Caries en niños. ¿Maltrato infantil o ignorancia parental? / Caries in children. Child abuse or parental ignorance?

El maltrato infantil es un tema polémico en la actualidad, y se caracteriza por realizar acciones u omisiones intencionales destinadas a menoscabar o afectar la integridad física y/o psicológica de un menor. Frecuentemente se considera a la caries en niños como un indicador objetivo de maltrato infantil. La caries es una enfermedad extremadamente común en la población infantil en México y en el mundo, por lo que su relación con el maltrato infantil carece de un sustento real. El desarrollo de caries en niños no es un evento premeditado ni intencional, es más bien la consecuencia de malos hábitos higiénicos y dietéticos que el odontólogo tiene la obligación de corregir y erradicar para asistir a los pacientes pediátricos a recuperar su salud bucodental. El objetivo del presente artículo es debatir la relación entre la caries temprana de la infancia y el maltrato infantil (AU)

Child abuse is currently a controversial issue and is characterized by intentional actions or omissions intended to undermine the physical and/or psychological integrity of a minor. Caries in children is often considered an objective indicator of child abuse. Caries is an extremely common disease in the child population in Mexico and in the world, so its relationship with child abuse lacks any real support. The development of cavities in children is not a premeditated or intentional event, it is rather the consequence of poor hygienic and dietary habits that the dentist has the obligation to correct and eradicate in order to assist pediatric patients to regain their oral health. The aim of this article is to discuss the relationship between early childhood caries and child abuse (AU)

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.

Infecciones de vía aérea superior relacionada con el uso del biberón en la alimentación del lactante menor / Infecções das vias aéreas superiores relacionados com o uso da garrafa de alimentação do lactente / Upper airway infections related to the use of the feeding bottle in feeding the young infant

ResumenIntroducción. La lactancia materna ofrece un efecto protector contra las infecciones respiratorias, principalmente de la vía aérea superior; por tanto, es necesario determinar si su sustitución por biberón afecta la incidencia de infecciones respiratorias del tracto superior.Método. Utilizando la metodología de práctica clínica basada en evidencia (PCBE), y según las etapas fundamentales del sistema PICO, se planteó la interrogante: en el lactante menor ¿el uso del biberón para la alimentación comparado con el amamantamiento exclusivo aumenta el riesgo de infecciones en las vías aéreas superiores? Se realizó una búsqueda de artículos en la base de datos en línea PubMed, después de establecer los criterios de inclusión y exclusión y realizar un análisis crítico se seleccionó 5 documentos que dieran respuesta a la pregunta planteada.Resultado. A partir de la búsqueda en la base de datos Pub Med, se obtuvo 969 artículos publicados; tras depurar los resultados iniciales, se logró un total de 25 publicaciones vinculadas a estudios clínicos que abordan la relación entre lactancia materna exclusiva y la incidencia de infecciones respiratorias de vía aérea superior en el lactante menor. Finalmente, se consiguió cinco publicaciones que investigaron el uso del biberón y su posible asociación con infecciones respiratorias. La evaluación de estos estudios evidenció que su calidad es de nivel medio. Las publicaciones concluyen que hay una mayor incidencia de infecciones respiratorias de vía aérea superior en infantes lactantes menores, en los que la lactancia materna no es exclusiva, sino mixta o sustituida por el uso de biberón.Conclusión. Esta revisión breve de literatura muestra que existe evidencia de mediana calidad que apoya la asociación entre el uso de biberón en la alimentación y una mayor incidencia de infecciones respiratorias de vía aérea superior en el lactante menor.

AbstractIntroduction. Breastfeeding provides a protective effect against respiratory infections, mainly of the upper airway; therefore, it is necessary to determine whether replacing the bottle affect incidence of respiratory infections upper tract.Method.Using the methodology of evidence based clinical practice, and according to the acronym PICO, the question was raised:¿ in the lower infant does the use of bottle feeding compared to exclusive breastfeeding increases the risk of infections the upper airways? a search was conducted of articles in the database PubMed, after establishing the criteria for inclusion and exclusion and critically analyze five documents that give answer to the question posed was selected.Result. From searching the database Pub Med, 969 articles published was obtained; after debugging the initial results, a total of 25 publications related to clinical studies addressing the relationship between exclusive breastfeeding and the incidence of respiratory infections upper airway in the lower infant was achieved. Finally, five publications that investigated the use of the feeding bottle and its possible association with respiratory infections was achieved. The evaluation of these studies showed that its quality is average. Publications conclude that there is a higher incidence of respiratory infections of upper airway in infants younger infants, in which breastfeeding is not exclusive, but mixed or replaced by the use of a feeding bottle.Conclusion. This brief review of literature shows that there is evidence of medium quality that supports the association between feeding bottle use and an increased incidence of upper respiratory infections in the lower infant.

ResumoIntrodução.O aleitamento materno proporciona um efeito protector contra infecções respiratórias, principalmente das vias aéreas superiores; Portanto, é necessário determinar se garrafa Substituir a incidência de infecções respiratórias afetam trato superior.Método.Utilizando a metodologia da prática clínica baseada em evidências (PCBE), e de acordo com os estágios fundamentais do sistema PICO, foi levantada a questão: na criança menor é que o uso de mamadeira em relação ao aleitamento materno exclusivo aumenta o risco de infecções as vias aéreas superiores? foi realizada uma pesquisa de artigos no PubMed banco de dados on-line, depois de estabelecer os critérios de inclusão e exclusão e analisar criticamente cinco documentos dar resposta à questão colocada foi selecionado.Resultado. De pesquisar na base de dados Pub Med, 969 artigos publicados foi obtido; após a depuração os resultados iniciais, um total de 25 publicações relacionadas com estudos clínicos sobre a relação entre a amamentação exclusiva ea incidência de infecções respiratórias das vias aéreas superiores na criança menor foi alcançado. Finalmente, cinco publicações que investigaram a utilização da garrafa e a sua possível associação com infecções respiratórias foi conseguida. A avaliação destes estudos mostraram que a sua qualidade é média. Publicações concluir que há uma maior incidência de infecções respiratórias de vias aéreas superiores de lactentes crianças mais jovens, em que a amamentação não é exclusiva, mas mista ou substituído pelo uso de uma garrafa. Conclusão. Esta breve revisão da literatura mostra que há evidências de que de qualidade média que suporta a associação entre o uso de garrafa em alimentos e uma incidência aumentada de infecções respiratórias de vias aéreas superiores na criança menor.

Interferência dos bicos ortodônticos e convencionais no sistema estomatognático: revisão sistemática / Interference of conventional and orthodontic nipples in system stomatognatic: systematic review

RESUMO Objetivo: Verificar se o tipo de bico, ortodôntico ou convencional, de chupeta e mamadeira, tem alguma influência sobre as alterações encontradas no sistema estomatognático causadas pela manutenção do hábito de sucção. Estratégia de pesquisa: Por meio de uma revisão de literatura sistemática com metanálise, realizada a partir das bases de dados Lilacs, Medline e Embase e com a ferramenta de busca Google Acadêmico™, com os seguintes descritores em português e inglês: “Má oclusão” + “Chupetas”; “Má oclusão” + “Alimentação Artificial”; “Má oclusão” + “Mamadeira”, além das palavras “Bico Ortodôntico” + “Bico Convencional”. Critérios de seleção: Foram incluídos estudos que apresentassem em seus métodos a comparação de grupos que utilizaram chupeta e/ou mamadeira com bico convencional com grupos que utilizaram o bico ortodôntico, sem delimitação temporal. Análise dos dados: A análise do artigo na íntegra foi realizada de modo sistemático, com as seguintes categorias tabelando os resultados pertinentes: objetivo, método - casuística e avaliação, resultados e conclusão. Resultados: Foram encontrados 1.041 trabalhos, período de 1969 a 2013, desses foram excluídos 848 trabalhos, devido aos critérios de exclusão, e outros 174 que eram repetições. Foram lidos na íntegra 19 trabalhos, dos quais quatro artigos atenderam aos critérios de inclusão propostos, e três trabalhos foram incluídos na metanálise. Tais resultados expressaram que não há diferenças significantes entre os bicos ortodôntico e convencional quanto às implicações no sistema estomatognático. Conclusão: Não há possibilidade de concluir a existência de diferenças quanto às consequências no sistema estomatognático ocasionadas por bicos convencionais e ortodônticos de chupetas/mamadeiras.

ABSTRACT Purpose: Check if the type of nozzle, orthodontic or conventional, of pacifier and bottle have any influence on the changes found in the stomatognathic system caused by the maintenance of the sucking habit. Research Strategies: Through a systematic literature review with meta-analysis, performed from the databases Lilacs, Medline and Embase and Scholar Google, with the following key words in Portuguese and English: “malocclusion” + “Pacifiers “; “Malocclusion” + “Bottle Feeding”; “Malocclusion” + “Bottle feeding” beyond words “Orthodontic Beak” + “Conventional Beak”. Selection Criteria: We included studies that presented in their methods to compare groups who used pacifiers and/or bottle with conventional nozzle with groups using orthodontic nipple without temporal delimitation. Data Analysis: The analysis of the article in its entirety was performed systematically, ordering the relevant results in the following categories: objective, method—case studies and evaluation, results, and conclusion. Results: Found 1,041 jobs, from the period 1969 to 2013, 848 jobs were excluded based on the exclusion criteria and another 174 that were repetitions. A total of 19 articles were read in full of which 4 articles met the proposed inclusion criteria, and three studies were included in the meta-analysis. These results show that there are no significant differences between the orthodontic and conventional nozzles on the implications of the stomatognathic system. Conclusion: There is no way to conclude that there are differences as to the consequences to the stomatognathic system caused by conventional nozzles and orthodontic pacifier/bottle.

Breastfeeding, bottle feeding and risk of malocclusion in mixed and permanent dentitions: a systematic review

Abstract The aim of the present study was to search for scientific evidence concerning the association between breastfeeding and bottle feeding and risk of malocclusion in mixed and permanent dentitions. An electronic search was performed in eight databases up to February 2015. Additionally, a gray literature search and hand searches of the reference lists of the selected studies were also carried out. There were no restrictions on language or on year of publication. The methodology of the included articles was evaluated using the Newcastle Ottawa scale. Out of the 817 identified citations, six studies fulfilled the eligibility criteria and were included in the systematic review. One study showed that children with mixed and permanent dentitions breastfed for more than 6 months presented greater mean protrusion of mandibular incisors and inclination of maxillary incisors compared with those breastfed for less than 6 months or those who were bottle-fed (p < 0.05). One study revealed that breastfeeding and bruxism were associated with Class II [OR = 3.14 (1.28 - 7.66)] and Class III [OR = 2.78 (1.21 - 6.36)] malocclusion in children with permanent dentition, while another study showed that an increase in breastfeeding duration was associated with a lower risk of malocclusion in children with both mixed and permanent dentitions (p < 0.001). Three studies did not report any significant association. Risk of bias was high in most selected articles. These findings do not support an association between breastfeeding and bottle feeding and the occurrence of malocclusion in mixed and permanent dentitions.

Duración de lactancia materna exclusiva, estado nutricional y dislipidemia en pacientes pediátricos / Duration of the exclusive breastfeeding, the nutritional status and dyslipidemia seen in pediatric patients

INTRODUCCIÓN: el abandono precoz de la lactancia materna exclusiva trae complicaciones a corto y largo plazo. OBJETIVO: determinar el estado nutricional y las alteraciones lipídicas en pacientes pediátricos según la duración de la lactancia materna exclusiva. MÉTODOS: estudio descriptivo de corte transversal en 50 pacientes, de edades comprendidas entre 1 y 18 años, con diferente tiempo de duración de la lactancia materna exclusiva, pertenecientes al consultorio médico 25, del área de salud del policlínico "Carlos Manuel Portuondo", en el período comprendido desde noviembre de 2012 a noviembre de 2013. Se estudiaron las variables edad, sexo, estado nutricional, tiempo de lactancia materna exclusiva, colesterol y triglicéridos. Los datos fueron incluidos en una base de datos automatizada con la hoja de cálculo electrónica Excel 2003, y resumidos y representados en tablas estadísticas y expresados textualmente. Se utilizó la estadística descriptiva. RESULTADOS: de los 42 pacientes que abandonaron precozmente la lactancia materna exclusiva, el 81 % presentó malnutrición, y el 74 % hipertrigliceridemia. CONCLUSIONES: resulta insuficiente la promoción de la lactancia materna exclusiva, expresada por la sustitución artificial de esta a medida que el niño transcurre por los primeros 6 meses de vida.

INTRODUCTION: the early cessation of exclusive breastfeeding brings short- and long term complications. OBJECTIVE: to determine the nutritional status and lipid alterations in pediatric patients according to the duration of exclusive breastfeeding. METHODS: descriptive and cross-sectional study of 50 patients aged one to 18 years and with varied lengths of time of exclusive breastfeeding, who were seen at the doctor's office no. 25 of "Carlos Manuel Portuondo" polyclinics in the period of November 2012 through November 2013. The study variables were age, sex, nutritional status, duration of exclusive breastfeeding, and cholesterol and triglyceride levels. The collected data were introduced into a database with electronic Excel 2003 spreadsheet and summarized and shown in statistical tables and textually expressed. Summary statistics were used. RESULTS: out of 42 patients who were early weaned, 81% presented with malnutrition and 74% with hypertriglyceridemia. CONCLUSIONS: promotion of the use of exclusive breastfeeding is poor since the mother's milk is replaced in the course of the first 6 months of life of the child.

Nefrolitíase pediátrica: uma complicação da amamentação ineficaz? / Pediatric nephrolithiasis: a complication of ineffective breastfeeding?

A nefrolitíase constitui-se na formação de conglomerados cristalinos e de matriz orgânica que podem se localizar no trato urinário, com dimensões e localização capazes de conferir significado clínico-patológico. Os fatores dietéticos têm sido mostrados como fatores de risco para a ocorrência de litíase urinária. O presente artigo teve por objetivo relatar e relacionar com a assistência de enfermagem, por meio de um plano de cuidados, um caso ocorrido entre dezembro de 2014 e fevereiro de 2015, em um hospital público do Distrito Federal, Brasil, em que a criança tinha como sintomatologia principal a eliminação de cálculos renais de diferentes tamanhos e em grande quantidade por meio do canal urinário. A associação com o aleitamento materno ineficaz é explicada no sentido em que a habilidade da criança até os seis meses de vida em manejar alguns alimentos distintos do leite materno é limitada, pois seus sistemas digestivo e renal ainda estão imaturos. Os fatos descritos neste estudo evidenciam a importância da atuação profissional no manejo do aleitamento materno exclusivo e no aconselhamento nutricional e de saúde, tendo em vista que estes são fatores modificáveis frente à prevenção de patologias e complicações.

Nephrolithiasis consists of the formation of crystalline clusters and organic matrix that can be located in the urinary tract, with dimensions and location capable of providing clinical and pathological significance. Dietary factors have been shown to be risk factors for the occurrence of urolithiasis. This article aims to describe and relate to nursing care through a care plan, a case occurred between December 2014 and February 2015 in a public hospital in the Distrito Federal, Brazil, in which the child had as main symptoms the elimination of kidney stones of different sizes and in large quantities through the urinary tract. The association with ineffective breastfeeding is explained in the sense that the child's ability to six months of life in handling some distinct breast milk foods is limited because their digestive and renal systems are still immature. The facts described in this study show the importance of professional practice in the management of exclusive breastfeeding and nutrition counseling and health, given that these factors are modifiable front of prevention of diseases and complications.

Bottle feeding, increased overjet and Class 2 primary canine relationship: is there any association?

The aim of this study was to investigate the association between bottle feeding and prevalence rates of increased overjet and Class 2 primary canine relationship. The sample consisted of 911 children (461 boys, 450 girls) aged 3 (13.9 percent), 4 (40.8 percent), 5 (34 percent) and 6 (11.3 percent) years, with complete primary dentition. Information about nutritive and nonnutritive (pacifier and/or digit) sucking habits was collected through questionnaires. Three calibrated dentists (κ: 0.9-1.0 and Rs > 0.90) performed the clinical assessments. The children were divided into four groups: G1 - not bottle-fed; G2 - exclusively bottle-fed; G3 - breast- and bottle-fed, bottle feeding ceased before 3 years of age; and G4 - breast- and bottle-fed, bottle feeding ceased between 3 and 4 years of age. Associations between nutritive and nonnutritive sucking behaviors and the malocclusions studied were analyzed by multiple binary logistic regression (α= 0.05). The frequencies of increased overjet were: 25.3 percent (G1), 38.8 percent (G2), 39.2 percent (G3) and 47.8 percent (G4). The percentages of Class 2 canine relationship were: 27.9 percent (G1), 48.8 percent (G2), 43.4 percent (G3) and 43 percent (G4). No significant effect of bottle feeding was found. The chances of diagnosing increased overjet (O.R. = 4.42, p < 0.001) and Class 2 canine relationship (O.R. = 4.02, p < 0.001) were greater for children with pacifier and/or digit-sucking habits, compared to those without a history of nonnutritive sucking behavior. It may be suggested that bottle feeding alone is not directly associated with higher prevalence rates of increased overjet and Class 2 canine relationship in the primary dentition.

Non-nutritive sucking habits, anterior open bite and associated factors in Brazilian children aged 30-59 months

The aim of the present study was to investigate the prevalence of non-nutritive sucking habits and anterior open bite as well as their main causes (associated factors) in Brazilian children aged 30-59 months. A cross-sectional study was carried out during the National Immunization Day for polio in the city of Recife in the northeastern region of Brazil. The sample was made up of 1,308 children. Data were collected from interviews with mothers or guardians as well as from clinical examinations carried out by previously trained dental students. The chi-square test was used for statistical analysis at 5 percent significance level. The prevalence of non-nutritive sucking habits was 40 percent, and the habits were associated with gender (p=0.001), age (p=0.003) and feeding type (p<0.001). Anterior open bite was detected in 30.4 percent of children, and it was significantly associated with feeding type (p<0.001) and non-nutritive sucking habits (p<0.001). The variables found to be associated factors in the present study for the occurrence of non-nutritive sucking habits and anterior open bite emphasize the need to establish strategies that include orientation regarding health promotion based on the "common determining factors" approach. Public health policies should be adopted to encourage a longer duration of breastfeeding, thereby contributing towards reducing the prevalence of non-nutritive sucking habits and anterior open bite.

O objetivo do presente estudo foi avaliar a prevalência de hábitos de sucção não nutritiva e mordida aberta anterior, assim como, determinar os seus fatores de risco (fatores associados) em crianças brasileiras de 30-59 meses. Um estudo transversal foi realizado durante o Dia Nacional de Vacinação contra a pólio na cidade do Recife, situada na região nordeste do Brasil. A amostra foi composta por 1308 crianças. Os dados foram coletados a partir de entrevistas com as mães ou responsáveis, bem como, de exames clínicos realizados por estudantes de odontologia, previamente treinados. O teste qui-quadrado foi utilizado para análise estatística com nível de significância de 5 por cento. A prevalência de hábitos de sucção não nutritiva foi de 40 por cento, e os hábitos estavam associados com sexo (p=0,001), idade (p=0,003) e tipo de alimentação (p<0,001). A mordida aberta anterior foi detectada em 30,4 por cento das crianças. A mordida aberta anterior foi significativamente associada com o tipo de alimentação (p<0,001) e hábitos de sucção não nutritiva (p<0,001). No presente estudo, as variáveis consideradas fatores associados para a ocorrência de hábitos de sucção não nutritiva e mordida aberta anterior enfatizam a necessidade de estabelecer estratégias que incluam a orientação sobre a promoção da saúde baseada na abordagem dos "fatores de risco comum". Deste modo, as políticas públicas de saúde devem ser adotadas para incentivar uma maior duração do aleitamento materno, contribuindo, assim, para reduzir a prevalência de hábitos de sucção não nutritiva e mordida aberta anterior.

Role of feeding practices in causation of diarrhea in young infants [06 months of age]

To study the role of feeding practices in causation of diarrhea in young infants. This was a comparative cross sectional study conducted at OPD and Indoor Pediatrics Departments of Nishtar Hospital, Multan during the period from April 2008 to August 2008. A total of one hundred and sixty two infants of 06 months of age both male and female were included in the study by simple random technique. Half of the infants were on Breast feeding and half were on bottle feeding. Data were collected from parents/attendant of the young infants by a pre-tested structured questionnaire. The Data was analyzed by applying various Statistical formulas and tests such as frequencies, percentages, Means and Chi square test etc. Out of 86 Breast fed infants diarrhea was present in 30 [35%] infants and it was absent in 56 [65%] infants. Out of total 86 bottle fed infants diarrhea was present in 48 [56%] infants and it was absent in 38 [44%] infants. The level of significance was set at 0.001. It was concluded that bottle fed infants has significantly higher instances of diarrhea than breast fed infants. The proportion of male and female infants was same in both bottle fed and breast fed infants, so gender was eliminated as a confounding factor

Paratyphoid sepsis.

A large for gestational age male baby was born to a healthy young primigravida, on L-thyroxime, at 40 weeks by caesarean delivery in a tertiary care hospital. The baby had episodes of hypoglycemia during his immediate four postnatal days in the nursery that were successfully managed with intravenous glucose administration. The baby became unwell on day 5 and had a positive sepsis-screening test. Blood culture revealed a multidrug susceptible S. Paratyphi A strain, which he probably acquired on the first or second postnatal day from the contaminated expressed breast milk or the formula feed.

Conseqüências do uso da mamadeira para o desenvolvimento orofacial em crianças inicialmente amamentadas ao peito / Consequences of bottle-feeding to the oral facial development of initially breastfed children

OBJETIVO: Identificar e avaliar as possíveis conseqüências do uso da mamadeira sobre o desenvolvimento orofacial em crianças que foram amamentadas até pelo menos, os 6 meses de vida. MÉTODOS: Participaram do estudo 202 crianças (4 anos de idade) que freqüentaram o Programa de Atenção Precoce à Saúde. A amostra foi dividida em: G1 (crianças que utilizaram apenas copo para ingestão de líquidos) e G2 (utilizaram mamadeira). RESULTADOS: Selamento labial foi observado em 82 por cento das crianças do G1 e em 65 por cento do G2 (p = 0,0065). Repouso da língua no arco superior foi encontrado em 73 por cento das crianças do G1 e em 47 por cento do G2 (p < 0,0001). Observou-se maior ocorrência de respiração nasal em 69 por cento do G1 e em 37 por cento do G2 (p < 0,0001). A maxila mostrou-se normal em 90 por cento do G1 e em 78 por cento do G2 (p = 0,0206). CONCLUSÃO: Usar mamadeira, mesmo entre crianças que receberam aleitamento materno, interfere negativamente sobre o desenvolvimento orofacial.

OBJECTIVE: To identify and assess the possible consequences of bottle-feeding on the oral facial development of children who were breastfed up to at least six months of age. METHODS: Two hundred and two children (4 years of age) enrolled in an early health attention program participated in the study. The sample was divided into two groups: G1 (children who used only a cup to drink) and G2 (those who used a bottle). RESULTS: Lip closure was observed in 82 percent of the children in G1 and in 65 percent of those in G2 (p = 0.0065). The tongue coming to rest in the maxillary arch was found in 73 percent of the children in G1 and in 47 percent of those in G2 (p = 0.0001). Nasal breathing was observed in 69 percent of G1 and in 37 percent of G2 (p = 0.0001). The maxilla was shown to be normal in 90 percent of G1 and in 78 percent of G2 (p = 0.0206). CONCLUSIONS: Use of the bottle, even among breastfed children interferes negatively with oral facial development.

Influencia de la succión deglución sobre el crecimiento y desarrollo orofacial / Effect of the suction-swallowing action on orofacial development and growth

Introducción. Todas las funciones que se cumplen en la cavidad bucal (succión, deglución, masticación, y fonación) estimulan el crecimiento y desarrollo orofaciales. El ambiente funcional juega un rol muy importante pudiendo alterar dicho crecimiento ejerciendo también una acción sobre el desarrollo oclusal. Objetivos. Esta investigación relevó las características oclusales de la población infantil de la ciudad de Córdoba, Argentina relacionándolas con el estrato social y la influencia favorable de la lactancia materna, frente a la lactancia artificial, como moderadora del perfil biosicoafectivo de los niños permitiendo un crecimiento maxilofacial óptimo y favoreciendo la armonía del equilibrio neuromuscular. Se evaluó además, a los hábitos orales disfuncionales como factores predisponentes para alterar el crecimiento y desarrollo orofacial. Materiales y Métodos. La muestra estuvo constituida por 290 niños de 5 años de ambos sexos pertenecientes a una cohorte del Estudio CLACyD. Los datos fueron analizados con el paquete estadístico SPSS/PC 4.0. Resultados. Los resultados mostraron que el 69% de los niños alimentados con lactancia materna presentaban oclusión normal, mientras que aquéllos con lactancia artificial el porcentaje encontrado fue del 53.3%. Dentro de las mal oclusiones la sobremordida fue más prevalente en los niños con lactancia materna (25.3%) y la mordida cruzada lateral en los con lactancia artificial {16.9%). En cuanto a los hábitos orales disfuncionales el mayor porcentaje encontrado fue la interposición lingual en niños con lactancia artificial (20%) asociada con mordida abierta, datos estadísticamente significativos. Conclusión. En este estudio se observó que el amamantamiento favorece el crecimiento y desarrollo orofacial existiendo menor predisposición a desviaciones de los patrones de normalidad...

Introduction. All the functions that take place in the oral cavity (sucking, swallowing, mastication and phonation), not only play an important role in stimulating orofacial development and growth but may also alter such growth and affect occlusal development. Purpose.- The purpose oft his research work was to show the occlusal characteristics of children in the City of Córdoba, Argentina, in relation to their social background. This paper also aimed to show the favourable effect of breastfeeding as a moderator of fue bio psycho affective profile of children, which allows an excellent...

Problemas comuns na lactação e seu manejo / Common problems during lactation and their management

Objetivo: Apresentar uma revisão atualizada sobre problemas comuns relacionados à lactação e seu manejo. Fonte dos dados: Foi realizada extensa revisão bibliográfica sobre o tópico, sendo utilizadas publicações selecionadas a partir de pesquisa na base de dados MEDLINE e de organismos nacionais e internacionais. Foram utilizados também livros-texto e alguns artigos-chave selecionados a partir de citações em outros artigos. Síntese dos dados: Vários dos problemas comuns enfrentados durante a lactação - ingurgitamento mamário, traumas mamilares, bloqueio de ducto lactífero, infecções mamárias e baixa produção de leite - têm a sua origem em condições que levam a um esvaziamento mamário inadequado. Assim, má técnica de amamentação, mamadas infreqüentes e em horários predeterminados, uso de chupetas e de complementos alimentares constituem importantes fatores que podem predispor ao aparecimento de complicações da lactação. Nessas condições, o manejo adequado é imprescindível, pois, se não tratadas adequadamente, com freqüência levam ao desmame precoce. Para a abordagem dos fatores que dificultam o esvaziamento adequado das mamas, há medidas específicas. Além disso, o suporte emocional e medidas que visem dar maior conforto à lactante não podem ser negligenciadas. Conclusões: A maioria dos problemas comuns relacionados à lactação pode ser prevenida com esvaziamento adequado das mamas. Uma vez presentes, os problemas devem ser manejados adequadamente, evitando-se, assim, o desmame precoce decorrente de situações dolorosas e, por vezes, debilitantes para a nutriz.

The prevalence and pattern of nursing caries in preschool children of Tehran.

This cross sectional study was carried out to determine the prevalence and pattern of nursing caries and its relevant factors in preschool children of Tehrari. 620 children aged 2-6 yrs were selected randomly from 22 kindergartens in Tehran. They were examined for dental caries. The criteria used for nursing caries was presence of caries on buccal or palatal surfaces of at least two maxillary incisors with absence of caries in mandibular incisors. A questionaire was used for evaluation of related factors.

Comparison of levels of mutans streptococci and lactobacilli in children with nursing bottle caries, rampant caries, healthy children with 3-5 dmft/DMFT and healthy caries free children.

Ten children from each group of nursing caries, rampant caries, 3-5 dmft/DMFT and caries free children were selected and plaque samples from carious lesion, early carious lesion, sound tooth surface as well as salivary sample were collected. The levels of mutans streptococci and lactobacilli were estimated at all the sample sites. The result further supported the role of mutans streptococci in the initiation and of lactobacilli in the progression of the dental caries.

Factors underlying failure of breast feeding in Kuwait

In response to a long perceived but only recently marked decline in breast- feeding in Kuwait, this study was conducted to investigate the factors underlying the failure of breast-feed. All 982 infants attending the largest primary health center for vaccination during data gathering period in the five governorates were included in the study. Mothers were interviewed about the method of infant feeding, its characteristics, parental and maternal characteristics known to be associated with feeding. Data were gathered via personal interviews with the mothers. Failure of breast-feeding was significantly associated with improper feeding practices as delayed onset of breast feeding after birth, not giving breast milk as first food and early introduction of supplementary foods. Other significant associates were parental age, education and occupation, mother's knowledge, suffering health problems during pregnancy or labor, her previous pregnancies and the type of contraceptive use. Educational programs emphasizing giving breast milk as the first food shortly after birth, not beginning supplements before the fourth month and using contraceptives other than pills, while breast feeding are to be targeted to middle educated parents at the two extremes of age, working mothers and those suffering problems during pregnancy or labor