Implementing the nurturing care framework: resources

WHO and UNICEF have developed a range of tools to facilitate the implementation of the Nurturing care framework. The brochure provides an overview of the essential tools with their links.

Encontro com Especialistas - Contato pele a pele imediato e prolongado com os pais: experiências exitosas

Encontro com as Especialistas Aline Hennemann, enfermeira materno infantil, referência técnica do Método Canguru CACRIAD/DGCI/SAPS/Ministério da Saúde; Silvia Cavalcante, CNR HUUFMA; Geisy Lima, CNR IMIP; e Carmem Guimarães, CNR IMIP. Apresentação de experiências exitosas: (1) CPP imediato, precoce e prolongado: com Marivanda Goudard, neonatologista, coordenadora do CER Maternidade de Alta Complexidade do Maranhão (MACMA) e Euda Maria Aranda, neonatologista, coordenadora do CER Instituto Cândida Vargas/PB; (2) O uso de fotografias como facilitador da Posição Canguru: com Gláucia Maria Moreira Galvão, neonatologista, tutora do MC, docente FAMINAS-BH.

Encontro com Especialistas - Contato pele a pele imediato e prolongado com os pais: o que estamos fazendo para sua garantia?

Encontro com as Especialistas Sônia Venâncio, Coordenadora da Atenção à Saúde da Criança e do Adolescente (CACRIAD/DGCI/SAPS/Ministério da Saúde); Mônica Iassanã Reis, Coordenadora da Atenção à Saúde da Mulher (COSMU/DGCI/SAPS/Ministério da Saúde); Patrícia Santana Santos, Coordenadora da Atenção à Saúde do Homem (COSAH/DGCI/SAPS/Ministério da Ssúde); Zeni Lamy, médica neonatologista da UFMA e Coordenadora do Método Canguru; Aline Hennemann, enfermeira materno infantil, referência técnica do Método Canguru CACRIAD/DGCI/SAPS/Ministério da Saúde; e Denise Suguitani, diretora executiva da ONG Prematuridade.com.

Encontro com Especialistas - Contato pele a pele pela perspectiva obstétrica: como garantir esse cuidado desde o pré-natal?

Encontro com os Especialistas Janini Ginani, Coordenadora-Geral de Saúde Perinatal e Aleitamento Materno (CGSPAM/SAPS/MS); Luana Flausino Melo da Silva, médica ginecologista e obstetra, consultora técnica da CGPAM/SAPS/MS; Francisco Lázaro Pereira de Souza, médico ginecologista e obstetra, membro da Rede Brasileira para Estudos da Hipertensão na Gravidez (RBEHG); e Sérgio Marba, médico neonatologista da Universidade Estadual de Campinas (Unicamp).

Encontro com Especialistas - Garantindo o contato pele a pele imediato com os pais

Encontro com os Especialistas Janini Ginani, Coordenadora-Geral de Saúde Perinatal e Aleitamento Materno (CGSPAM/SAPS/MS); Licia Maria Oliveira Moreira, médica neonatlogista, professora do Departamento de Pediatria da Universidade Federal da Bahia (UFBA) e presidente do Departamento Científico de Neonatologia da Sociedade Brasileira de Pediatria (SBP); Maria Aparecida Munhoz Gaíva, representante da Sociedade Brasileira de Enfermeiros Pediatras (SOBEP); Sérgio Marba, médico neonatologista da Universidade Estadual de Campinas (Unicamp); e Zeni Lamy, médica neonatologista da Universidade Federal do Maranhão (UFMA).

Encontro com Especialistas - Aleitamento Materno Exclusivo até os seis meses: o papel dos profissionais de saúde

Encontro com as Especialistas Maria José Guardia Mattar, pediatra/neonatologista, membro do Departamento Científico de Amamentação da Sociedade de Pediatria de São Paulo, Coordenadora da Rede Paulista Banco de Leite Humano, e Renata Oliveira Giesta, enfermeira supervisora da equipe técnica de saúde do Banco de Leite Humano no Hospital Maternidade Leonor Mendes de Barros (SP) e assessora técnica da Coordenação Regional Sudeste do SAMU.

Child health promotion during the COVID-19 pandemic: A health and welfare sector collaboration

Background: Fragmented service provision and a lack of efficient cooperation between health and welfare sectors serving children and families remain ongoing challenges in South Africa. The coronavirus disease 2019 (COVID-19) pandemic escalated this fragmentation. A community of practice (CoP) was established by the Centre for Social Development in Africa to promote collaboration between the sectors and to assist communities in their environments. Aim: To explore and describe collaboration on child health promotion between professional nurses and social workers, who formed part of the CoP during the COVID-19 pandemic. Setting: The study was conducted in five public schools from four of the seven district regions of the City of Johannesburg, Gauteng province. Methods: A qualitative, exploratory, descriptive research design was employed to conduct psychosocial and health screenings of children and their families. Focus group interviews were conducted, and field notes were used to collect and confirm data from the team. Results: Four themes emerged. Participants shared their positive and negative experiences faced during the fieldwork, their realisation of the value of collaboration between various sectors and their desire and capacity to do more. Conclusion: Participants indicated that collaboration between the health and welfare sectors is vital to support and promote the health of children and their families. The COVID-19 pandemic highlighted the need for collaboration between these sectors in the children and their families' ongoing struggles. Contribution: The importance of these sectors being engaged as a team highlighted the multisectoral influence shaping child development outcomes, supporting children's human rights and advancing social and economic justice.

Abordaje fisioterapéutico en el tratamiento del cólico del lactante. Una revisión sistemática / Physiotherapeutic approach in the treatment of the infant colic. A systematic review

Objetivo: El objetivo de esta revisión será evaluar la efectividad de los diferentes tratamientos fisioterapéuticos de los que disponemos actualmente para reducir los casos o mejorar la sintomatología del bebé que padece cólico del lactante. Material y métodos: La búsqueda se realizó en las bases de datos Pubmed, PEDro y Scopus con las palabras clave infantcolic, physiotherapy y musculoskeletal manipulations. Se seleccionaron publicaciones de los últimos 20 años en inglés o en español. En ellas se evaluaban bebés con cólicos infantiles que se sometieron a diferentes tratamientos fisioterapéuticos. Las principales variables estudiadas fueron el patrón de llanto y la duración del sueño, y se usó como principal instrumento de medida el diario de llanto de 24horas. Para evaluar la calidad metodológica de los estudios se empleó la escala PEDro. Resultados: Tras la búsqueda bibliográfica se seleccionaron 13 ensayos clínicos controlados y aleatorizados. Estos estudios fueron clasificados según el tipo de tratamiento aplicado (masoterapia, manipulación espinal, manipulación craneal, reflexología y acupuntura) y estudiados, obteniéndose favorables resultados sobre todo con la aplicación de masoterapia. Conclusiones: Se han encontrado resultados favorables para el manejo de la sintomatología del cólico del lactante, reduciéndose las horas de llanto y aumentado las horas de sueño a través de los tratamientos fisioterapéuticos estudiados: masoterapia, manipulación espinal, manipulación craneal, reflexología y acupuntura.

Objective: To assess critically the effectiveness of the different physiotherapeutic treatments that we currently have to reduce cases or improve the symptomatology of the infant colic. Material and methods: A randomized clinical trial search was conducted in Pubmed, PEDro and Scopus databases using “infant colic”, “physiotherapy” and “musculoskeletal manipulations” as keywords. Publications of the last 20 years and of English or Spanish language were selected. In these studies, babies with infant colic were treated with different physiotherapeutic treatments. The variables studies were mainly the crying pattern, the duration of sleep and de 24-hour crying diary, which was used as the main measuring instrument. “PEDro” scale was used in order to evaluate the quality of the studies. Results: Thirteen clinical randomized trials were selected. The studies were classified according to the treatment applied (masotherapy, spinal manipulation, cranial manipulation, reflexology and acupuncture) and the effects reported, obtaining positive results specially those where masotherapy was used. Conclusions: Most of the studies showed favorable results of the treatments for infant colic. Masotherapy, spinal manipulation, cranial manipulation, reflexology and acupuncture improve infant colic symptoms, reducing crying hours and increasing sleep hours.

Panic or peace - prioritising infant welfare when medicating feverish infants: a grounded theory study of adherence in a paediatric clinical trial.

BACKGROUND: Literature on factors influencing medication adherence within paediatric clinical trials is sparse. The Paracetamol and Ibuprofen in the Primary Prevention of Asthma in Tamariki (PIPPA Tamariki) trial is an open-label, randomised controlled trial aiming to determine whether paracetamol treatment, compared with ibuprofen treatment, as required for fever and pain in the first year of life, increases the risk of asthma at age six years. To inform strategies for reducing trial medication crossovers, understanding factors influencing the observed ibuprofen-to-paracetamol crossovers (non-protocol adherence) is vital. The aim of this study was to investigate the factors influencing the decision-making process when administering or prescribing ibuprofen to infants that may contribute to the crossover events in the PIPPA Tamariki trial. METHODS: Constructivist grounded theory methods were employed. We conducted semi-structured interviews of caregivers of enrolled PIPPA Tamariki infants and healthcare professionals in various healthcare settings. Increasing theoretical sensitivity of the interviewers led to theoretical sampling of participants who could expand on the teams' early constructed codes. Transcribed interviews were coded and analysed using the constant comparative method of concurrent data collection and analysis. RESULTS: Between September and December 2020, 20 participants (12 caregivers; 8 healthcare professionals) were interviewed. We constructed a grounded theory of prioritising infant welfare that represents a basic social process when caregivers and healthcare professionals medicate feverish infants. This process comprises three categories: historical, trusting relationships and being discerning; and is modified by one condition: being conflicted. Participants bring with them historical ideas. Trusting relationships with researchers, treating clinicians and family play a central role in enabling participants to challenge historical ideas and be discerning. Trial medication crossovers occur when participants become conflicted, and they revert to historical practices that feel familiar and safer. CONCLUSIONS: We identified factors and a basic social process influencing ibuprofen use in infants and trial medication crossover events, which can inform strategies for promoting adherence in the PIPPA Tamariki trial. Future studies should explore the role of trusting relationships between researchers and treating clinicians when conducting research.

Consumo de alimentos açucarados e qualidade do sono no primeiro ano de vida: dados de uma coorte de nascimentos no nordeste do Brasil / Consumo de alimentos azucarados y calidad del sueño en el primer año de vida: datos de una cohorte de nacimiento en el noreste de Brasil / Consumption of sugary foods and quality of sleep in the first year of life: data from a birth cohort in northeastern Brazil

RESUMO Objetivo: investigar a duração do sono (DS), a frequência de despertares noturnos (DN) e o consumo de alimentos açucarados no primeiro ano de vida e verificar a associação entre o consumo desses alimentos e a má qualidade do sono. Métodos: a população do estudo foi composta de 179 crianças integrantes de uma coorte de nascimentos de Rio Largo-AL. As mães foram questionadas sobre a oferta regular de alimentos açucarados (açúcar/farinhas de cereais instantâneas com açúcar/bebidas açucaradas/doces) e o sono foi investigado pelo questionário traduzido e validado Brief Infant Sleep Questionnaire. Foram considerados indicadores de má qualidade do sono DS<12h e DN>2. Os testes de qui-quadrado de Pearson e exato de Fisher foram adotados para verificar associações entre o consumo de açucarados e a má qualidade do sono aos seis e 12 meses (p<0,05). Resultados: mais da metade das crianças apresentou DS<1 2h (60,3%) e cerca de » DN>2. O consumo regular de pelo menos uma das categorias de açucarados foi verificado entre 50,6, 91,1 e 100% das crianças aos três, seis e 12 meses de idade, respectivamente. Não foram encontradas associações entre o consumo desses alimentos e os indicadores de má qualidade de sono. Conclusão: o consumo de açucarados e a má qualidade de sono foram frequentes em nosso estudo, no entanto, não se identificou associação entre as variáveis. Mais investigações são necessárias para elucidar como o sono e a alimentação se inter-relacionam e se potencializam mutuamente como fatores determinantes do crescimento e desenvolvimento de lactentes.

RESUMEN Objetivo: investigar la duración del sueño (DS), la frecuencia de despertares nocturnos (DN) y el consumo de alimentos azucarados en el primer año de vida y verificar la asociación entre el consumo de estos alimentos y la mala calidad del sueño. Métodos: la población de estudio consistió en 179 niños de una cohorte de nacimiento en Rio Largo-AL. Se preguntó a las madres sobre el suministro regular de alimentos azucarados (azúcar / harinas de cereales instantáneas con azúcar / bebidas endulzadas / dulces) y se investigó el sueño mediante el cuestionario traducido y validado BriefInfantSleepQuestionnaire. Fueron considerados indicadores de mala calidad del sueño DS <12h y DN> 2. Se utilizaron las pruebas de chi-cuadrado de Pearson y exacta de Fisher para verificar las asociaciones entre el consumo de azúcar y la mala calidad del sueño a los seis y 12 meses (p <0.05). Resultados: más de la mitad de los niños tenían DS <1 2 h (60,3%) y alrededor de » DN> 2. Se verificó el consumo regular de al menos una de las categorías azucaradas entre el 50,6, el 91,1 y el 100% de los niños a los tres, seis y 12 meses de edad, respectivamente. No se encontraron asociaciones entre el consumo de estos alimentos y los indicadores de mala calidad del sueño. Conclusión: el consumo de azucarados y la mala calidad del sueño fueron frecuentes en nuestro estudio, sin embargo, no se identificó asociación entre las variables. Se necesita más investigación para dilucidar cómo el sueño y la alimentación se interrelacionan y se mejoran mutuamente como determinantes del crecimiento y desarrollo infantil.

ABSTRACT Objective: to investigate sleep duration (SD), frequency of night awakenings (NA) and consumption of sugary foods in the first year of life and to verify the association between consumption of these foods and poor sleep quality. Methods: the study population consisted of 179 children from a birth cohort in Rio Largo-AL. Mothers were asked about the regular supply of sugary foods (sugar/instant cereal flours with sugar/sweetened drinks/sweets) and sleep was investigated by the translated and validated Brief Infant Sleep Questionnaire. DS<12h and AN>2 were considered indicators of poor sleep quality. Pearson's chi-square and Fisher's exact tests were used to verify associations between sugary consumption and poor sleep quality at six and 12 months (p<0.05). Results: more than half of the children had SD<1 2h (60.3%) and about » AN>2. Regular consumption of at least one of the sugary categories was verified among 50.6, 91.1 and 100% of children at three, six and 12 months of age, respectively. No associations were found between the consumption of these foods and indicators of poor sleep quality. Conclusion: sugary consumption and poor sleep quality were frequent in our study; however, no association was identified between the variables. More investigations are needed to elucidate how sleep and feeding are interrelated and mutually potentiate as determinants of infant growth and development.

Protecting Breastfeeding during the COVID-19 Pandemic: A Scoping Review of Perinatal Care Recommendations in the Context of Maternal and Child Well-Being.

The objective of this scoping review is to determine to what extent the recommendations on perinatal care protect breastfeeding during the COVID-19 pandemic. The review follows the PRISMA ScR Extension guidelines. The research was conducted in Scopus, Medline via Pubmed, and Web of Science databases from 1 March 2020 to 31 May 2021, using 392 combinations of keywords. We searched for reviews and original papers published in English providing recommendations on delivery mode, companion during labor, the possibility of skin-to-skin contact (SSC), breastfeeding, and visitors policy. After screening, 86 out of 8416 publications qualified for data extraction. The majority of them indicated that COVID-19 infection is not a sufficient reason for a cesarean section; however, on a national level, cesarean births in severely ill patients were overrepresented. A significant number of recommendations deprived mothers of the necessary support during their labor and stay in the maternity ward. A shared decision-making model was hardly visible. Only the earliest COVID-19 recommendations suspended direct breastfeeding; in later publications, decisions were related to the mother's health, but other options of natural feeding were rarely discussed.

Impact of Plans of Safe Care on Prenatally Substance Exposed Infants.

OBJECTIVE: To assess the impact of recent federal statute changes mandating child welfare-based Plan of Safe Care (POSC) supportive programming and community-based linkages to treatment providers, resources, and services for families of infants affected by prenatal substance exposure (IPSE). STUDY DESIGN: Retrospective review of Delaware's statewide child welfare case registry data for IPSE birth notifications and subsequent hotline reports for serious physical injury/fatality concerns from November 1, 2018-October 31, 2020. Abstracted variables included IPSE sex, substance exposure type, family characteristics (maternal personal child welfare history or mental health diagnosis, treatment engagement), and POSC referrals. RESULTS: Of 1436 IPSE, 1347 (93.8%) had POSC support. Most IPSE (67.2%) had exposure to single substance types prenatally. Nearly 90% avoided out-of-home placement. Nearly one-fourth of mothers delivered a prior IPSE; 40% of mothers had personal histories of childhood protective services involvement. Also, 43.5% of mothers and 9.1% of fathers were referred to community-based resources, including substance use, mental health treatment, parenting classes, and home visiting nursing. Nearly 58% of IPSE were referred for pediatric/developmental assessment. Notably, 0.82% (11 out of 1347) of IPSE with POSC sustained serious physical or fatal injury. CONCLUSIONS: POSC promote supportive, potentially protective linkages to community-based programming for IPSE and their families.