ABSTRACT
OBJECTIVE: To evaluate the effect of oropharyngeal colostrum immunotherapy (OCI) on the mortality of preterm newborns (PTNB) with very low birth weight (VLBW). METHOD: Non-randomized clinical trial, carried out with 138 mother-child pairs attended at a public maternity hospital. The treatment group used raw colostrum, dripping 4 drops (0.2 ml) into the oropharyngeal mucosa, totaling 8 administrations in 24 h, up to the 7th complete day of life (OCI). The control group was composed of newborns admitted to the same maternity hospital before the implementation of the OCI. Analyzes were performed: descriptive, bivariate, multiple logistic regression, and survival analysis, with a significance level of 5% and 95% CI. RESULTS: The treatment group had an RR of death of 0.26 (95% CI = 0.07-0.67; p = 0.00), adjusted for maternal age, marital status, gestational hypertension, type of delivery, number of prenatal visits, and birth weight. Number Needed to Treat (NNT) demonstrated that for every 5 individuals treated with OCI, one death was prevented NNT = 4.9 (95% CI = 1.84-5.20); however, for PTNB with VLBW who remained hospitalized for 50, 100 and 150 days, the NNT reduces to 4, 4 and 3, respectively. CONCLUSION: The OCI proved to be a beneficial intervention, since it reduced the risk of mortality in PTNB with VLBW when compared to the control group.
Subject(s)
Colostrum , Premature Birth , Infant, Newborn , Humans , Female , Pregnancy , Infant, Very Low Birth Weight , Birth Weight , Immunotherapy , Risk Reduction BehaviorABSTRACT
Abstract Objective To evaluate the effect of oropharyngeal colostrum immunotherapy (OCI) on the mortality of preterm newborns (PTNB) with very low birth weight (VLBW). Method Non-randomized clinical trial, carried out with 138 mother-child pairs attended at a public maternity hospital. The treatment group used raw colostrum, dripping 4 drops (0.2 ml) into the oropharyngeal mucosa, totaling 8 administrations in 24 h, up to the 7th complete day of life (OCI). The control group was composed of newborns admitted to the same maternity hospital before the implementation of the OCI. Analyzes were performed: descriptive, bivariate, multiple logistic regression, and survival analysis, with a significance level of 5% and 95% CI. Results The treatment group had an RR of death of 0.26 (95% CI = 0.07-0.67; p= 0.00), adjusted for maternal age, marital status, gestational hypertension, type of delivery, number of prenatal visits, and birth weight. Number Needed to Treat (NNT) demonstrated that for every 5 individuals treated with OCI, one death was prevented NNT = 4.9 (95% CI = 1.84-5.20); however, for PTNB with VLBW who remained hospitalized for 50, 100 and 150 days, the NNT reduces to 4, 4 and 3, respectively. Conclusion The OCI proved to be a beneficial intervention, since it reduced the risk of mortality in PTNB with VLBW when compared to the control group.
ABSTRACT
Abstract Objective Synthesize the information about the factors associated with maintenance of breastfeeding for 12 months or more. Data source A systematic review was conducted in the Pubmed/Medline, Scielo, and Lilacs databases, including articles published in Portuguese or English since 2004 on the factors associated with breastfeeding maintenance for at least 12 months; review articles and those with qualitative design were excluded. The factors were organized into four levels, according to the chronological proximity to the outcome: distal, distal intermediate, proximal intermediate, and proximal; nationality and place/area of residence were considered contextual factors. Summary of data 1174 articles were identified, of which 19 were included in this review, comprising seven cohort studies and 12 cross-sectional studies. A total of 39 of the 75 assessed factors were associated with the outcome at least once. The factors with the highest percentages of associations with maintenance of breastfeeding for 12 months or more, considering the number of times they were tested were: children whose parents are the caregivers (100%), none type of maternal exposure to smoke (54%), children and/or parents are immigrants/foreigners (50%), live in urban areas (42.9%), older maternal age (40%), married women (37.5%), higher level of maternal education (31.3%), greater parity (30.8%), and lower income (30%). Conclusions The maintenance of breastfeeding for 12 months or more is associated with multiple factors, emphasizing the contextual factors and those related to some maternal sociodemographic characteristics. Associations differ in effect and magnitude between the different populations studied.
Resumo Objetivo Sintetizar as informações sobre os fatores associados à manutenção da amamentação por 12 meses ou mais. Fontes de dados Foi conduzida revisão sistemática nas bases de dados Pubmed/Medline, Scielo e Lilacs, inclusive artigos publicados em língua portuguesa ou inglesa desde 2004 sobre fatores associados à amamentação por, no mínimo, 12 meses. Excluíram-se artigos de revisão e com delineamento qualitativo. Os fatores foram organizados em quatro níveis de acordo com a proximidade cronológica com o desfecho: distal, intermediário distal, intermediário proximal e proximal; nacionalidade e local/área de residência foram considerados fatores contextuais. Síntese dos dados Identificaram-se 1.174 artigos, dos quais 19 foram selecionados para revisão, sete estudos de coorte e 12 transversais. Dos 75 fatores explorados, 39 mostraram-se associados ao desfecho ao menos uma vez. Os fatores com os maiores percentuais de associações com a manutenção da amamentação por 12 meses ou mais, considerando o número de vezes que foram testados, foram: filhos terem os pais como cuidadores (100%), algum tipo de exposição materna ao fumo (54%), crianças e/ou pais serem imigrantes/estrangeiros (50%), morar em zona urbana (42,9%), maior idade materna (40%), mãe ser casada (37,5%), maior escolaridade materna (31,3%), maior número de filhos (30,8%) e menor renda familiar (30%). Conclusões A manutenção da amamentação por 12 meses ou mais está associada a múltiplos fatores, com destaque para os fatores contextuais e os relacionados a algumas características sociodemográficas das mães. As associações diferem em efeito e magnitude entre as diferentes populações estudadas.
Subject(s)
Humans , Female , Infant, Newborn , Infant , Breast Feeding/statistics & numerical data , Socioeconomic Factors , Time Factors , Risk Factors , Maternal BehaviorABSTRACT
OBJECTIVE: Synthesize the information about the factors associated with maintenance of breastfeeding for 12 months or more. DATA SOURCE: A systematic review was conducted in the Pubmed/Medline, Scielo, and Lilacs databases, including articles published in Portuguese or English since 2004 on the factors associated with breastfeeding maintenance for at least 12 months; review articles and those with qualitative design were excluded. The factors were organized into four levels, according to the chronological proximity to the outcome: distal, distal intermediate, proximal intermediate, and proximal; nationality and place/area of residence were considered contextual factors. SUMMARY OF DATA: 1174 articles were identified, of which 19 were included in this review, comprising seven cohort studies and 12 cross-sectional studies. A total of 39 of the 75 assessed factors were associated with the outcome at least once. The factors with the highest percentages of associations with maintenance of breastfeeding for 12 months or more, considering the number of times they were tested were: children whose parents are the caregivers (100%), none type of maternal exposure to smoke (54%), children and/or parents are immigrants/foreigners (50%), live in urban areas (42.9%), older maternal age (40%), married women (37.5%), higher level of maternal education (31.3%), greater parity (30.8%), and lower income (30%). CONCLUSIONS: The maintenance of breastfeeding for 12 months or more is associated with multiple factors, emphasizing the contextual factors and those related to some maternal sociodemographic characteristics. Associations differ in effect and magnitude between the different populations studied.
Subject(s)
Breast Feeding/statistics & numerical data , Female , Humans , Infant , Infant, Newborn , Maternal Behavior , Risk Factors , Socioeconomic Factors , Time FactorsABSTRACT
OBJETIVO: Averiguar os fatores associados à interrupção do aleitamento materno exclusivo no primeiro mês de lactação na cidade de Feira de Santana, BA. MÉTODOS: Estudo de coorte com 1.309 duplas mães-bebês selecionadas em todas as maternidades do município. Os dados foram coletados no hospital e domicílio ao final do primeiro mês. A associação entre desfecho e variáveis de interesse foi avaliada por meio de regressão logística. RESULTADOS: Falta de experiência prévia com amamentação (razão de prevalência 1,24; IC95 por cento 1,75-1,43), presença de fissura mamilar (razão de prevalência 1,25; IC95 por cento 1,09-1,43), horários pré-determinados para amamentar (razão de prevalência 1,42; IC95 por cento 1,09-1,84) e uso de chupeta (razão de prevalência 1,53; IC95 por cento 1,34-1,76) foram identificados como fatores preditivos da interrupção do aleitamento exclusivo. CONCLUSÕES: Medidas de prevenção da interrupção do aleitamento exclusivo devem priorizar mulheres sem experiência com amamentação e contemplar prevenção de traumas mamilares, incentivo à prática do aleitamento em livre demanda e desestímulo ao uso de chupeta.
OBJECTIVE: To investigate factors associated with discontinuation of exclusive breastfeeding in the first month of lactation, in the city of Feira de Santana, Brazil. METHODS: Cohort study with follow-up of 1,309 mother-child pairs selected from all maternities in the municipality. Data were collected in hospital and in home visits during the first month of life. Logistic regression analysis was used to examine the relationship between outcome and variables of interest. RESULTS: Lack of prior breastfeeding experience (PR 1.24; 95 percentCI 1.75-1.43), cracked nipples (PR 1.25; 95 percentCI 1.09-1.43), use of fixed breastfeeding schedules (PR 1.42; 95 percentCI 1.09-1.84) and pacifier use (PR 1.53; 95 percentCI 1.34-1.76) were identified as factors predicting discontinuation of exclusive breastfeeding. CONCLUSIONS: Measures to prevent early discontinuation of exclusive breastfeeding must focus on women without breastfeeding experience and include prevention of nipple trauma, encourage breastfeeding on demand, and discourage the use of pacifiers.
Subject(s)
Female , Humans , Infant, Newborn , Male , Breast Feeding/statistics & numerical data , Weaning , Brazil , Cohort Studies , Mother-Child Relations , Mothers/psychology , Postpartum Period , Prevalence , Risk FactorsABSTRACT
OBJECTIVE: To describe the eating habits of breastfed and non-breastfed children through the analysis of food intake by children younger than one year of age in Feira de Santana in 2001. METHODS: Cross-sectional study. The mothers of children younger than one year answered a questionnaire during the national vaccination day in 44 (71%) vaccination units selected by simple stratification. 2,319 children were evaluated, representing 24.3% of the estimated population. Prevalence ratio and 95% confidence interval were calculated. Statistical significance was determined using the chi-square test. RESULTS: Non-breastfed children aged four months or younger were 8.2 and 6.7 times more likely to receive the family food (95% CI: 3.23-20.66) or vegetable soup (95% CI: 3.84-11.78), respectively. In the same age group, the prevalence of non-breastfed children receiving water, juice, and fruit was significantly higher in relation to breastfed children (70.7% vs 19.7%, 63.3% vs 26.7%, 33.3% vs 4.9% and 14.4% vs 1.4%, respectively). CONCLUSION: Breastfed children had healthier habits than non-breastfed children in terms of the introduction of complementary foods.
Subject(s)
Bottle Feeding , Breast Feeding , Feeding Behavior , Adult , Brazil , Female , Health Promotion , Humans , Infant , Infant Food , Infant, Newborn , Male , Pacifiers , Surveys and QuestionnairesABSTRACT
OBJETIVOS: Descrever os hábitos alimentares de crianças amamentadas e não-amamentadas através da análise dos alimentos consumidos pelas crianças menores de 1 ano de idade na cidade de Feira de Santana, BA, no ano de 2001. MÉTODOS: Foi realizado um estudo transversal, no qual foram aplicados questionários às mães das crianças menores de 1 ano no dia nacional de vacinação, presentes nas 44 (71 por cento) unidades de vacinação, selecionadas por estratificação simples. Foram avaliadas 2.319 crianças, representando 24,3 por cento da população estimada. As medidas de associação calculadas foram: razão de prevalência, com intervalo de confiança a 95 por cento, e de significância estatística, através do teste do qui-quadrado com respectivo valor p. RESULTADOS: Nas crianças com idade igual ou inferior a 4 meses e não-amamentadas, foi observada uma chance 8,2 e 6,7 vezes maior de a criança ser alimentada, respectivamente, com a refeição da família (IC 95 por cento 3,23-20,66) e com papas de legumes (IC 95 por cento 3,84-11,78). Na mesma faixa etária, as prevalências de crianças não-amamentadas que receberam água, chás, sucos e papa de frutas foram significativamente maiores (70,7 por cento versus 19,7 por cento, 63,3 por cento versus 26,7 por cento, 33,3 por cento versus 4,9 por cento e 14,4 por cento versus 1,4 por cento, respectivamente). CONCLUSÕES: As crianças amamentadas, quando comparadas com as não-amamentadas, apresentaram melhores hábitos no que se refere à época de introdução dos alimentos complementares.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Adult , Bottle Feeding , Breast Feeding , Feeding Behavior , Brazil , Health Promotion , Infant Food , Pacifiers , Surveys and QuestionnairesABSTRACT
OBJETIVO: O leite materno, por suas características nutricionais e imunológicas, protege a criança contra a diarréia. Para avaliar a proteçäo da amamentaçäo contra a diarréia em menores de um ano, foi realizado um estudo transversal em Feira de Santana, Bahia, no ano de 2001. MÉTODOS: Foram aplicados questionários às mäes, por 104 universitários, no dia nacional de vacinaçäo, nas 44 (71,0 por cento) unidades selecionadas por estratificaçäo simples e avaliadas 2.319 crianças, representando 24,3 por cento da populaçäo estimada. Foi calculada a razäo de prevalência e considerado como significante p< 0,05 e intervalo de 95 por cento de confiança. RESULTADOS: A ocorrência de diarréia foi elevada (11,6 por cento), com maior freqüência após o sexto mês (63,3 por cento). As crianças menores que seis meses que näo mamavam apresentaram uma chance de 64,0 por cento (IC95 por cento: 1,07-2,51) a mais para a diarréia (p< 0,02) do que aquelas amamentadas. Quando comparadas com as que mamavam exclusivamente, houve um aumento dessa chance para 82,0 por cento (IC95 por cento: 1,11-3,01) entre as näo amamentadas. CONCLUSÖES: Foi evidente a proteçäo da amamentaçäo e do aleitamento exclusivo contra a diarréia nos menores de seis meses