[Overweight and obesity prevalence estimates in a population from Zaragoza by using different growth references]. / Estimación de la prevalencia de sobrepeso y obesidad infantil en un sector sanitario de Zaragoza utilizando diferentes estándares de crecimiento.

OBJECTIVES: To investigate the prevalence of overweight and obesity among our pediatric population and observe whether the use of different growth references for classification produce significant differences. MATERIAL AND METHODS: A total of 35824 boys and girls aged between 2 and 14 years were included. Body mass index (BMI) was used to calculate the prevalence of overweight-obesity by age and sex. Prevalence was obtained by using a set of national references (Hernández's standards) and the references of World Health Organization (WHO standards). Prevalences were compared for each age and sex subset, as well as with the percentage of patients who had an overweight-obesity diagnosis in the clinical record. RESULTS: The overall prevalence of overweight-obesity among children aged 2 to 14 years was 17.0% (95% CI; 16.1%-18.0%) according to the Hernández standards vs 30.8% (95% CI; 29.9%-31.7%) according to WHO standards (10.1% vs 12.2% obese, and 6.9% vs 18.6% overweight). It was significantly higher in boys, by both standards, due to the higher prevalence of obesity. By using the Hernández standards the prevalence was significantly lower than by using WHO standards for all ages and for both sexes. A low percentage of patients were found to have an obesity-overweight diagnosis in the clinical record (from 3% to 22% at the ages of 2 and 14 years, respectively). CONCLUSIONS: The prevalence of overweight-obesity in our population is high, especially among boys. Using Hernández standards leads to an under-estimation of the problem, especially because it detects less overweight patients, thus we recommend using the WHO standards in our daily practice. The low number of overweight-obesity diagnoses in the clinical records might reflect that there is little awareness of the problem by the professionals.

[Chemical pollution and breast milk: Taking positions]. / Contaminantes químicos y lactancia materna: tomando posiciones.

Chemical pollution affects all ecosystems of our planet. Human milk has been used as a biomarker of environmental pollution as, due to bioaccumulation processes in fat tissue, many chemical compounds reach measurable concentrations that can be readily tested in breast milk. Quite frequently information about the presence of contaminants in breast milk appears in the media, leading to misunderstanding among parents and health professionals, and in some cases breastfeeding the child is stopped. In this article, the Breastfeeding Committee of the Spanish Association of Paediatrics stresses the importance of promoting breastfeeding as the healthiest option, because its benefits clearly outweigh any health risks associated with chemical contaminants in breast milk. Breast milk contains protective factors that counteract the potential effects related to prenatal exposure to environmental pollutants. This article summarises the key recommendations to reduce the level of chemical contaminants in breast milk. It also highlights the importance of government involvement in the development of programs to eliminate or reduce chemical contamination of food and the environment. In this way, the negative effects on child health resulting from exposure to these toxic compounds through the placenta and breast milk may be prevented.

[Use of pacifiers and breastfeeding]. / Uso del chupete y lactancia materna.

Pacifiers are widely used in developed societies. They are used for soothing infants, reducing their stress and pain during procedures and to help them sleep. The use of pacifiers has been associated, however, with a shorter duration and exclusivity of breastfeeding, with higher rates of otitis media and dental problems, as well as a higher risk of accidents during infancy. Recent studies have also described a relationship between pacifier use and SIDS, especially when used during infant́s sleep. Other described benefits are analgesia and stimulation of non-nutritive sucking in preterm and term infants. There is, at present, wide debate and controversy on whether or not to recommend its use; thus it seems important for professionals and parents to be aware of the risks and benefits associated to its use, particularly related to breastfeeding. Due to the existing controversy of scientific findings, the Committee on Breastfeeding of the Spanish Paediatrics Society, publishes this review, trying to summarise present evidence with the objective of, after analysing scientific results and recommendations, making recommendations regarding the use of the pacifier in the breastfed infant.

Breast-feeding in Spain.

Human milk is the best way to nurture the human infant. By breast-feeding their babies, mothers provide them with the best opportunities to wholly develop their potential, while protecting the infants and themselves from a whole range of diseases in the near future and in the years to come. Even though these benefits are widely known and there is ample scientific evidence on the topic, it seems from published data that Spanish women are not breast-feeding their babies as much and for as long as they should. Less than 90% start breast-feeding, at 1 month there is already an attrition of 30%, at 3 months more than half of the infants are taking artificial milk and by 6 months only 10% continue to breast-feed their infants. Low birth weight, Caesarean section and low study level are among the more significant factors that negatively affect breast-feeding. There is still work to do to improve this situation. Promotion of breast-feeding among the general population, mothers and health professionals is needed.