Aspectos influenciadores da introdução alimentar infantil / Influential aspects of the introduction of infant food / Aspectos que influyen en la introducción de alimentos en la infancia

Introdução: O Ministério da Saúde recomenda que a introdução alimentar infantil seja feita aos 6 meses de idade, porém, observa-se que muitas famílias introduzem alimentos antes dessa faixa etária, o que pode prejudicar a saúde da criança. Isso pode ocorrer devido às crenças existentes, experiências prévias da família, entre outros fatores de ordem social e cultural. Objetivo: Investigar aspectos influenciadores da introdução alimentar de crianças. Métodos: O presente estudo trata-se de uma pesquisa transversal, quantitativa, com amostra não probabilística, de conveniência. Foram incluídos no estudo 22 pais ou responsáveis de crianças com idade até 24 meses. Foi aplicado um questionário com os pais ou responsáveis que continha perguntas relacionadas à criança, à família e aos fatores socioculturais; introdução alimentar; e crenças e conhecimentos sobre introdução alimentar. Resultados: Houve prevalência de aleitamento materno exclusivo até os 6 meses de 31,8% e introdução alimentar em tempo oportuno de 45%. Os resultados demonstram correlação entre escolaridade, renda, presença de plano de saúde e ocupação dos pais fora de casa com conhecimento sobre alimentação complementar. Encontrou-se também correlação entre o conhecimento dos pais e tempo de aleitamento materno exclusivo e tempo em que foi introduzida alimentação complementar. Conclusão: A partir dos resultados pode-se inferir que o nível de instrução, a ocupação e a renda familiar exercem influência no conhecimento dos pais sobre introdução alimentar. E que este conhecimento influencia a duração do aleitamento materno exclusivo e a época da introdução alimentar.

Introduction: The Ministry of Health recommends that the introduction of infant food be made at 6 months of age; however, it is observed that many families introduce food before this age group, which can harm the child's health. This may be due to existing beliefs, previous family experiences, and other social and cultural factors. Objective: To investigate aspects that influence the food introduction for children. Methods: The present study is a cross-sectional, quantitative research, with a non-probabilistic, convenience sample. The study included 22 parents or guardians of children aged up to 24 months. A questionnaire containing questions related to the child, the family and socio-cultural factors and questions about food introduction, beliefs and knowledge about this introduction, was applied with the parents or guardians. Results: There was a prevalence of exclusive breastfeeding up to 6 months of 31.8% and right timely feeding of 45%. The results show a correlation between schooling, income, health insurance and occupation of parents outside the home with knowledge about complementary feeding. A correlation was also found between the parents' knowledge and the duration of exclusive breastfeeding and the time when complementary feeding was introduced. Conclusion: From the results, it can be inferred that the level of education, occupation and family income influence the parents' knowledge about food introduction. And that this knowledge influences the duration of exclusive breastfeeding and the timing of food introduction.

Introducción: El Ministerio de Salud recomienda la introducción de alimentos para bebés a los 6 meses de edad, sin embargo, se observa que muchas familias introducen alimentos antes de este grupo de edad, lo que puede dañar la salud del niño. Esto puede deberse a creencias existentes, experiencias familiares previas, entre otros factores sociales y culturales. Objetivo: investigar aspectos que influyen en la introducción de alimentos en los niños. Métodos: Este estudio es una investigación transversal, cuantitativa, con una muestra de conveniencia no probabilística. El estudio incluyó a 22 padres o tutores de niños de hasta 24 meses. Se aplicó un cuestionario con los padres o tutores que contenía preguntas relacionadas con el niño, la familia y factores socioculturales; introducción de alimentos; y creencias y conocimientos sobre la introducción de alimentos. Resultados: hubo una prevalencia de lactancia materna exclusiva hasta 6 meses de 31,8% y alimentación oportuna de 45%. Los resultados demuestran una correlación entre escolaridad, ingresos, presencia de seguro de salud y ocupación de padres fuera del hogar con conocimiento sobre alimentación complementaria. También se encontró una correlación entre el conocimiento de los padres y el tiempo de lactancia materna exclusiva y el momento en que se introdujo la alimentación complementaria. Conclusión: a partir de los resultados, se puede inferir que el nivel de educación, la ocupación y el ingreso familiar influyen en el conocimiento de los padres sobre la introducción de alimentos. Y que este conocimiento influye en la duración de lactancia materna exclusiva y el tiempo de introducción de alimentos.

Aplicación de prácticas clave: lactancia materna, alimentación complementaria, micronutrientes, desarrollo mental y social de niños menores de 5 años / Application of key practices: breastfeeding, complementary feeding, micronutrients, mental and social development of children under 5 years of age

Objetivo: evaluar la aplicación de la estrategia AIEPI en la promoción de la lactancia materna exclusiva, alimentación complementaria, uso de micronutrientes y prevención de alteraciones en el desarrollo mental y social de los niños menores de 5 años. Materiales y métodos: estudio cuantitativo descriptivo-correlacional; se utilizó una muestra de 323 padres de familia y/o cuidadores. Resultados: la lactancia materna exclusiva se proporcionó en un 52% y en la alimentación complementaria los alimentos de elección fueron los cereales 77,1%, tubérculos 71,8%, frutas 40% y verduras 43%. Administran cantidades suficientes de micronutrientes 82,4%. El 92,6% brindan caricias y un 83,9% usan el juego como forma de estímulo para sus hijos. Hubo correlación entre la edad del cuidador y la lactancia materna exclusiva (p valor 0,019), de igual forma se correlaciono la edad del cuidador (mayores de 23 años) y la inclusión de la alimentación complementaria como cereales (p valor 0,000) /NOTA: "p" quiere decir muchas. Conclusión: se evidencia que las prácticas relacionadas con el componente uno de la estrategia AIEPI relacionada a la lactancia materna, alimentación complementaria, micronutrientes, desarrollo mental y social de niños menores de 5 años, son aplicadas en un sector de Cartagena; sin embargo, existes resultados que constituyen porcentajes significativos en el aumento del riesgo de aparición de enfermedades como la diarrea e infección respiratoria aguda..Au

Objective: to evaluate the application of the IMCI strategy, in the promotion of exclusive breastfeeding, complementary feeding, use of micronutrients and prevention of alterations in the mental and social development of children under 5 years of age. Materials and methods: descriptive-correlational quantitative study, a sample of 323 parents and / or caregivers was used. Results: exclusive breastfeeding was provided in 52% and in complementary feeding the foods of choice were cereals 77.1%, tubers 71.8%, fruits 40% and vegetables 43%. They administer enough micronutrients 82.4%.92.6% provide caresses and 83.9% use the game as a form of encouragement for their children. There was a correlation between the age of the caregiver and exclusive breastfeeding (p value 0.019), in the same way the age of the caregiver (over 23 years) and the inclusion of complementary feeding such as cereals (p value 0.000) were correlated. Conclusion: it is evidenced that the practices related to component one of the IMCI strategy related to breastfeeding, complementary feeding, micronutrients, mental and social development of children under 5 years of age, are applied in a sector of Cartagena; however, there are results that constitute significant percentages in the increased risk of the appearance of diseases such as diarrhea and acute respiratory infection..Au

Feeding practices and early weaning in the neonatal period: a cohort study

ABSTRACT OBJECTIVE To describe feeding practices and the risk factors for the mixed breastfeeding and early weaning in the neonatal period. METHODS Cohort study, which we collected socioeconomic, demographic, health care and feeding data from 415 mother/child binomials born in four public maternity hospitals in Natal/Brazil. They were followed-up at 48 hours, 7 and 28 days after birth. The association was established using Pearson's Chi-square test and Poisson's regression, after adjusting it to other variables. RESULTS The prevalence of mixed breastfeeding in the first 2 days was 47,2% and early weaning in 7 and 28 days was 8,4% and 16,2% in that order. The main reasons for mixed breastfeeding and early weaning were: colostrum deficiency (33.8%), difficulty in latching/sucking (23.5%) and "little milk" (70.0%). The use of formula/milk/porridge remained associated with maternal age ≤ 20 years (RR = 0.64; 95%CI: 0.47-0.86), age 20-29 years (RR = 0,70; 95%CI: 0,57-0,87), primiparity (RR = 1.37; 95%CI: 1.11-1.60) and cesarean delivery (RR = 1.20; 95%CI: 1.00-1.45) at 2 days; absence of paternal support (RR = 4.98; 95%CI: 2.54-9.79) and pacifier use (RR = 3.21; 95%CI: 1.63-6.32) at 7 days; and only pacifier use (RR = 2.48; 95%CI: 1.53-4.02) at 28 days. CONCLUSIONS Early weaning was associated with maternal and health care factors, thus suggesting the need to readjust good practices and educational actions to achieve the exclusive offer to the maternal breast in the neonatal period.

Changes of serum immunoglobulin IgG in peripheral blood of infants and effects of different feeding methods on immune function in infants / 中国实用护理杂志

Objective To investigate the changes of serum immunoglobulin IgG in peripheral blood of infants aged 0-6 months,and to compare the effects of breast feeding and artificial feeding on the immune function of infants. Methods A total of 90 neonates born from January 2016 to December 2016 were divided into three groups: breast feeding group, mixed feeding group and artificial feeding group. There were 30 newborns in each group.Peripheral blood samples were collected at postnatal 1 d,3 d,7 d, 14 d, 42 d, 3 months and 6 months respectively. Serum levels of IgG were determined by radioimmunoassay, and the contents of each group were compared. T lymphocyte subsets(CD3+, CD4+, CD8+)in peripheral blood at postnatal 6 months were detected. Results The content of IgG in serum of neonatal decreased gradually with the increase of postnatal days.The serum IgG content at postnatal 14 d in the breast feeding group, the mixed feeding group and the artificial feeding group was (95.14 ± 4.55), (90.89±4.35),(91.74±4.19)mg/L respectively,and the breast feeding group was significantly higher than the other two groups,the difference among the groups was statistically significant(F=7.965,P<0.05).The CD8+T lymphocyte cells in the breast feeding group, the mixed feeding group and the artificial feeding group was 0.389 4±0.060 1,0.294 2±0.062 6,0.308 4±0.071 6 respectively,and the breast feeding group was significantly higher than the mixed feeding group and the artificial feeding group,and the difference among the groups was statistically significant(F=4.941,P<0.05).Conclusions Breast feeding can reduce the serum IgG content of infant consumption,slowing the pace of decline,effectively improve the infant's own ability to synthesize IgG,so as to improve infant immunity,promote their healthy growth,it is worthy of clinical application.

Dificuldades na introdução de alimentos complementares ao aleitamento materno em bebês não disfágicos: efeitos da atuação fonoaudiológica / Difficulties in introduction of complementary foods to breastfeeding in non-dysphagic babies: effects of speech-language pathological interference / Dificultades en la introducción de alimentos complementarios a la lactancia materna en bebés no disfágicos: efectos de la actuación fonoaudiológica

Introdução: No período de transição do aleitamento materno para alimento pastoso e/ou sólido, tal modificação pode não ser bem aceita pela mãe e/ou pelo bebê e ocasionar problemas de alimentação e/ ou de linguagem subsequentes. Objetivo: descrever os efeitos da atuação fonoaudiológica diante das dificuldades na introdução de alimentos complementares ao aleitamento materno em bebês não disfágicos numa abordagem biopsíquica. Método: Estudo realizado em instituição de saúde filantrópica, de acordo com critérios éticos estabelecidos para pesquisas com seres humanos. Casuística: Cinco díades mãe/ bebê, bebês de ambos os gêneros, na faixa etária entre 5 e 8 meses, com dificuldades no desmame e sem diagnóstico de disfagia orofaríngea neurogênica ou mecânica. A amostragem foi obtida por conveniência. Procedimento: Foram realizados quatro encontros, sendo três visitas domiciliares, nos quais foram aplicados três instrumentos de avaliação, adaptados a partir da literatura. Após a ação fonoaudiológica foi reaplicado o último, para efeitos de comparação pré e pós. Resultados: Após a atuação fonoaudiológica, houve eliminação de episódios de engasgos, as refeições se tornaram mais prazerosas para a díade mãe/ bebê e os bebês passaram a aceitar melhor os alimentos. Os resultados revelaram diferença estatisticamente significativa entre os obtidos pré e pós atuação fonoaudiológica: média inicial era de 16,0 pontos (dp=1,0) e final 21,2 pontos (dp=0,8/ p= 0,001), (p=0,001). Conclusão: A atuação fonoaudiológica numa abordagem biopsíquica promoveu benefícios nos casos estudados.

Introduction: In the transition period from breastfeeding to pasty and/or solid food, such modification may be not well accepted by the mother and/or baby and cause subsequent feeding and/or language problems. Objective: To describe the effects resulting from speech and language therapy while facing the difficulties in the introduction of complementary foods to breastfeeding in non-dysphagic babies in a biopsychic approach. Method: studies carried out by philanthropic institution of health in accordance with ethical criteria for research with human beings. Casuistry: Five mother/baby dyads, babies from both genders over between 5 and 8 months old showing weaning difficulties to pasty food and without any diagnosis of either mechanical or neurogenic oropharyngeal dysphagia. The sampling was obtained by convenience. Procedures: Four meetings were conducted, three of home visits, in which were applied three evaluation instruments adapted from literature. After the speech-language pathological interference the last one was a reapplication for the purpose of comparing before and after. Results: After speechlanguage pathological interference, choking episodes were eliminated, meals became more pleasuring for mother/baby dyads and babies started accepting food more adequately. The results show that there was statistically significant difference between before and after speech-language pathological interference. Initially, the average was 16,0 points (dp=1,0), and end 21,2 points (dp=0,8), (p=0,001). Conclusion: Speech-language pathological interference in a biopsychic approach promoted benefits in the cases studied.

Introduçción: En el período de transición de la lactancia para alimentos pastosos y / o sólidos, la modificación puede no ser bien aceptada por la madre y / o el bebé y causar problemas de alimentación y / o lenguaje subsecuentes. Objetivo: Describir los efectos de la actuación fonoaudiológica frente a las dificultades en la introducción de alimentos complementarios a la lactancia materna en bebés no disfágicos en un abordaje biopsíquico. Método: Estudio realizado en instituición de salud filantrópica de acuerdo con critérios éticos establecidos par las investigaciones con seres humanos. Casuística: Cinco díadas madre/bebé, bebés de ambos géneros y de edades comprendidas entre los 5 y 8 meses, con dificultades en el destete y sin diagnóstico de disfagia orofaríngea neurogénica o mecánica. La muestra fue obtenida por conveniencia. Procedimiento: Se han realizado cuatro encuentros, siendo tres en visitas domiciliares, en los cuales se aplicaron tres instrumentos de evaluación adaptados de la literatura. Después de la acción fonoaudiológica se reaplicó el último, a fin de comparar el antes y el después. Resultados: Después de la actuación fonoaudiológica, hubo eliminación de episodios de asfixia, los momentos de alimentación se hizieron más agradables para la díada madre / bebé y los bebés comenzaron a aceptar mejor los alimentos. Estos resultados revelaron diferencia estadísticamente significativa entre los datos obtenidos antes y después de la actuación fonoaudiológica: el promedio inicial era 16,0 puntos (dp=1,0) y el final 21,2 puntos (dp=0,8/ p= 0,001), (p=0,001). Conclusión: En los casos estudiados, la actuación fonoaudiológica en un abordaje biopsíquico promovió benefícios.

Ronda clínica y epidemiológica: club de revistas / Clinical and epidemiological round: journal club

RESUMEN En esta edición de la Ronda Clínica y Epidemiológica analizamos cuatro artículos que consideramos importantes para la práctica clínica. El estudio del grupo SPIROMICS busca replantear la necesidad de la espirometría para el diagnóstico de enfermedad pulmonar obstructiva crónica (EPOC), especialmente en los pacientes con antecedente de tabaquismo que tienen función pulmonar normal, pero desarrollan desenlaces de enfermedad pulmonar crónica. Borja-Gómez y colaboradores, por otro lado, validan un enfoque sistemático para descartar infecciones bacterianas invasivas en niños febriles menores de 3 meses. El estudio de Talan y colaboradores estima la utilidad del tratamiento antibiótico con trimetoprim-sulfametoxazol, adicional al drenaje quirúrgico, como una estrategia para mejorar la curación de abscesos en piel en una población con alta prevalencia de Staphylococcus aureus resistente a meticilina (MRSA). Por último, el estudio del grupo EAT que analiza la introducción de alimentos alergénicos en lactantes a partir de los 3 meses, como una estrategia para proteger contra el desarrollo de reacciones alérgicas alimentarias posteriores.

SUMMARY In this edition of Ronda Clínica y Epidemiológica four articles that we consider important for clinical practice are analyzed. The study by the SPIROMICS group wanted to rethink the use of spirometry for the diagnosis of chronic obstructive pulmonary disease (COPD), mainly in symptomatic patients with smoking history and preserved pulmonary function, but with outcomes similar to those developed in chronic pulmonary disease. Borja Gómez et al. aimed at validating a step-by-step approach for young febrile infants, in order to discard an invasive bacterial infection. The study by Talan et al. wanted to demonstrate that antibiotic therapy with trimethoprim-sulfamethoxazole, in addition to surgical drainage, was associated with a higher cure rate for cutaneous abscesses compared to placebo in a population with high prevalence of methicillinresistant Staphylococcus aureus (MRSA) infection. Lastly, the EAT study analyzed the early introduction of allergenic foods in breast-fed infants, starting at the age of 3 months, as a strategy to protect them against the development of posterior food allergy.

Infant Feeding Practices of HIV Positive Mothers in Lagos, South-western Nigeria

Introduction: Infant feeding choices made by mothers in the context of HIV infection depend on a number of factors. In our environment, the relative contribution of some of these factors is not known. Methods: The infant feeding practices of HIV positive mothers seen over a decade (July 2004 and December 2015) at a large HIV treatment centre in Lagos, South-western Nigeria were reviewed. Information on maternal socio-economic characteristics, obstetric, HIV treatment history and infant feeding choices were extracted from the program data base for analysis with SPSS version 20. Results: Exclusive formula feeding (EFF) was the most common feeding practice of the mothers ( 86.4%). However, it decreased from 95.3 % before 2010 to 79.5% after 2010. Exclusive breastfeeding (EBF) was practised by only 9.0% of the mothers. Mixed breastfeeding practice increased from 1.1% pre-2010 to 4.1% post-2010. The provision of free infant formula was found not to influence significantly the EFF or EBF rates but the MBF rate. MBF rate decreased from 3.0% pre-free formula to 1.7% after the introduction of free infant formula. Conclusion: Exclusive formula feeding was the most practised infant feeding method in this study (86.4%). Change in infant feeding guidelines was found to influence the infant feeding choice of HIV positive mothers. Health workers implementing PMTCT programs in our setting should be made aware of the risk of mixed breastfeeding with the new guidelines and educate mothers on its dangers at every contact with the health system.

Efetividade de intervenções em creches públicas pautadas na educação alimentar e nutricional com diferentes abordagens na promoção da alimentação complementar saudável / Effectiveness of interventions in public day care centers based on food and nutrition education with different approaches in the promotion of healthy complementary feeding

lntrodução: As praticas alimentares nos primeiros anos de vida constituem marco importante na formação de hábitos saudáveis, sendo fundamental que todos os envolvidos no processo de cuidar da criança recebam orientações sobre o aleitamento materno e a adequada introdução dos alimentos complementares. Objetivo: lnvestigar a efetividade de abordagens diferentes de intervenções nutricionais sobre o conhecimento, crenças, atitudes e intenções de cuidadores de lactentes das creches municipais de Nova Lima, Minas Gerais, em relação a alimentação complementar. Materiais e Métodos: Trata-se de um estudo de intervenção controlado, não randomizado, efetuado com profissionais da educação e pais de crianças matriculadas nos berçários I e II das creches publicas do referido município. Os participantes foram divididos em dois grupos: controle (GC) - educação alimentar e nutricional padrão composta pela oferta de orientações escritas; e intervenção (GI) que além de receber as informações do GC participou de quatro reuniões bimestrais sobre alimentação complementar saudável. Utilizou-se como base para as ações materiais institucionais como o Guia Alimentar para Crianças Menores de Dois Anos e Cademos de Atenção Básica. Em ambos os grupos, avaliou- se antes e após as atividades educativas (duração média: 8 meses), a mudança no conhecimento dos profissionais sobre o tema e as crenças, atitudes e intenções dos pais por meio de questionários específicos. Os dados obtidos foram analisados por meio de estatística descritiva e aplicação dos testes Kolmogorov-Smirnov, Mann-Whitney, qui-quadrado, exato de Fisher, Mcnemar, t de Student, Wilcoxon, correlacaode Spearman e Ancova, a um nivel de 5% de siqnificância, Resultados: Participaram do estudo 90 profissionais (GC: 50 e GI: 40) e 169 pais de alunos (GC:97 e Gl:72).Ap6s as intervenções, houve incremento significativo na...

Introduction: The eating habits in the early years of life are an important milestone in the formation of healthy habits. It is essential that everyone involved in the care of children receive guidance on breastfeeding and complementary feeding. Objective: To investigate the effectiveness of different approaches of nutritional intervention on knowledge, beliefs, attitudes and intentions of caregivers of children ages 4 to 24 months of child day care municipal centers in Nova Lima I Minas Gerais. Materials and Methods: The study was conducted as a non-randomized controlled intervention with education professionals and parents of children enrolled in nursery I and II of childday care municipal centers. The participants were divided into two groups: control (GC)- Standard food and nutrition education guidance through written guidelines; and intervention (GI) that in addition to receiving the GC information, participated in four bimonthly meetings about complementary healthy feeding. It was used as basis for actions, institutional material as the Food Guide for Children Under Two Years and Primary Care Notebooks. In both groups was evaluated before and after the educational activities (average duration: 8 months), the change in the professionals'knowledge on the subject and the change in beliefs, attitudes and parental intentions through specific questionnaires. Data were analyzed using descriptive statistics and application of the Kolmogorov-Smirnov test, Mann-Whitney, chi-square, Fisher's exact, McNemar, Student t, Wilcoxon, Spearman correlation and Ancova at a level of 5%significance. Results: The study included 90 professionals (GC: 50 and GI: 40) and 169 parents of children GC:97 e Gl:72). After the interventions, there was a significant increase in the average of right answers of the professionals in GI ([12,2 (11.6 -12.7) vs 10.7 (10.2 -11.2) in GC; p = 0,001] and improvement among parents of...

Infant feeding practices in the Peruvian Amazon: implications for programs to improve feeding / Prácticas de alimentación de lactantes en la Amazonia Peruana: implicaciones para los programas de mejora de la alimentación

OBJECTIVE: To characterize feeding practices in a community in the Peruvian Amazon and to consider how this information could be used to strengthen programs and policies designed to improve nutrition and reduce child malnutrition in vulnerable communities METHODS: Data from three structured questionnaires were combined to produce a comprehensive depiction of feeding in a sample of 246 infants from birth through 8 months of life in the community of Santa Clara de Nanay near Iquitos, Peru. Breastfeeding initiation practices, exclusive breastfeeding in the first 180 days of life, the introduction of solids, and complementary feeding practices from 6-8 months, were described and related to maternal, infant, and household characteristics, including food insecurity RESULTS: The median duration of exclusive breastfeeding was 19 days. However, over the first 180 days of life, children were exclusively breastfed on 46.1% of days. Overall, 68.3% of infants received some semi-solid or solid food between 0-6 months and all had received semi-solids by the end of 8 months of age. The proportion of infants consuming a minimally acceptable (frequent and diverse) complementary diet was 2.9%, 7.9%, and 16.1% at 6, 7, and 8 months respectively CONCLUSIONS: Although breastfeeding is nearly universal, promotion programs are needed in Santa Clara to 1) delay the introduction of plain water, other non-breast milk liquids, and semi-solid foods; 2) extend the period of exclusive breastfeeding; and 3) increase food diversity and the frequency of feeding during the period of complementary feeding. These results can be used to guide programs and policies to improve nutrition and reduce child malnutrition.

OBJETIVOS: Determinar las prácticas de alimentación en una comunidad de la Amazonia peruana y analizar cómo esta información podría usarse para fortalecer los programas y las políticas diseñadas para mejorar la nutrición y reducir la desnutrición infantil en las comunidades vulnerables MÉTODOS: Se combinaron datos de tres cuestionarios estructurados para obtener una descripción integral de la alimentación en una muestra de 246 lactantes, desde el nacimiento y hasta los 8 meses de vida, en la comunidad de Santa Clara de Nanay cerca de Iquitos, Perú. Se describieron las prácticas de iniciación de la lactancia materna, lactancia materna exclusiva en los 180 primeros días de vida e introducción de alimentos sólidos y las prácticas de alimentación complementaria desde los 6 hasta los 8 meses, y se las relacionó con las características maternas, de los lactantes y los hogares, lo que incluyó la inseguridad alimentaria RESULTADOS: La mediana de duración de la lactancia materna exclusiva fue 19 días. Sin embargo, en los 180 primeros días de vida los niños habían sido amamantados exclusivamente 46,1% de los días. En términos generales, 68,3% de los lactantes recibieron algún alimento semisólido o sólido entre los 0 y los 6 meses de vida, y hacia el final del octavo mes de vida todos habían recibido alimentos semisólidos. La proporción de lactantes cuyo régimen alimentario complementario había sido mínimamente aceptable (frecuente y diverso) fue 2,9% a los 6 meses, 7,9% a los 7 meses y 16,1% a los 8 meses CONCLUSIONES: A pesar de que la lactancia materna es prácticamente universal, en Santa Clara son necesarios programas de promoción para 1) retrasar la introducción de agua corriente, otros líquidos fuera de la leche materna y alimentos semisólidos; 2) extender el período de lactancia materna exclusiva, y 3) aumentar la diversidad de los alimentos y la frecuencia de la alimentación durante el período de alimentación complementaria. Estos resultados pueden ser útiles para guiar los programas y las políticas de mejora de la nutrición y reducir la desnutrición infantil.

Alimentação no primeiro ano de vida e prevenção de doenças alérgicas: evidências atuais / Feeding in the first year of life and prevention of allergic diseases: current evidence

A prevalência de doenças alérgicas aumentou significantemente nos últimos anos. Devido a este rápido aumento, surgiu o interêsse em se identificar estratégias de prevenção ou redução do risco de se desenvolver alergia. Acredita-se que esta alta prevalência seja consequência de mudanças ambientais modernas, como o desenvolvimento industrial, mudanças climáticas e de hábitos alimentares que poderiam afetar a função imunológica, independente do seu caráter genético. O presente estudo tem como objetivo discutir o papel da alimentação no primeiro ano de vida sobre a prevenção de doenças alérgicas, através de revisão bibliográfica com base em artigos publicados entre 2003 e abril de 2014, disponíveis nos bancos de dados PubMed, SciELOe LILACS. Com relação ao aleitamento materno, existem poucas evidências do seu efeito protetor para o desenvolvimento de alergia. A recomendação de manter o aleitamento materno exclusivo por período de 4 a 6 meses deve-se a outros benefícios associados a esta prática. Há dados suficientes para a indicação da utilização de fórmulas parcialmente ou extensamente hidrolisadas, com alergenicidade reduzida comprovada, para aqueles com alto risco de desenvolvimento de atopia, quando a amamentação exclusiva não for possível. O início da alimentação complementar é recomendado após 4-6 meses, com atenção à variedade dos alimentos. A alimentação no primeiro ano de vida parece ser importante para a modulação do desenvolvimento do sistema imunológico e prevenção de alergias...

The prevalence of allergic diseases has significantly increased in recent years. Such rapid increase has stimulated research into strategies to prevent or reduce the risk of allergy. It is believed that this high prevalence may be due to recent environmental changes, including industrial development, climate change, and dietary habits, all of which may affect imune function, regardless of genetic background. The aim of the present study was to discuss the role played by feeding in the first year of life in the prevention of allergic diseases. In order to do that, the literature was browsed for articles published between 2003 and April 2014 and available in the PubMed, SciELO, and LILACS databases. With regard to breast feeding, there is little evidence of a protective effect of this practice against the development of allergy. The recommendation of maintaining exclusive breast feeding for 4-6 months is based on other associated benefits. Conversely, there is sufficient evidence to recommend the use of partially or extensively hydrolyzed formula, with proven low allergenic activity, in infants at high risk of developing atopy when exclusive breast feeding is not possible. The initiation of complementary feeding is recommended after 4-6 months, and the variety of foods should be selected with care. Feeding in the first year of life appears to be important to modulate the development of the immune system and to prevent allergies...

Práticas alimentares no primeiro ano de vida / Eating habits in the first year of life / Hábitos alimenticios en el primer año de vida

O estudo buscou analisar a literatura publicada referente às práticas alimentares no primeiro ano de vida de filhos de mães adolescentes, por meio de uma revisão integrativa nas bases de dados Lilacs, Medline e Cochrane, no período de 2000 a 2010. Foram utilizadas as palavras-chave: adolescente, aleitamento materno, alimentação mista e nutrição do lactente, sendo selecionados onze artigos científicos, que compuseram a amostra do estudo. Os resultados apontaram a incipiência de pesquisas publicadas sobre o tema proposto, sobretudo para as que versam sobre alimentação complementar, desvelando uma lacuna na produção mundial sobre o tema. Novas pesquisas, portanto, precisam ser desenvolvidas com foco em mães adolescentes, devendo-se explorar a alimentação infantil em toda sua dimensão.

The study aimed to examine the relevant published literature to food practices in the first year of life of teenage mothers' children, through an integrative review within Lilacs, Medline and Cochrane, databases from 2000 to 2010. We used the keywords: adolescent, breastfeeding, mixed feeding and infant nutrition, from which we selected eleven articles that composed the study sample. The results indicated the paucity of published research on the proposed topic, especially for those focusing on complementary feeding, revealing a gap in global production on the subject. New researches, therefore, need to be developed with a focus on teenage mothers, exploring infant feeding in all its dimensions.

El estudio trató de examinar la bibliografía publicada sobre los hábitos alimenticios en el primer año de vida de los hijos de madres adolescentes, mediante una revisión integradora en las bases de datos Lilacs, Medline y Cochrane, en el período de 2000 a 2010. Hemos usado las palabras clave: adolescente, lactancia materna, alimentación mixta y nutrición del lactante, siendo seleccionados once trabajos, los cuales compusieran la muestra del estudio. Los resultados indicaron la escasez de investigaciones publicadas sobre el tema propuesto, especialmente para aquellos que se ocupan de la alimentación complementaria, con una brecha en la producción mundial sobre el tema. Nuevos estudios, por lo tanto, necesitan ser desarrollados con un enfoque en las madres adolescentes, y explorar la alimentación infantil en todas sus dimensiones.

Nutritional Status and Eating Behavior of Lactating Women in Daejeon / 대한지역사회영양학회지

Nutrients intake status of 73 lactating women, that is 45 breast feeding (BF), 13 formula feeding (FF) and 15 mixed feeding (MF), living in Daejeon was investigated. Self-recorded food intakes for two weekdays and eating behaviors using questionnaires were surveyed from May to August 2008. Subjects aged 29.2 +/- 3.4 years and their infants aged 8.2 +/- 3.2 months. Body mass index of the subjects was 21.0 +/- 3.2. Of the subjects 23.3% were employed. Daily energy intake was 1953 +/- 391 kcal. Mean adequacy ratio (MAR) was 0.77 +/- 0.14 and was higher in FF (0.86 +/- 0.13) than in BF (0.76 +/- 0.11) and MF (0.72 +/- 0.18). Nutrients that over 50% of the subjects took less than estimated average requirement were vitamin A, riboflavin, folate, vitamin C and calcium. And index of nutritional qualities of those 5 nutrients were below one Forty six and sixths percent (46.6%) of the subjects showed GMFVD = 11111 pattern of five food group intakes and 57.5% took meals three times daily, 56.2% skipped often breakfast, and 64.4% dined out two times and more per week. Subjects having lower MAR ( or = 0.83, n = 24), showed more skipping daily meals and less frequency of eating-out, and took less legumes, vegetables, fishes, and milk. As the results, intakes of calcium, vitamin A, riboflavin, folate, and vitamin C were insufficient in lactating women, especially in BF and MF mothers. Meal skipping and low intakes of dairy foods, legumes, vegetables, and fishes might have adverse influences on nutritional status of lactating women. Accordingly, nutrition care program for lactating women should be focused on intake of three meals daily and a variety of food.

Alimentação complementar e desenvolvimento sensoriomotor oral: possíveis implicações / Complementary feeding and oral sensorimotor development: possible implications

A alimentação infantil tem sido objeto de estudo há muitos anos. Nas últimas décadas, as atenções estiveram centradas na prática do aleitamento materno, mas mais recentemente e crescente a preocupação de profissionais da saúde em compreender melhor o processo de alimentação complementar ou mister do lactente. Analisamos em crianças de cinco a oito meses de idade, com dificuldade na transição alimentar, aspectos do desenvolvimento motor global e sensoriomotor oral, em estudo exploratório que envolveu 88 bebês que realizavam acompanhamento em Serviço de Puericultura. Os dados foram obtidos pela realização de entrevista com as mães ou suas substitutas, seguida de observação da criança por ocasião da consulta de rotina. Os dados foram analisados por estatística descritiva e inferencial. Os resultados revelaram que, dentre as crianças que estavam em transição alimentar, 31,8% (28/88) das mães ou suas substitutas vivenciaram dificuldades em introduzir novos alimentos. Foi observada maior freqüência de alterações no desenvolvimento motor global e sensoriomotor oral nas crianças que apresentaram dificuldade na introdução da alimentação complementar. Os dados sugerem possível relação entre aceitação da alimentação complementar e nível de maturidade neuromotora da criança.

Children's feeding has been the object of studies for many years. In the last decades, attention has been centered on breastfeeding practices. However, more recently health professionals have tried to better understand the mix or complementary feeding in the infancy. Aspects of global motor and oral sensorimotor development in children of five to eight months of age with difficulties in food transition were analyzed in this exploratory study involving 88 babies who were being attended at the Child Care Service. Data were obtained by carrying out interviews with the mothers or their substitutes, followed by observing the children during their attendance. Data were analyzed by inferential and descriptive statistics. The results revealed that among children in feeding transition, 31.8% (28/88) of the mothers or their substitutes had difficulties in introducing new foods. A major frequency of alterations of the development of the global and oralsensorimotor development was observed in children that presented difficulties with the introduction of complementary feeding. A possible relationship between the acceptance of complementary feeding and the neuromotor maturity level of the child is suggested.

Infant Feeding Practices and the Factors that Influence Feeding Practices among Women in Seoul and the Chungbuk Area / 대한지역사회영양학회지

In order to obtain baseline data for the development of an educational program on breastfeeding, a survey was carried out to investigate infant feeding practices, the characteristics the subjects have in common, and the factors that influence the feeding methods among women in Seoul and the Chungbuk area. Subjects included 671 lactating mothers who visited public health centers or pediatric clinics between December 1999 and February 2000, and were interviewed using a questionnaire. The results were as follows : With respect to feeding methods, the incidence of breastfeeding, formula feeding, mixed feeding and formula feeding switched from breastfeeding was 20.6%, 29.8%, 11.6%, and 38.0%, respectively. With respect to the characteristics the subjects had in common, the incidence of women who planned their infants' feeding methods before pregnancy, during pregancy, and after delivery was 48.7%, 31.0%, and 20.3%, respectively. The incidence of women who started breastfeeding in the hospital after delivery was 38.8%. About seventy seven percet of the subjects had not previously attended an educational program on breastfeeding, and most of these wanted to participate in the future in an educational program to learn about breastfeeding. Some of the topics they were interested in were 'Nutritional Management for Sufficient Breast Milk' (60.3%), "Breast Care" (25.0%), and "Correct Nursing Positions" (9.8%). Most (88.2%) of the women who breastfeed suffered from physical discomforts including discomfort of the waist, and legs and discomfort due to cracked or sore nipples. "Insufficient breast milk" was the main reason for breastfeeding cessation or for switching to formula feeding. With respect to formula feeding practices, the main reasons for selecting a specific brand of formula were "the same brand the hospital used after delivery" (34.3%) and "an advertised brand" (23.3%). The strongest factor for promoting breastfeeding was "the support of husband or parents", next were "breastfeeding in the hospital after delivery" and "planning to breastfeed before pregnancy" in that order. The characteristics the subjects had in common relating to formula feeding were "mother's job", "high economic level", "Caesarian section" and "planning to breastfeed after delivery". In conclusion, it is recommended that breastfeeding be pro-moted, and educational programs be developed and offered as soon as possible to each group which had unfavorable attitudes toward breastfeeding. In addition, the monitoring and supervision of formula advertisements is required to protect consumers from the adverse effects of exaggerated advertising.

A Statistical Study of Feeding Trends

A statistical study was done on the feeding trends of 2,965 children who had visited both the out-patient clinic and the well-baby clinic of Padiatric Department, St. Benedict Hosp., from Sept., 1979 to Aud., 1980. 1) Among the total 2,965 children, the distribution according to age was about the same. The percentage of male and female was 58.5% respectively. As for geographical area of the cases, the majority were from Busan City Kyung Nam Province and the percentage was 96% and 3% respectively. 2) As for the methods of feeding, breast-feeding was 65%, artificial-feeding 18% and mixed-feeding 15%. 81% among the total cases had been on breast-feeding at one time or another. 3) As for feeding trends according to age, the younger the chile was, the more frequent the chance of artificial feeding. 4) Breast-feeding was less common in the children of premature delivery than children of full-term delivery. 5) Breast-feeding was less common among children with difficult delivery than children with easy delivery. 6) Breast-feeding was less common among children of hospital delivery than children of home delivery. 7) The higher the education level of the mother, the less common breast-feeding was. 8) Breast-feeding was less common among children from Busan City than children from Kyung Nam Province. 9) As for the beginning of feeding, in case of breast-feeding 56% were from 3rd day after bitrh and also in case of mixed-feeding 56% were from 3rd day after birth. 10) As for the duration of breas-feeding children with more than 12months of breast-feeding were most common(48%) and children with less than 6months of breast-feeding least common(8%). 11) The reasons for breast-feeding or mixed-feeding were not enough breast-milk 59%), mother's job 8%), baby's illness 8%), mother's illness 6%) and mother's breast problem 4%) by its frequency.

DIFFERENT FEEDING PRACTICES OF CHINESE INFANTS WITHIN FOUR MONTHS OF AGE IN 2002 / 营养学报

Objective:To study the different feeding practices of Chinese infants within four months of age in 2002. Method:The method of multi-steps cluster sampling was adopted. In order to ensure the sample size sufficient additional subjects were included in this survey. Results:More than two thirds (71.6%) of infants within four months of age had been almost exclusively breastfed, 65.5% and 74.4% in urban and rural areas respectively. The average percentage of mixed feeding was 23.0% (27.0% in urban and 21.2% in rural areas); and that of artificial feeding was 5.4% (7.5% in urban and 4.4% in rural areas). The rate of breastfeeding decreased with the increase of family income. Conclusion:Although the rate of almost exclusive breastfeeding is increasing, there is still far away from the aim of 85% in 2001-2010 National Outline for Children.