mínima de refeição" (FMR) e "dieta minimamente aceitável" (DMA). Resultados Três indicadores apresentaram concordância ruim, e apenas um moderada; as prevalências dos indicadores da OMS foram superiores às do MS (IAC, 94,3% versus 20,7%; DMD, 75,2% versus 50,7%; FMR, 97,2% versus 44,8%; DMA, 96,8% versus 26,9%). Conclusão A maioria dos indicadores tiveram concordância ruim e as prevalências de indicadores da OMS superaram as do MS.

Is there scientific relevance to the plot of films and documentaries about eating disorders? / ¿Tiene relevancia científica la trama de películas y documentales sobre trastornos alimentarios? / Há pertinência científica no enredo dos filmes e documentários sobre transtornos alimentares?

ABSTRACT Objectives: to analyze films and documentaries about eating disorders from the last twenty years, identifying the way they approach the topic as well as their relevance for didactic use in teaching the health field. Methods: a descriptive study, whose data collection was carried out on the main streaming and video platforms, resulting in the survey of 60 media. Of these, only 25 had audio/subtitles in Portuguese (inclusion criteria). scientific relevance was analyzed considering psychopathological and epidemiological aspects of these disorders. A questionnaire about the plot, characters and descriptive data analysis were used. Results: most media were dramas about female teenagers who tried to conform to beauty stereotypes, whose symptoms portrayed converged with current medical diagnostic manuals. Conclusions: in practical terms, a classificatory list of 11 media was prepared that could be used as a teaching resource for teaching this topic in the health field.

RESUMEN Objetivos: analizar películas y documentales sobre trastornos alimentarios de los últimos veinte años, identificando la forma en que abordan el tema, así como su relevancia para su uso didáctico en la enseñanza del campo de la salud. Métodos: estudio descriptivo, cuya recolección de datos se realizó en las principales plataformas de streaming y video, dando como resultado la encuesta a 60 medios. De estos, sólo 25 tenían audio/subtítulos en portugués (criterios de inclusión). Se analizó la relevancia científica considerando aspectos psicopatológicos y epidemiológicos de estos trastornos. Se utilizó un cuestionario sobre la trama, los personajes y el análisis de datos descriptivos. Resultados: la mayoría de los medios fueron dramas sobre mujeres adolescentes que intentaban ajustarse a estereotipos de belleza, cuyos síntomas retratados convergían con los manuales de diagnóstico médico vigentes. Conclusiones: en términos prácticos, se elaboró un listado clasificatorio de 11 medios que podrían ser utilizados como recurso didáctico para la enseñanza de este tema en el campo de la salud.

RESUMO Objetivos: analisar filmes e documentários sobre transtornos alimentares dos últimos vinte anos, identificando o modo como abordam a temática, bem como sua pertinência para o uso didático no ensino do campo da saúde. Métodos: estudo descritivo, cuja coleta de dados foi realizada nas principais plataformas de streaming e vídeos, resultando no levantamento de 60 mídias. Dessas, apenas 25 tinham áudio/legenda em português (critério de inclusão). A pertinência científica foi analisada considerando aspectos psicopatológicos e epidemiológicos desses transtornos. Utilizaram-se um questionário sobre o enredo, as personagens e análise descritiva dos dados. Resultados: a maioria das mídias eram dramas sobre adolescentes do sexo feminino que tentavam adequar-se aos estereótipos de beleza, cujos sintomas retratados convergiam com os manuais de diagnósticos médicos atuais. Conclusões: em termos práticos, elaborou-se uma lista classificatória de 11 mídias que poderão ser utilizadas como recurso didático para o ensino desse tema no campo da saúde.

Aleitamento materno exclusivo e uso da bolsa canguru em bebês a termo entre o primeiro e segundo mês de idade / Exclusive breastfeeding and the use of kangaroo slings among full-term infants between their first and second months of age / Amamantamiento materno exclusivo y uso de la bolsa canguro en bebés a término entre el primer y segundo mes de edad

Objetivo: verificar a associação entre o uso da bolsa canguru, desde a maternidade até o domicílio, e aleitamento materno exclusivo, entre o 1o e 2o mês de idade, em bebês a termo saudáveis; identificar o nível de autoeficácia para o aleitamento materno, das mães que utilizaram a bolsa canguru. Métodos: estudo transversal com mães que receberam uma bolsa canguru após o parto, na maternidade, e foram orientadas sobre manterem seus bebês nesta postura, pelo menos uma hora por dia. Entre um e dois meses após o nascimento, foram investigadas a frequência do uso da bolsa canguru, autoeficácia materna da amamentação e tipo de alimentação dos bebês. Para análise foi empregado o teste ꭓ2 ou Exato de Fisher e o coeficiente V de Cramer (p < 0,05). Resultados: participaram 98 mães. Todas utilizaram a bolsa canguru no alojamento conjunto, 39,8% utilizaram três ou mais vezes por semana, no domicílio entre o primeiro e segundo mês após o parto; 70,4% dos bebês permaneceram em Aleitamento Materno Exclusivo (AME), o nível da autoeficácia materna para amamentação foi alto. AME esteve associado ao uso da bolsa canguru no domicílio (p = 0,014). Conclusão: bebês a termo saudáveis podem se beneficiar do uso da bolsa canguru desde a maternidade, estendido até o domicílio.

Objectives: to verify the association between kangaroo slings used from maternity hospital to home, and exclusive breastfeeding among healthy full-term babies between the 1st and 2nd months of age; to identify breastfeeding self-efficacy level of those mothers using a kangaroo sling. Method: this cross-sectional study addressed mothers who received a kangaroo sling after giving birth, at maternity hospital, and were instructed to keep the babies in this posture at least one hour daily. The frequency with which the mothers used the kangaroo sling, breastfeeding self-efficacy, and the type of feeding were investigated between one and two months after delivery. ꭓ2 or Fisher's exact test and Cramer's V coefficient (p < 0.05) were adopted in the analysis. Results: ninety-eight mothers participated in the study. All of them used the kangaroo sling in rooming-in; 39.8% used it three or more times a week at home between the 1st and 2nd months after giving birth; 70.4% of the babies remained on Exclusive Breastfeeding (EBF), the level of breastfeeding self-efficacy was high, and EBF was associated with the use of a kangaroo sling at home (p = 0.014). Conclusion: healthy full-term babies can benefit from using a kangaroo sling, starting at the maternity hospital and extending its use to home.

Objetivo: verificar la asociación entre el uso de la bolsa canguro, desde la maternidad hasta el domicilio, y amamantamiento materno exclusivo, entre el 1o e 2o mes de edad, en bebés a término saludables; identificar el nivel de autoeficacia para el amamantamiento materno, de las madres que utilizaron la bolsa canguro. Métodos: estudio transversal con madres que recibieron una bolsa canguro después del parto, en la maternidad, y fueron orientadas sobre mantener sus bebés en esta postura, por lo menos una hora por día. Entre uno y dos meses después del nacimiento, fueron investigadas la frecuencia del uso de la bolsa canguro, autoeficacia materna del amamantamiento y tipo de alimentación de los bebés. Para el análisis fue empleado el test ꭓ2 o Exacto de Fisher y el coeficiente V de Cramer (p < 0,05). Resultados: participaron 98 madres. Todas utilizaron la bolsa canguro en alojamiento conjunto, 39,8% utilizaron tres o más veces por semana, en el domicilio entre el primero y segundo mes después el parto; 70,4%, de los bebés, permaneció en Lactancia Materno Exclusivo (LME); el nivel de la autoeficacia materna para amamantamiento fue alto. El LME estuvo asociado al uso de la bolsa canguro en el domicilio (p = 0,014). Conclusión: bebés a término saludables pueden beneficiarse del uso de la bolsa canguro desde la maternidad, extendido hasta el domicilio.

Comparação da introdução das consistências na introdução da alimentação complementar entre recém-nascidos prematuros e a termo - Coorte de 0 a 12 meses / Comparison of the introduction of consistencies in complementary feeding introduction between preterm and full-term newborns - Cohort from 0 to 12 months

RESUMO Objetivo Comparar a introdução das consistências no período da alimentação complementar de recém-nascidos prematuros e recém-nascidos a termo até os 12 meses de vida, bem como avaliar a presença de disfunção motora oral e a sua relação com dificuldade na introdução das consistências alimentares nestes grupos. Método Trata-se de um estudo do tipo observacional, analítico, coorte, com coleta de dados ambispectiva, realizado na Secretaria Municipal de Saúde de Mafra - SC. A amostra do estudo foi constituída de 87 recém-nascidos, sendo 41 a termo e 46 prematuros. Na coleta de dados, foram realizadas entrevistas com as mães/responsáveis. A avaliação antropométrica foi realizada por nutricionista por meio de mensuração do peso corporal, comprimento e perímetro cefálico, seguida de avaliação das habilidades motoras orais e funcionais por meio do PAD-PED adaptado, avaliação da mamada, avaliação do desenvolvimento neuropsicomotor, avaliação da presença de depressão materna e risco psíquico da criança, até os 12 meses de vida de idade corrigida. Resultados A disfunção motora oral foi observada em 15 recém-nascidos, em ambos os grupos, na consistência líquida na primeira avaliação, persistiu em dois casos nos recém-nascidos a termo e em três casos nos recém-nascidos pré-termo, na última avaliação para a consistência sólida. Conclusão Não foi observada diferença na introdução das consistências alimentares entre os grupos. O aleitamento materno foi mais frequente nos a termo na primeira avaliação e semelhante nas demais avaliações. Com relação aos preditivos para disfunção motora oral, a mamadeira aumentou a chance em cerca de 7 vezes e procedimentos orais invasivos cerca de 6 vezes.

ABSTRACT Purpose To compare the introduction of consistencies during the period of complementary feeding of preterm and full-term newborns up to 12 months of life, as well as to evaluate the presence of oral motor dysfunction and its relation to difficulty in introducing food consistencies in these groups. Methods This is an observational, analytical, cohort study, with ambispective data collection, carried out at the Municipal Department of Health of Mafra, state of Santa Catarina, Brazil. The study sample consisted of 87 newborns, 41 full-term and 46 preterm. While data was collected, interviews were held with the mothers/guardians. The anthropometric assessment was carried out by a nutritionist by measuring body weight, length, and head circumference, followed by assessment of oral and functional motor skills by the adapted Clinical Evaluation Protocol of Pediatric Dysphagia (PAD-PED), assessment of breastfeeding and neuropsychomotor development, and assessment of the presence of maternal depression and psychological risk of children with up to 12 months of corrected age. Results We verified oral motor dysfunction in 15 newborns, in both groups, in the liquid consistency in the first assessment, persisting in two cases in the full-term newborns and in three cases in the preterm infants, in the last assessment for the solid consistency. Conclusion We observed no difference in the introduction of food consistencies between groups. Breastfeeding was more frequent in newborns in the first assessment and similar in other assessments. Regarding the predictors for oral motor dysfunction, bottle feeding increased the odds by about seven times and invasive oral procedures by about six times.

Dysfunctional suction dynamics in newborns with ankyloglossia / Dinâmica de sucção disfuncional em recém-nascidos com anquiloglossia

ABSTRACT Purpose Compare infant suction in babies with and without ankyloglossia using a microprocessor-controlled pressure sensor coupled to a pacifier. Methods Fifty-five infants from 0 to 2 months of age underwent clinical examination for ankyloglossia, after which they were offered a silicone pacifier connected to the pressure acquisition device and suction activity was recorded. Thus, we extracted the frequency of sucks within a burst, the average suck duration, the burst duration, the number of sucks per burst, the maximum amplitude of sucks per burst and the inter-burst interval. Results The key difference in newborns with ankyloglossia in relation to control was that they perform longer bursts of suction activity. Conclusion The longer burst durations are likely a compensatory strategy and may underlie the pain reported by mothers during breastfeeding. We therefore propose a method for objectively quantifying some parameters of infant suction capacity and demonstrate its use in assisting the evaluation of ankyloglossia.

RESUMO Objetivo Comparar a sucção infantil em bebês com e sem anquiloglossia usando um sensor de pressão controlado por microprocessador acoplado a uma chupeta. Método Cinquenta e cinco lactentes de 0 a 2 meses de idade foram submetidos ao exame clínico de anquiloglossia, em seguida foi oferecido uma chupeta de silicone conectada ao dispositivo de aquisição de pressão e a atividade de sucção foi registrada. Assim, obtivemos dados sobre a frequência de sucções dentro de um período de sucções, a duração média da sucção, a duração da rajada, o número de sucções por rajada, a amplitude máxima das sucções por rajada e o intervalo entre rajadas. O teste t não pareado foi utilizado para comparações entre os grupos. Resultados A principal diferença dos recém-nascidos com anquiloglossia em relação aos do grupo controle é que eles realizam rajadas mais longas durante a atividade de sucção. Conclusão A duração mais longa das rajadas é provavelmente uma estratégia compensatória e pode estar por trás da dor relatada pelas mães durante a amamentação. Portanto, propomos um método para quantificar objetivamente alguns parâmetros da sucção infantil e demonstramos seu uso para auxiliar na avaliação da anquiloglossia.

Ankyloglossia severity in infants: maternal pain, self-efficacy, and functional aspects of breastfeeding / Gravidade da anquiloglossia em bebês: dor materna, autoeficácia e aspectos funcionais do aleitamento materno

ABSTRACT Objective: To analyze functional aspects of breastfeeding, self-efficacy, and pain reported by mothers during breastfeeding, in newborns with severe and mild ankyloglossia. Methods: This is an observational study, carried out with 81 babies with ankyloglossia, assessed by the Bristol Tongue Assessment Tool (severe: scores 0-3; mild: scores 4-6) nested in a cohort carried out at the University Hospital of the Federal University of Maranhão, São Luis, Brazil. The functional aspects of breastfeeding were analyzed using the Breastfeeding Observation Form of the United Nations Children's Fund (BOF-UNICEF) and the LATCH Scoring System. Breastfeeding self-efficacy was measured using the Breastfeeding Self-Efficacy Scale — Short-Form. Pain indicators were evaluated by the Short-Form McGill Pain Questionnaire. The significance level adopted was 5%. Results: Maternal age was 26.7±0.8 years, and 64.2% reported high school education. Most babies were male (67.9%), and the birth weight was 3232±60g. A significant association was detected in the sucking aspect evaluated by the BOF-UNICEF [β=0.22 (95%CI 0.07; 0.73), p-value=0.013]. However, the groups did not differ in the assessment of breastfeeding performed by the LATCH scale. The groups had no differences in the assessment of breastfeeding self-efficacy reported by mothers, and in pain scores. Conclusions: Despite the observation of sucking difficulty in infants with severe ankyloglossia., the quality of breastfeeding in general, maternal pain, and self-efficacy reported by mothers do not differ when compared with infants with mild ankyloglossia. Therefore, the severity of ankyloglossia seems not to affect the breastfeeding indicators.

RESUMO Objetivo: Analisar aspectos funcionais da amamentação, autoeficácia e dor relatada pelas mães durante a amamentação, em recém-nascidos com anquiloglossia grave e leve. Métodos: Estudo observacional, realizado com 81 bebês diagnosticados com anquiloglossia avaliados pelo Bristol Tongue Assessment Tool (grave: escores 0-3; leve: escores: 4-6), aninhados em um estudo de coorte realizado no Hospital Universitário da Universidade Federal do Maranhão, São Luís, Brasil. Os aspectos funcionais do aleitamento materno foram analisados por meio do Formulário de Observação da Amamentação do Fundo Internacional para a Infância das Nações Unidas (BOF-UNICEF) e da Escala LATCH. Aautoeficácia foi mensurada por meio da Breastfeeding Self-Efficacy Scale — Short-Form. Os indicadores de dor foram avaliados pelo Short-Form McGill Pain Questionnaire. O nível de significância adotado foi de 5%. Resultados: A idade materna foi 26,7±0,8 anos, e 64,2% concluíram o ensino médio. A maioria dos recém-nascidos era do sexo masculino (67,9%), e o peso ao nascer foi 3232±60g. Foi detectada associação significante no aspecto da sucção avaliado pelo BOF-UNICEF [β=0,22 (IC95% 0,07; 0,73), p=0,013]. No entanto, os grupos não diferiram na avaliação do aleitamento materno realizada pela escala LATCH. Os grupos não apresentaram diferenças na avaliação da autoeficácia em amamentar relatada pelas mães e no escore de dor. Conclusões: Apesar de ter sido observada dificuldade de sucção em lactentes com anquiloglossia grave, a qualidade da amamentação em geral, a dor materna e a autoeficácia relatada pelas mães não diferem quando comparadas com as de lactentes com anquiloglossia leve. Assim, a gravidade da anquiloglossia parece não afetar os indicadores de amamentação.

Improving breastfeeding among adolescent mothers: a prospective cohort

ABSTRACT BACKGROUND: Exclusive breastfeeding is recommended for the first six months, and mother's age impact early weaning. Educational support and relevant information can increase breastfeeding rates. OBJECTIVE: To determine whether antenatal education enhances the maintenance, intention, and confidence in breastfeeding among adolescents. DESIGN AND SETTING: A prospective cohort study involving primiparous adolescents who gave birth at the Woman's Hospital (CAISM), Universidade Estadual de Campinas, Brazil. METHODS: Adolescent mothers were categorized into two groups based on the location of prenatal care: those at the Woman's Hospital (WH) who received antenatal education, and at the Primary Care (PC) who did not receive antenatal education. All adolescents received breastfeeding orientation during their postpartum hospital stay. The groups were compared using the Student's t-test, Mann-Whitney U test, and chi-squared test. Log-binomial models were used to compare the groups at different time intervals. RESULTS: The study included 132 adolescents: 59 in the WH group and 73 in the PC group. Six months postpartum, adolescents in the WH group demonstrated higher engagement in breastfeeding (P < 0.005) and exclusive breastfeeding (P = 0.04) than PC group. PC group showed greater lack of confidence in breastfeeding (P = 0.02) and felt less prepared (P = 0.01). Notably, all WH adolescents reported a stronger desire to breastfeed after antenatal education. CONCLUSION: Antenatal education significantly improves the maintenance, intention, and confidence of breastfeeding among adolescents. This education approach can be implemented across all healthcare levels and should be made accessible to all women throughout the pregnancy and postpartum period.