Avaliação da eficácia do acessório mamilo na remoção dos hábitos deletérios / Evaluation of the effectiveness of the nipple accessory in the removal of the deletery habits

Objetivo: avaliar a eficácia do acessório mamilo aplicado a aparelhos ortopédicos/ ortodônticos no tratamento de hábitos deletérios de sucção de chupeta, língua, lábio e dedo, e onicofagia em pacientes tratados nos últimos 20 anos com o aparelho. Métodos: Trata-se de um estudo clínico observacional, retrospectivo, no qual a amostra foi composta de prontuários de pacientes de ambos os gêneros, atendidos por profissionais habilitados pelo aparelho mamilo, que os utilizaram em crianças de 03 a 16 anos portadoras de hábitos deletérios. Os prontuários utilizados, correspondem a pacientes tratados entre os anos 2000 a 2020. Todas as análises foram realizadas no programa R, com nível de significância de 5%. Resultados: Foram analisados 142 prontuários, nos quais 122 foram incluídos, por estarem dentro dos critérios de inclusão propostos no estudo e 20 foram excluídos da pesquisa por apresentarem informações incompletas e/ou não preenchidas corretamente. O hábito com maior incidência foi o de sucção digital, em 71,3% dos pacientes, 91,8% dos pacientes deixaram o hábito, destacando que nos casos de sucção de chupeta e onicofagia, o sucesso na remoção do hábito foi de 100%, em ambos os casos. O tempo médio de uso do aparelho foi de 4,8 meses, variando de 0,6 a 14 meses. O tempo médio para a remoção do hábito após a instalação do aparelho foi de 1,6 meses, variando de 0 a 12 meses. Conclusão: O aparelho mamilo, mostra-se como uma alternativa de alta eficácia na remoção de hábitos deletérios de sução de chupeta, dedo, língua e onicofagia.(AU)

Objective: Evaluate the effectiveness of the nipple accessory applied to orthopedic/orthodontic appliances in the treatment of harmful pacifier, tongue, lip and finger sucking habits, and onychophagia in patients treated in the last 20 years with the device. Methods: This is an observational, retrospective clinical study, in which the sample consisted of medical records of patients of both genders, assisted by professionals qualified by the nipple device, who used them in children aged 03 to 16 years with deleterious habits. The medical records used correspond to patients treated between the years 2000 and 2020. All analyzes were performed in the R program, with a significance level of 5%. Results: 142 medical records were analyzed, in which 122 were included, as they were within the inclusion criteria proposed in the study and 20 were excluded from the research because they presented incomplete information and/or not filled in correctly. The habit with the highest incidence was digital sucking, in 71.3% of patients, 91.8% of patients quit the habit, noting that in cases of pacifier sucking and onychophagia, success in removing the habit was 100%, in both cases. The average time of use of the device was 4.8 months, ranging from 0.6 to 14 months. The mean time to remove the habit after installing the device was 1.6 months, ranging from 0 to 12 months. Conclusion: The nipple device is a highly efficient alternative for removing harmful habits of pacifier, finger, tongue and onychophagy sucking.(AU)

Os malefícios da "Luva Chupeta" de látex na Unidade Neonatal / The harmful effects of the latex "Glove Pacifier" in the Neonatal Unit / Los efectos nocivos del "Guante Chupete" de látex em La Unidad Neonatal

Na Iniciativa Hospital Amigo da Criança-Neofoi proposto o uso da chupeta na Unidade Neonatal (UN) de modo terapêutico, e sempre com supervisão de um profissional de saúde. Mas observa-se que o aparato conhecido como "Luva Chupeta" fabricado com o uso de uma luva de látex está sendo utilizado como alternativa para acalentar o recém-nascido (RN). Apesar de poucos estudos, é evidente que esse dispositivo deve ser contraindicado na UN, uma vez que pode provocar alergia ao látex, transmitir infecções, provocar acidentes graves como aspiração laringotraqueal do algodão devido ao rompimento da luva de látex, e dependendo do tamanho do material, obstruir as vias aéreas, e levar a óbito. Além do mais, o dispositivo pode interferir negativamente no crescimento e no desenvolvimento craniofacial e causar prejuízos associados à amamentação e na saúde materno infantil. A substituição da "Luva Chupeta" por outras estratégias, até mesmo pela chupeta convencional ou ortodôntica, para lidar com a dor e situações de estresse do RN deve ser decisiva para evitar os riscos de acidentes graves. O Protocolo de uso de bicos, Protocolo de manejo da dor do RN, adoção do Método Canguru na UN para promoção do desenvolvimento e comportamento do RN, e a capacitação/monitoramento das práticas adotas pela Equipe Materno Infantil, quanto ao cuidado ofertado são alternativas mais complexas, mas que devem ser analisadas por aqueles que desejam oferecer confiabilidade aos seus processos institucionais. (AU)

In the Baby-Friendly Hospital-Neo Initiative, the use of pacifiers in the Neonatal Unit (UN) was proposed in a therapeutic way, and always under the supervision of a health professional. However, it should be noted that the device known as "Pacifier Glove" manufactured using a latex glove is being used as an alternative to cherish the newborn. Despite few studies, it is clear that this device should be contraindicated in the UN, since it can cause allergy to latex, transmit infections, cause serious accidents such as laryngotracheal aspiration of cotton due to the rupture of the latex glove, and depending on the size of the material, obstruct the airways, and lead to death. Furthermore, the device may interfere with craniofacial growth and development and cause harm associated with breastfeeding and maternal and child health. The substitution of the "Pacifier Glove" for other strategies, even for the conventional or orthodontic pacifier, to deal with the pain and stress situations of the baby should be avoided to avoid the risk of serious accidents.The teat use protocol, the baby's pain management protocol, the adoption of the Kangaroo Method in the neonatal unit to promote the baby's development and behavior, and the training/monitoring of the practices adopted by the Maternal and Child Team, regarding the care offered, are alternatives more complex, but which must be analyzed by those who wish to offer reliability to their institutional processes. (AU)

En la Iniciativa Hospital Amigo del Niño-Neo, se propuso terapéuticamente el uso del chupete en la Unidad Neonatal (UN), y siempre bajo la supervisión de un profesional de la salud. Pero se observa que el dispositivo conocido como "chupete Gluva", fabricado con el uso de un guante de látex, está siendo utilizado como una alternativa para cuidar al recién nacido (NB). A pesar de los pocos estudios, es evidente que este dispositivo debe estar contraindicado en la NU, ya que puede causar alergia al látex, transmitir infecciones, ocasionar accidentes graves como aspiración laringotraqueal de algodón por rotura del guante de látex, y dependiendo de la El tamaño del material obstruye las vías respiratorias y provoca la muerte. Además, el dispositivo puede interferir negativamente con el crecimiento y desarrollo craneofacial y causar daños asociados con la lactancia materna y la salud maternoinfantil. La sustitución del "Dummy Glove" por otras estrategias, incluso el chupete convencional u ortodóncico, para hacer frente a las situaciones de dolor y estrés del RN debe ser determinante para evitar el riesgo de accidentes graves. El Protocolo de Uso del Pezón, el Protocolo de Manejo del Dolor del RN, la adopción del Método Canguro en la NU para promover el desarrollo y comportamiento del RN, y la capacitación/seguimiento de las prácticas adoptadas por el Equipo Materno Infantil, en cuanto a los cuidados ofrecidos, son más alternativas eficientes, complejas, pero que deben ser analizadas por quienes deseen brindar confiabilidad a sus procesos institucionales. (AU)

Tratamento de mordida aberta causada por excessivo hábito de sucção de chupeta por meio de uma abordagem psico-pedagógica. acompanhamento por 11 anos: relato de caso / Treatment of open bite caused by excessive pacifier sucking through a psycho-pedagogical approach. follow-up for 11 years: case report

Objetivo: reportar o sucesso da utilização de uma abordagem psico-pedagógica precoce para resolução de uma mordida mordida aberta lateral causada por sucção de chupeta. Relato do caso: paciente com 3 anos de idade em dentadura decídua, sexo feminino, apresentando mordida aberta unilateral. Foi empregada uma técnica psico-pedagógica, utilizando terapia cognitivo-comportamental para ajudar a criança a lidar com questões, como estresse e ansiedade, por meio da contação de histórias por meio de livros infantis especializados. Resultado: após 2 anos de acompanhamento a mordida aberta foi completamente corrigida e não houve recorrência do hábito. Após 11 anos de acompanhamento, observou- se estabilidade da auto-correção, sem recorrência da mordida aberta lateral. Conclusão: uma vez que crianças em idade pré-escolar podem não apresentar maturidade suficiente para uso de aparelhos interceptativos, uma abordagem psico-pedagógica pode ser uma opção de tratamento viável.

Objective: the purpose of this article is to report a successful approach in an early psycho-pedagogical approach in a case of lateral open bite. Case report: a 3-year-old female patient in deciduous dentition presenting an unilateral open bite. A psycho-pedagogical technique was employed, using cognitive behavioral therapy to help the children to deal with issues, as stress and anxiety through the storytelling by means of specialized children´s books. No interceptive conduct was used. Results: after 2 years of follow-up, the open bite was completely corrected and there was no recurrence of the habit. After 11 years of follow-up, stability of self-correction was observed, with no recurrence of lateral open bite. Conclusion: since preschool-aged children may not be mature enough to use orthodontic interceptive devices, a psycho-pedagogical approach may be a viable treatment option.

Análise comparativa entre a influência da amamentação e hábitos bucais deletérios no crescimento craniofacial / Comparative analysis between the influence of breastfeeding and deleterial oral habits on craniofacial growth

A adoção da chupeta e mamadeira pelos pais podem trazer problemas no desenvolvimento craniofacial da criança. A sucção digital é outro fator influenciador da má formação da face, este pode ser antecedido pela mamadeira e chupeta. O conhecimento sobre o desenvolvimento facial correto ajuda no reconhecimento de desvios da normalidade. Foi realizada uma revisão da literatura a fim de analisar e comparar os efeitos no crescimento facial entre os hábitos deletérios e a amamentação fisiológica. Muitos registros de malformações causadas por hábitos deletérios foram encontrados. Conclui-se que a amamentação natural ainda é a melhor forma de alimentação para crianças, e nenhuma outra opção será melhor que a fisiológica, sendo aconselhável evitar o uso dos demais(AU)

The adoption of pacifiers and bottles by parents can bring problems in the child's craniofacial development. Finger sucking is another factor influencing the malformation of the face, which can be preceded by the bottle and pacifier. Knowledge about correct facial development helps in recognizing deviations from normality. A literature review was carried out in order to analyze and compare the effects on facial growth between harmful habits and physiological breastfeeding. Many records of malformations caused by deleterious habits were found. It is concluded that natural breastfeeding is still the best form of feeding for children, and no other option will be better than the physiological one, being advisable to avoid the use of the others(AU)

Association between Pacifier Use, Bottle-Feeding, and Pre-Postnatal Variables: A Cohort Study

ABSTRACT Objective: To determine the prevalence and analyze the variables associated with the use of pacifiers and/or bottles by infants up to 6 months of age. Material and Methods: Data on sociodemographic characteristics, intention to offer pacifier and bottle-feeding, pregnancy and breastfeeding (BF) variables were collected at baseline by interviews and a self-administered questionnaire among pregnant women in the 3rd trimester. After delivery, mother-baby binomials were followed by phone calls at the 1st, 3rd, and 6th months of the baby's life (n=467) to gather information on the type of delivery, baby's gender, BF in the first hour of the newborn's life, baby's weight, mother's return to work, and oral habits. Association analyses were performed using logistic regression models with a 5% significance level with the pacifier/bottle-feeding use as the outcome. Results: Most mothers (52.5%) reported their babies used bottle-feeding, 48.2% used pacifiers and 33.4% used both of them throughout the 6 months. Intention to offer pacifier and bottle-feeding was reported by 45.0% and 54.8% of the mothers at the 3rd trimester of the pregnancy, respectively. Not living in one's own residence (OR=1.53; 95%CI: 1.05-2.24) and having the prenatal intention of offering a pacifier (OR=2.50; 95%CI: 1.63-3.83) to the baby were significantly associated with pacifier use. Variables significantly associated with bottle-feeding were mother's return to work (OR=2.48; 95%CI: 1.54-3.97), baby's lower birth weight (OR=1.58; IC95%: 1.07-2.33), and prenatal intention to offer bottle-feeding (OR=2.51; 95%CI 1.56-4.04). Conclusion: About half of the babies used pacifiers or were bottle-fed, which were associated with the mother's prenatal intention to offer them to their babies and socioeconomic factors.

Increased Genioglossus Muscle FDG Activity Due to Using Pacifier.

ABSTRACT: An 18-month-old girl with history of liver transplant underwent FDG PET/CT to evaluate posttransplant lymphoproliferative disorder. In addition to multistation hypermetabolic lymphadenopathy and abnormal activity in the liver, stomach, and small bowel, in keeping with known posttransplant lymphoproliferative disorder, the images also showed focal activity in the submental region. This submental activity persisted on 2 separate follow-up FDG PET/CT studies, even though other foci of abnormal activity resolved after chemotherapy. Records revealed that the patient was sucking on a pacifier prior to all 3 FDG PET/CT studies, and the submental uptake corresponded with genioglossus muscle activity.

Fatores associados à continuidade do aleitamento materno por 12 meses ou mais em mulheres trabalhadoras de um hospital geral / Factors associated with breastfeeding continuation for 12 months or more among working mothers in a general hospital

Resumo O objetivo deste estudo é identificar fatores associados à continuidade da amamentação por 12 meses ou mais em mulheres trabalhadoras. Estudo transversal realizado por meio de entrevista com 251 trabalhadoras de um hospital, com filhos biológicos entre 12 e 36 meses de idade, não gemelares e sem doença que afetasse a amamentação, e amamentando quando do seu retorno ao trabalho. Para a associação entre a continuidade da amamentação e as variáveis de exposição utilizou-se a regressão multivariável de Poisson. Apenas uma variável relacionada ao local de trabalho da mulher mostrou associação significativa com o desfecho. Trabalhar durante o dia aumentou em 37% a prevalência da amamentação por 12 meses ou mais. Os fatores não relacionados ao trabalho da mulher que mostraram associação positiva com o desfecho: mãe sem curso superior, experiência de amamentação superior a 12 meses; criança não receber outro leite quando a mãe retornou ao trabalho e não ter usado chupeta. Por outro lado, maior idade da mãe, maior idade gestacional, apoio do cuidador da criança e apoio profissional na amamentação associaram-se negativamente ao desfecho. Fatores não relacionados diretamente ao trabalho materno tiveram maior participação na continuidade da amamentação por 12 meses ou mais.

Abstract This article aims to identify factors associated with breastfeeding continuation for at least 12 months among working mothers in a hospital in the south of Brazil. We conducted a cross-sectional study, interviewing 251 women who breastfed after returning to work. Eligibility criteria included non-twin biological children aged between 12 and 36 months and the absence of an illness (mother and/or child) that could affect breastfeeding. The association between breastfeeding continuation and the exposure variables was tested using Poisson multivariate regression. Only one work-related variable showed a significant association with the outcome. Working only during the day increased the prevalence of BF continuation for at least 12 months by 37%. The following non-work-related factors showed a positive association with the outcome: mothers without a college degree; mothers with at least 12 months' prior breastfeeding experience; child not given milks other than breast milk when the mother returned to work, and not using a pacifier. The following variables showed a negative association with the outcome: older maternal age; older gestational age; mother receiving support from the child's caregiver; and mother receiving professional breastfeeding support. Non-work-related factors had a greater influence on breastfeeding continuation for at least 12 months among working mothers.

Velocidade de crescimento de crianças de uma coorte até o sexto mês de vida / Growth rate of children of a cohort up to the sixth month of life

Resumo O objetivo deste artigo é investigar fatores que contribuíram na velocidade de crescimento de crianças até o sexto mês de vida. Coorte com 144 crianças observadas ao nascimento e no primeiro, segundo e sexto mês de vida. As velocidades de perímetro cefálico (cm/mês), peso (g/dia) e comprimento (cm/mês) foram comparadas segundo características ao nascimento, da gravidez, maternas, da família e relacionadas à alimentação, adoecimento e cuidados de saúde da criança. O sexo feminino e a dificuldade de amamentar contribuíram com a desaceleração das três velocidades de crescimento; a não vacinação materna contra o tétano, as velocidades de perímetro cefálico e comprimento. Transtorno mental materno grave, insegurança alimentar moderada/grave, consumo de mingau e o não acompanhamento da criança influenciaram as velocidades de perímetro cefálico e peso. Uso de bebida alcoólica durante a gravidez, parto cesariano, aleitamento materno misto/predominante, uso de fórmula infantil e episódios de diarreia/vômito influenciaram a velocidade de perímetro cefálico; pré-natal inadequado, ade peso; mães baixinhas e uso chupeta, a de comprimento. Sobressaem fatores modificáveis como o consumo de mingau e de fórmula infantil e o uso de chupeta que têm em comum a relação com o aleitamento materno do lactente.

Abstract The scope of this article is to investigate factors that contributed to the growth rate of children from birth through the sixth month of life. It involves a cohort study with 144 children observed at birth and in the first, second and sixth months of life. Child head circumference (cm/month), weight (g/day) and length (cm/month) rates were compared according to birth, pregnancy, maternal and family characteristics and those related to the food, illness and health care of the child. The female sex and difficulty in breastfeeding contributed to the deceleration of all three growth rates, while maternal non-vaccination against tetanus affected the increase of head circumference and of child length. Severe maternal mental disorder, moderate/severe food insecurity, oatmeal consumption and failure to follow-up the development of the child influenced the head circumference and weight rates. The intake of alcohol during pregnancy, cesarean delivery, mixed/predominant breastfeeding, use of infant formula and episodes of diarrhea/vomiting affected the head circumference, while inadequate prenatal care affected weight, and low-stature mothers and pacifier use affected length. Modifiable factors are highlighted, such as the consumption of oatmeal and infant formula, and the use of pacifiers, which are related to breastfeeding in infants.

Sudden infant death syndrome prevention.

We looked at existing recommendations and supporting evidence for successful strategies to prevent the sudden infant death syndrome (SIDS).We conducted a literature search up to the 14th of December 2020 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported.Current evidence supports statistical associations between risk factors and SIDS, but there is globally limited evidence by controlled studies assessing the effect of the social promotion strategies to prevent SIDS through knowledge, attitude and practices, due to obvious ethical reasons. A dramatic decline in SIDS incidence has been observed in many countries after the introduction of "Back to Sleep" campaigns for prevention of SIDS. All infants should be placed to sleep in a safe environment including supine position, a firm surface, no soft objects and loose bedding, no head covering, no overheating, and room-sharing without bed-sharing. Breastfeeding on demand and the use of pacifier during sleep time protect against SIDS and should be recommended. Parents should be advised against the use of tobacco, alcohol and illicit drugs during gestation and after birth.

Expectation of parental control and the maintenance of bottle-feeding in childhood

Abstract Objective: To investigate association between parental locus of control (belief of individuals about what or who has control of the events of their lives) and bottle feeding habits among children from 3 to 5 years of age. Methodology: Parental locus of control validated in Brazil, and semi-structured questionnaire to obtain sociodemographic, health, and oral habit behaviors was applied to mothers of 992 preschool children. Outcome variable "use of feeding bottle" was studied according to the time of its use (≤36 months and >36 months). Simple logistic regression models were adjusted and raw odds ratios were estimated for variables of distal blocks, which contemplated parental locus of control, socioeconomic characteristics of family, and maternal habits. In the intermediate block, the variables for conditions of the child's birth and place of health care attendance during the prenatal period and early childhood were included. In the proximal block, the time of breastfeeding and pacifier use were reported. Variables were analyzed from the distal to the proximal block, and the individual analyses that presented p ≤ 0.20 remained in each model; included in the subsequent block were the variables with p ≤ 0.10, because this was a study of prevention. Results: Longer time of feeding bottle use was associated with the internal parental locus of control, mothers older than 31 years of age, white race, premature children, who used pacifiers and are treated in the private health system. Conclusions: Children who maintained the habit of feeding bottle use for a longer time were those whose mother presented an internal locus of control.

Innovation in surgical training: Simulating prosthetic heart valves and annuloplasty rings using pacifiers for cardiac surgery wet-labs in a resource limited setting.

Conducting a hands-on cardiac wet-lab on valvular surgeries in a resource-limited setting is restricted by the lack of prosthetic heart valves and annuloplasty rings for developing cognitive and technical skills required to understand and protect the three-dimensional cardiac anatomy. In recent times, simulation is regarded as an effective tool in surgical education and has proven to improve the technical skills of trainees. The current short report presents a novel simulator to mimic heart valve replacement surgeries by using a pacifier as a prosthetic valve and annuloplasty ring. Considering resource-constraints in the local context, pacifier-based valve simulators can be usedful as they are cost-effective, readily available, easy to assemble, sturdy to use and have been remarkably helpful in teaching heart valve surgeries to residents and junior surgeons.

Effects of Sucrose and Nonnutritive Sucking on Pain Behavior in Neonates and Infants undergoing Wound Dressing after Surgery: A Randomized Controlled Trial.

INTRODUCTION: Wound dressing, a procedure that pediatric patients are commonly exposed to postoperatively, can cause strong physiological and pain behavioral responses despite being brief. This study evaluated the effects of using 24% sucrose plus a pacifier versus a pacifier alone to reduce the pain response from dressing wounds in neonates and infants. MATERIALS AND METHODS: Thirty-two neonates and infants who underwent surgery and required postoperative wound dressing were randomized to a pacifier group (n = 16) and a 24% sucrose plus pacifier group ("sucrose group"; n = 16). Demographic data, crying time, and pain behaviors were recorded using a video recorder. The pain behaviors were assessed independently using the neonatal infant pain scale (NIPS) by three assessors, who were expert in pediatric pain assessment and blinded to the subject allocations. RESULTS: Participants in the sucrose group were older than those in the pacifier group (6.19 ± 2.95 vs. 3.88 ± 3.2 months). While there were no differences in the NIPS scores of the two groups at 30, 120, and 240 seconds, the incidence of moderate-to-severe pain was lower in the sucrose group than the pacifier group at 120 seconds (37.5 vs. 50%). The crying time was lower in the sucrose group, but without statistical significance. CONCLUSION: The 24% sucrose plus pacifier was not superior to the pacifier alone in decreasing pain behavioral responses. Dressing wound pain produced a high-intensity pain behavioral response. A pain management strategy should be developed to lessen the postoperative procedural pain in pediatric patients.

Characterisation of anterior open bite in primary school-aged children: A preliminary study with artificial neural network analysis.

BACKGROUND: Non-nutritive sucking habits, bottle feeding, and facial hyperdivergency have been suggested as the influencing factors of anterior open bite (AOB). There was inconsistent reporting of prevalence and a gap of knowledge in the literature. AIM: The aim of this study was to investigate the prevalence of AOB in 7- to 12-year-olds, with a special interest to characterise the determinants of this malocclusion. DESIGN: A sample of 203 children aged 7 to 12 years were selected from a primary school in regional Australia. The legal guardian of each child completed a self-administered questionnaire. Data were assessed using methods of univariate statistics and neural analysis. RESULTS: The prevalence of AOB and thumb sucking was 24.1% and 23.2%, respectively. AOB was associated with the habit (correlation = 0.754) and duration (correlation = 0.574) of thumb sucking. Age, gender, birth order, feeding modality, sleep patterns, history of orthodontic treatment and tonsil, adenoid or grommet surgery, and parents' level of education were not related to AOB (correlation absolute value ≤ 0.474). CONCLUSIONS: Thumb sucking, specifically for prolonged duration, increases the risk of development of AOB. Cessation of thumb sucking habits should be encouraged at an early age to avoid the development of AOB.

Percepção de enfermeiros acerca do processo de titulação hospital amigo da criança / Percepción de enfermeros sobre el proceso de titulación hospi-tal amigo del niño / Nurses' perception about the titling process of hospital amigo da criança

RESUMO Objetivo: descrever a perceção dos enfermeiros acerca do processo de implantação da titulação de Hospital Amigo da Criança de um hospital escola do Sul do Brasil. Método: pesquisa com abordagem qualitativa descritiva e exploratória. A coleta de dados foi realizada por meio de entrevista semiestruturada com 14 enfermeiros que trabalham na Unidade Materno-infantil do Hospital Escola da Universidade Federal de Pelotas e os dados foram analisados segundo a proposta Operativa de Minayo. Resultados: os enfermeiros se sentem corresponsáveis, mesmo não participando de algumas fases do processo. Enfatizam que o processo é dificil, existe fragilidade no engajamento da equipe multidisciplinar, bem como no incentivo institucional. Destacaram que o incentivo ao aleitamento materno, o contato pele a pele, amamentação na 1ª hora de vida e o alojamento conjunto são as ações que potencializam o processo, contrapondo com o uso de bico/chupeta e o número de partos cesáreos realizados na instituição. Conclusão: a maioria dos enfermeiros declara-se participativa e atuante na busca pelo título de Hospital Amigo da Criança, mesmo não participando de todas as fases do processo e das atividades propostas. Os resultados apresentados poderão fornecer subsídios aos gestores e profissionais de saúde na construção de ações para garantir que mais hospitais alcancem a titulação e IHAC.

RESUMEN Objetivo: describir la percepción de los enfermeros sobre el proceso de implantación de la titulación de Hospital Amigo del Niño (IHAN) de un hospital escuela del Sur de Brasil. Método: investigación con abordaje cualitativo descriptivo y exploratorio. La recolección de datos fue realizada por medio de entrevista semiestructurada con 14 enfermeros que trabajan en una Unidad Materno-infantil del Hospital Escuela de la Universidad Federal de Pelotas y los datos fueron analizados según la propuesta Operativa de Minayo. Resultados: los enfermeros se sienten corresponsables, aunque no participen de algunas fases del proceso. Señalan que el proceso es difícil, existe fragilidad en el compromiso del equipo multidisciplinario, así como en el fomento institucional. Destacaron que el estímulo a la lactancia materna, el contacto piel a piel, lactancia en la 1ª hora de vida y el alojamiento conjunto son las acciones que potencian el proceso, contraponiendo con el uso de boquilla/chupete y el número de partos cesáreos realizados en la institución. Conclusión: la mayoría de los enfermeros se declara participativa y actuante en la búsqueda del título de Hospital Amigo del Niño, aunque no participen en todas las fases del proceso y de las actividades propuestas. Los resultados presentados podrán proporcionar colaboraciones a los gestores y profesionales de salud en la construcción de acciones para garantizar que más hospitales logren la titulación e IHAN

ABSTRACT Objective: to describe the nurses' perception about the implementation of the titling process of Hospital Amigo da Criança of a Teaching Hospital in southern Brazil. Method: it is a research with a descriptive and exploratory qualitative approach. The data collection was carried out through semi-structured interviews with 14 nurses who work in the Maternal-Infant Unit of the Teaching Hospital of the Federal University of Pelotas and the data were analyzed according to Minayo's Operative proposal. Results: the nurses feel co-responsible, even not participating in some phases of the process, they emphasize that the process is difficult, there is weakness in the engagement of the multidisciplinary team, as well as in institutional encouragement. They highlighted that encouraging breastfeeding, skin-to-skin contact, breastfeeding in the 1st hour of life and rooming-in are the actions that enhance the process, relying on the use of a nipple/pacifier and the number of cesarean deliveries performed in the institution. Conclusion: most nurses declare them selves participative and active in the search for the title of Hospital Amigo da Criança, even though they do not participate in all phases of the process and proposed activities. The results presented may provide subsidies to managers and health professionals in the construction of actions to ensure that more hospitals reach the title and "IHAC".

Dez passos para o sucesso no aleitamento materno: influência na continuidade da amamentação / Ten steps to breastfeeding success: the influence on breastfeeding continuity / Diez pasos para una lactancia exitosa: influencia en la continuidad de la lactancia materna

Objetivo: Avaliar as evidências, de produções científicas brasileiras, acerca da influência dos 10 passos para o sucesso do aleitamento materno na continuidade da amamentação. Método: revisão integrativa de produções científicas brasileiras, desenvolvida em junho de 2017, nas bases eletrônicas de dados LILACS, SCOPUS e PUBMED. Resultados: a normatização da assistência interfere positivamente na continuidade da amamentação. Treinar a equipe de saúde aumenta a prevalência de aleitamento materno. Orientar as vantagens e o manejo da lactação protege contra mastites, aleitamento misto e desmame precoce. Aqueles que receberam apoio no aleitamento materno na primeira meia hora após o parto estiveram mais propensos a mantê-lo no domicílio. Oferta de substitutos do leite materno, chupetas ou bicos artificiais interfere negativamente no estabelecimento e manutenção da amamentação. Conclusão: conclui-se, que os dez passos influenciam na continuidade da amamentação e, portanto, é importante que se amplie a cobertura nacional da IHAC

Objective: To evaluate the evidence of Brazilian scientific production about the influence of the 10 steps to succeed on breastfeeding continuity. Method: integrative review of Brazilian scientific literature developed at the databases LILACS, SCOPUS and MEDLINE in June of 2017. Results: the standardization of care positively interferes on breastfeeding continuity. Health team training increases the prevalence of breastfeeding. Professional orientation on the advantages and management of lactation protects against mastitis, mixed suckling and early weaning. Those who received support in breastfeeding within the first half hour after delivery were more likely to keep it at home. Provision of breast milk substitutes, pacifiers or artificial nipples interferes negatively in stablishing and maintaining breastfeeding. Conclusion: it is concluded that the ten steps influence on the continuity of breastfeeding and, therefore, it is important to expand the Child Friendly Hospital Initiative national coverage

Objetivo: Evaluar la evidencia de la producción científica brasileña sobre la influencia de los 10 pasos para tener éxito en la continuidad de la lactancia materna. Método: revisión integral de la literatura científica brasileña desarrollada en las bases de datos LILACS, SCOPUS y MEDLINE en junio de 2017. Resultados: La estandarización del cuidado interfiere positivamente en la continuidad de la lactancia materna. La capacitación de los equipos de salud aumenta la prevalencia de la lactancia materna. La orientación profesional sobre las ventajas y el manejo de la lactancia protege contra la mastitis, la lactancia mixta y el destete precoz. Aquellos que recibieron apoyo en la lactancia durante la primera media hora después del parto tenían más probabilidades de mantenerlo en casa. La provisión de sustitutos de la leche materna, chupones o pezones artificiales interfiere negativamente en el establecimiento y mantenimiento de la lactancia materna. Conclusión: se concluye que los diez pasos influyen en la continuidad de la lactancia materna y, por tanto, es importante ampliar la cobertura nacional de la Iniciativa Hospital Amigo de los Niños

Prevalence of anterior open bite and associated factors in schoolchildren in a municipality of southern Brazil / Prevalência de mordida aberta anterior e fatores associados em escolares de um município do sul do Brasil

Introduction: Open bite can generate relevant psychosocial impact in the daily life of the patient, both from the aesthetic and functional point of view. Objective The aim of this study was to estimate the prevalence and factors associated with the anterior open bite in children in the first school year in a municipality in southern Brazil. Material and method A cross-sectional study was carried out with six-year-old schoolchildren in Palhoça/SC. Interviews were conducted with mothers to gather socioeconomic and non-nutritive sucking habits information. Children oral clinical examinations were carried out in schools. Multivariate analyses were performed using Poisson regression with a robust estimator. The study involved 655 children, 50.5% being female. Result The prevalence of anterior open bite was 14.1% (95% CI 11.5; 16.7). Girls exhibited a lower prevalence [PR= 0.96 (95% CI 0.94; 0.99) p= 0.024] and those children who used a pacifier exhibited a higher prevalence of anterior open bite [PR= 1.04 (95% CI 1.01; 1.07) p= 0.003]. Conclusion The prevalence was 14.1% and that it was associated with gender and the use of pacifier, in a statistically significant and independent way.

Introdução: A mordida aberta pode gerar relevante impacto psicossocial no cotidiano do paciente, tanto do ponto de vista estético quanto funcional. Objetivo Estimar a prevalência e os fatores associados à mordida aberta anterior em crianças do primeiro ano escolar de um município do sul do Brasil. Material e método Estudo transversal constituído por escolares de seis anos de idade de Palhoça/SC. Foram realizadas entrevistas com as mães para obtenção de informações socioeconômicas e de hábitos de sucção não nutritivos. Exames clínicos bucais das crianças foram realizados nas escolas. Análises multivariadas foram realizadas por meio de regressão de Poisson com estimador robusto. Resultado O estudo envolveu 655 crianças sendo 50,5% do sexo feminino. A prevalência de mordida aberta anterior foi de 14,1% (IC 95% 11,5; 16,7). Meninas apresentaram prevalência menor [RP= 0,96 (IC 95% 0,94; 0,99) p= 0,024] e aqueles que utilizaram chupeta apresentaram uma maior prevalência [RP= 1,04 (IC 95% 1,01; 1,07) p= 0,003]. Conclusão A prevalência foi de 14,1% associada de forma estatisticamente significativa e independente com sexo e utilização de chupeta.

Hábitos associados à mordida aberta anterior em crianças: uma revisão integrativa / Habits associated to preceding open bite in children: an integrative revie

Objetivo: Analisar na literatura quais são os hábitos associados à mordida aberta anterior em crianças. Métodos: Realizou-se uma pesquisa bibliográfica referente aos artigos publicados de 2015 a 2020 nos bancos de dados on-line PubMed, Embase, SciELO, LILACS e BBO utilizando descritores e sinônimos MeSH, DeCS e Emtree com as seguintes etapas: identificação, triagem, elegibilidade e inclusão. Foram incluídos estudos observacionais, transversais ou de coorte, e artigos que demonstrassem hábitos associados à mordida aberta anterior em crianças de 2 a 12 anos de idade. Relatos de caso, revisões da literatura e outros tipos de estudos que não estavam de acordo com os critérios foram excluídos. Os artigos foram analisados por dois pesquisadores independentes e os estudos selecionados foram avaliados quanto à qualidade metodológica. Resultados: De um total de 462 artigos encontrados apenas 9 foram selecionados para o estudo. Desses, 8 (88,9%) apresentaram alta ou moderada qualidade metodológica, sendo apenas 1 (11,1%), dentre os artigos, de baixa qualidade. Mediante à análise dos estudos inclusos, observou-se que a manutenção de hábitos orais como sucção digital (66,6% dos artigos) e de chupeta (77,7%), bem como uso de mamadeira (33,3%) e duração do tempo de aleitamento materno (22,2%) pode ocasionar alterações na oclusão, fala, respiração, crescimento craniofacial, afetando diretamente a qualidade de vida da criança. Conclusão:Uma vez que a infância é a fase adequada para a implementação de novos hábitos saudáveis e tratamentos, é imprescindível que o cirurgião-dentista conheça essa associação, e adote medidas terapêuticas e preventivas.

Aim: To perform an analysis of in the literature regarding which habits are associated with anterior open bite in children. Methods:This was a bibliographic study conducted using articles published from 2015 to 2020 in the PubMed, Embase, SciELO, LILACS, and BBO online databases, using MeSH, DeCS, and Emtree descriptors and synonyms with the following steps: identification, screening, eligibility, and inclusion. Observational, cross-sectional, or cohort studies, as well as and articles demonstrating habits associated with anterior open bite in children aged 2 to 12 years, were included. Case reports, literature reviews, and other types of studies that were not in accordance with the criteria were excluded. The articles were evaluated by two independent researchers, and the selected studies were evaluated for methodological quality. Results:Of a total of 462 articles found, only nine were selected for the study. Of these, eight (88.9%) presented high or moderate methodological quality, with only 1 (11.1%) of the articles presenting a low quality. Through the analysis of the included studies, it was observed that the maintenance of oral habits, such as finger sucking (66.6% of the articles) and pacifiers (77.7%), as well as the use of a bottle (33.3%) and the duration of breastfeeding time (22.2%), may cause changes in occlusion, speech, breathing, and craniofacial growth, directly affecting the child's quality of life. Conclusion: Since childhood is the appropriate phase for the implementation of new healthy habits and treatments, it is essential for the dentist to understand this association and adopt therapeutic and preventive measures.

Malocclusion and Associated Factors in Early Childhood and Knowledge Level of Mothers from Childcare Groups

ABSTRACT Objective: To determine the prevalence of malocclusion and associated factors in children and the level of knowledge of mothers participating in the child care group of a basic health unit. Material and Methods: This is a cross-sectional study conducted in children between 18 and 72 months of a childcare group in Pelotas. Children whose parents or legal guardians signed the informed consent term participated in the study. Data were collected through a questionnaire previously tested and applied to the mothers, and a clinical examination of children's occlusion were performed by examiners after training and calibration. Statistical analysis was descriptive and analytic. In the bivariate analyses, it was used the Pearson, Fisher or Linear Trend Qui-Square tests and, in the multivariate analysis, the Poisson regression. Prevalence ratios and 95% confidence intervals were obtained, and a p-value <0.05 was used. Results: Forty-seven children were included and 41.3% presented malocclusion. The prevalence of malocclusion was associated with a higher number of children in the family (p<0.005) and breastfeeding for more than 12 months (p<0.05). The highest prevalence of open bite was associated with the use of a pacifier and working mothers (p<0.05). Conclusion: Most mothers reported having knowledge about the time and use of pacifiers in childhood. In this group, the prevalence of malocclusion in children was high and associated with behavioral and social factors.

Determinants of the introduction of early complementary feeding before and after the third month of life: a multinomial analysis

The introduction of early complementary feeding (ECF) is determined by different factors depending on when it occurs. The objective of this study was to analyze factors associated with the introduction of ECF in two different moments of the infant's life: from zero to three and from four to five months of age. A cohort with 3,306 dyads studied in the BRISA survey in São Luis/MA in 2010 was used. Questionnaires were applied at birth and at follow-up when the infants were 15 to 36 months of age of women with more than 20 weeks of gestational age, residing in this municipality. A multivariate model of multinomial logistic regression was used to verify associations between independent variables and ECF at 0 to 3 months and at 4 to 5 months of age. A hierarchical analysis model was used to select variables for confounding adjustment. Variables with a P-value <0.05 were considered significant. For ECF introduced between 0-3 months, the variables "use of pacifier", "maternal paid activity", "smoking", and "postpartum pregnancy" were identified as risk factors. The variables "use of pacifier" and "maternal paid activity" remained associated as a risk for ECF introduced from 4-5 months. The variable 'mother without partner' (RR=1.26 and P=0.04) represented a risk factor for ECF only for the 4-5 months period. Although each period presented specific risk factors, the use of pacifier and maternal professional activity were associated in the two periods studied, indicating their importance for the introduction of ECF.

Chupete: más que un calmante / Pacifier: more than a sedative

El chupete es un dispositivo utilizado para calmar a los lactantes y niños pequeños; sin embargo, se lo asocia a efectos nocivos. Muchas veces en la consulta los cuidadores solicitan la opinión de los profesionales de la salud sobre su uso; por este motivo, decidimos realizar una búsqueda bibliográfica de la mejor evidencia disponible. En base a la información recabada y analizada, concluimos que la introducción precoz del chupete (antes de las dos semanas de vida) no afectaría el amamantamiento hasta los seis meses, y que en niños con lactancia materna bien establecida y madres motivadas para amamantar, no influye en el destete precoz. Además existe evidencia débil a favor del uso del chupete para reducir el riesgo del síndrome de muerte súbita del lactante, mientras que su uso durante la dentición primaria se asocia al desarrollo de mordida cruzada posterior. (AU)

The pacifier is a device used to soo the infants and young children; however, it is associated with harmful effects. Many times during consultation, caregivers ask for the opinion of health professionals about its use; for this reason, we decided to perform a literature search of the best available evidence. Based on the collected and analyzed information, we concluded that the early introduction of the pacifier (before two weeks of life) would not affect breastfeeding until six months of age, and that in children with well-established breastfeeding and mothers motivated to breastfeed, it does not influence early weaning. Furthermore, there is weak evidence in favor of pacifier use to reduce the risk of sudden infant death syndrome, while its use during primary dentition is associated with the development of posterior crossbite. (AU)