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...

Influência de procedimentos educativos sobre os conceitos de berçários / The infl uence of educational procedures on the concepts of nurseries

A dualidade cuidado x educação é aspecto a ser considerado na rotina das instituições de educação infantil quepossuem berçário e os conceitos dos profissionais que nele atuam interferem nas práticas desenvolvidas, sendo necessário maior preocupação com a formação continuada. O objetivo foiverificar os efeitos de procedimentos educativos sobre conceitos relativos às funções e benefícios do berçário para a criança, junto a profissionais que atuam em instituição de educação infantil. Participaram professores e auxiliares de desenvolvimento de berçários municipais de Marília, entrevistados em quatro momentos – inicial, depois de cada um dos dois procedimentos educativos e seis meses após a intervenção. Essa consistiu em uma oficina de educação, uma vez por semana por um mês e práticas supervisionadas realizadas na rotina do berçário no total de 15 horas. Ambas focaram as atividades e seus benefícios para o desenvolvimento da criança. Verificou-se que os conhecimentos das educadoras decorriam do senso comum e que a oficina de educação proporcionou mudança nos seus níveis de informação, reforçada pela supervisão prática. A análise indica que a formação inicial e continuada das profissionais precisa contemplar aspectos específicos do desenvolvimento infantil para que concepções mais adequadas sejam construídas.

The duality care-education is an aspect to be considered in the routine of childhood education institutions thathave a nursery. The concepts of professionals who work in the nursery interfere with the developed practice, and require great concern regarding the continuing education. The objective of this study was to verify the effects of educational procedures on the concepts related to functions and benefi ts of the nursery for the child – from the professionals who work in a childhood education institution. These professionals were teachers and development assistants from municipal nurseries of Marília, interviewed fourtimes – initially, after each of the two rearing procedures, and six months after the procedures. These procedures consisted of educational workshops, once a week, for one month, and 15 hours of supervised practices in the nursery. Both practices focused on the activities and their benefi ts to the child’s development. We found that the educators’ knowledge comes from common sense, and that educational workshops provided changes ontheir information levels, which were strengthened by supervisedpractice. The analysis indicates that the initial and continuing education of professionals need to consider specifi c aspects of child development, so more adequate concepts are built.

Características cognitivas, emocionales y conductuales de niños preescolares del programa buen comienzo en el noroccidente de Medellín / Cognitive, emotional, and behavioral characteristics of preschoolers of the good start program in the northwestern area in Medellin

En el presente artículo derivado de investigación, se describen las características cognitivas, emocionales y conductuales de una muestra de 20 niños preescolares, que oscilan entren los 3 y 5 años de edad, de estrato socioeconómico bajo y que han sido beneficiados del programa estratégico de la Alcaldía de Medellín (Colombia), perteneciente a la Secretaría de Educación, denominado Buen Comienzo. El programa Buen Comienzo tiene como propósito la promoción del desarrollo integral,diverso e incluyente de niñas y niñas, desde en una perspectiva interdisciplinaria del ciclo vital, protección de los derechos y articulación interinstitucional.

In this current article, derived from a piece of research, the cognitive, emotional, and behavioral characteristics, of a sample of 20 preschoolers, are described and whose ages range between 3 and 5 years. They belong to a low socio-economic level and they have benefited from the strategic program at the Mayor’s Office in Medellin (Colombia), belonging to the Secretariat of Education program called theGood Start. Such a program aims the promotion of comprehensive, diverse, and inclusive development of children, from an interdisciplinary perspective of the life cycle, the protection of rights and the inter-institutional coordination.

Preventing diseases and outbreaks at child care centers using an education, evaluation, and inspection method.

From 2005 to 2008, Washoe County, Nevada, child care centers experienced an increase in illnesses from communicable disease outbreaks. The number of ill children and caregivers from these outbreaks went from 26 in 2005 to 266 in 2008, an increase of 923%. A clear need to reverse this trend existed. Therefore, in 2009 Washoe County strengthened its regulations for child care facilities by adding numerous communicable disease prevention standards. In addition, in 2009 a two-year education, evaluation, and inspection program was implemented at Washoe County child care centers. Following the implementation of this program, a decline occurred in the number of illnesses. The number of ill children and caregivers from outbreaks went from 266 in 2008 to 13 in 2011, a decrease of 95%.

Nutrition-education program improves preschoolers' at-home diet: a group randomized trial.

OBJECTIVE: This study evaluated whether a nutrition-education program in child-care centers improved children's at-home daily consumption of fruits and vegetables, at-home use of low-fat/fat-free milk, and other at-home dietary behaviors. MATERIALS AND METHODS: Twenty-four child-care centers serving low-income families were matched by region, type, and size, and then randomly assigned to either an intervention or control condition. In the 12 intervention centers, registered dietitian nutritionists provided nutrition education to children and parents separately during a 6- to 10-week period. They also held two training sessions for center staff, to educate them on healthy eating and physical activity policies at the centers, and distributed weekly parent newsletters that included activities and recipes. Parents (n=1,143) completed a mail or telephone survey at baseline and follow-up to report information on their child's fruit, vegetable, and milk consumption and other dietary behaviors at home. This study used general and generalized linear mixed models to evaluate program impacts, while accounting for the clustering of children within centers. This study included child age, child sex, household size, respondent race/ethnicity, respondent age, and respondent sex as covariates. RESULTS: The program had a substantial impact on children's at-home daily consumption of vegetables and use of low-fat/fat-free milk. This study also found a significant increase in the frequency of child-initiated vegetable snacking, which might have contributed to the significant increase in vegetable consumption. The program did not have a significant impact on fruit consumption or parental offerings of fruits and vegetables, child-initiated fruit snacking, or child fruit consumption. CONCLUSIONS: This intervention in child-care settings that emphasized children, parents, and teachers significantly increased at-home vegetable and low-fat/fat-free milk consumption among low-income preschoolers.

Percepções de educadores de creches acerca de práticas cotidianas na alimentação de lactentes: impacto de um treinamento / Perceptions of day care center teachers about daily practices of infant feeding: the impact of training

O artigo apresenta a importância da capacitação dos profissionais envolvidos com alimentação das crianças em creches, para que estes ofereçam alimentos adequados e promovam ações para que os lactentes incorporem práticas alimentares saudáveis desde o nascimento. Desta forma, o objetivo do presente trabalho foi avaliar o impacto de um treinamento de educadores de creches nas percepções e práticas acerca da alimentação infantil. Para avaliação do impacto do treinamento foi utilizada abordagem qualitativa, com aplicação da técnica do grupo focal. Foram realizados 16 grupos, sendo oito com as creches expostas ao treinamento e oito com as não-expostas, tendo em média de seis a 11 participantes por instituição, os quais apresentavam idades entre 19 e 66 anos. O discurso das educadoras que participaram do treinamento está pontuado de indícios de pequenas mudanças, ou pelo menos, de reconhecimento de que é preciso e possível mudar. Destaca-se a relevância de elaborar e executar programas de treinamento e educação nutricional para educadores de creches com supervisão contínua dos efeitos da capacitação como estratégia de saúde infantil.

This article stresses the importance of the qualification of professionals involved in thefeeding of children in daycare centers, such that they offeradequate food and programs are developed in order to fosterhealthy food habits in infantsfrom birth. Thus, the scope of this paper was to evaluate the impact of a training program for these daycare teachers in their perceptions and practicesin infant feeding. A qualitative approach was used to evaluate the impact of training, with the application of the focus grouptechnique. Sixteen groups were created, eight of whichwere daycare centerswith training and eight without training, the average number of participants being 6 to 11 per institution agedbetween 19 and 66. The discourse of the teachers who took part in the training program is replete with signs of small changes, or at least with the recognition that it is indeed necessary and possible to promote change. The importance of organizing and conducting training programs for the nutritional education of teachers inday care centersis emphasized, with the continuous supervision of the effects of the qualification as a strategy for infant health.

[Perceptions of day care center teachers about daily practices of infant feeding: the impact of training]. / Percepções de educadores de creches acerca de práticas cotidianas na alimentação de lactentes: impacto de um treinamento.

This article stresses the importance of the qualification of professionals involved in the feeding of children in daycare centers, such that they offer adequate food and programs are developed in order to foster healthy food habits in infants from birth. Thus, the scope of this paper was to evaluate the impact of a training program for these daycare teachers in their perceptions and practices in infant feeding. A qualitative approach was used to evaluate the impact of training, with the application of the focus group technique. Sixteen groups were created, eight of which were daycare centers with training and eight without training, the average number of participants being 6 to 11 per institution aged between 19 and 66. The discourse of the teachers who took part in the training program is replete with signs of small changes, or at least with the recognition that it is indeed necessary and possible to promote change. The importance of organizing and conducting training programs for the nutritional education of teachers in day care centers is emphasized, with the continuous supervision of the effects of the qualification as a strategy for infant health.

Use of paid child care health care consultants in early care and education settings: results of a national study comparing provision of health screening services among Head Start and non-Head Start centers.

INTRODUCTION: Child care health consultants (CCHCs) are health professionals who provide consultation and referral services to child care programs. The use of CCHCs has been recommended as an important component of high-quality child care. The purpose of this study was to examine the potential association between the use of paid CCHCs and child care center director reports of (a) center maintenance of health records and emergency procedures and (b) center facilitation of health screenings and assessments. METHOD: A national, randomized telephone survey of directors of 1822 licensed child care center directors was conducted. RESULTS: With a response rate of 93%, most directors (72.7%) reported that they did not employ a CCHC. However, directors employing CCHCs were more likely to report provision of health-promoting screenings and assessments for children in their center. This pattern held true for both Head Start and non-Head Start centers. DISCUSSION: This study suggests that CCHCs can serve as health promotion advocates in early care and education settings, helping centers establish appropriate policies and arranging for health assessments and screenings for children.

Is there a difference between center and home care providers' training, perceptions, and practices related to obesity prevention?

To compare the obesity related training, practices, and perceptions of home child care providers and center care providers. A self-administered survey was collected from child care providers who attended local child care training workshops in east central Illinois from March 2009 to August 2010. Study results were based on responses from 88 home care providers and 94 center providers. The survey questions addressed child care providers' training in the prior year, their obesity prevention practices including written policies, their perceptions of influences on children's health, and factors determining food menu selection. Paired t tests and Chi-square tests were used to compare the difference by child care type. 81.9% of home care providers and 58.6% of center care providers received nutrition training, while 66.7 and 43.0% of these providers received physical activity training, respectively. Nutrition content, guidelines or state regulations, and food availability were the most important factors that influenced both types of care providers' food service menus. Both care provider types perceived they have less influence on children's food preferences, eating habits, and weight status compared to the home environment. However, home care providers perceived a smaller discrepancy between the influences of child care and home environments compared to center care providers. Compared to center providers, home care providers were more likely to have had training, be involved with health promotion activities, and rate their influence higher on children's health behaviors. Findings underscore the need for obesity prevention efforts in both types of child care settings.

Aspectos epidemiológicos, sorológicos e moleculares das hepatites A, B e C em crianças e adolescentes matriculados em creches e escolas do ensino infantil e fundamental da rede municipal na cidade de Santos / Epidemiological, serological and molecular aspects of hepatitis A, B and C in children and teenagers enrolled at municipal daycare facilities, pre-schools and elementary schools in the city of Santos

As hepatites virais continuam sendo uma preocupação em nível de saúde pública no Brasil e no Mundo, tanto pelo número de indivíduos atingidos, como pela possibilidade de complicação das formas agudas e crônicas. Segundo a Organização Mundial de Saúde (OMS), 170 milhões de pessoas são portadoras crônicas de hepatite C e 350 milhões portadoras crônicas de hepatite B. No Brasil, a estimativa de portadores de hepatite B crônica é de aproximadamente 600 mil pessoas e de hepatite C crônica, 1,5 milhão. Quanto à hepatite aguda A foram confirmados no país, em 2010, 5943 casos. O objetivo deste estudo foi conhecer a prevalência de marcadores sorológicos dos vírus das hepatites A, B e C em crianças e adolescentes matriculados em creches e escolas de ensino infantil e fundamental da rede municipal na cidade de Santos; conhecer os aspectos moleculares dos vírus das hepatites B e C, identificando o genótipo dos dois agentes e estudar modo de aquisição nos casos com sorologias positivas. Tratou-se de um estudo transversal realizado no período de 28 de Junho a 14 de Dezembro de 2007 onde foram coletadas 4680 amostras de sangue colhidas através de punção capilar e ao mesmo tempo aplicado um questionário nos familiares das crianças e adolescentes. Os exames sorológicos foram realizados utilizando a técnica de ELISA. O estudo molecular foi realizado pela técnica de reação em cadeia de polimerase "in House". A idade da população estudada variou de 7 meses a 18 anos e 1 m. A prevalência geral do anti-HVA IgG reagente foi de 9,7% e desses 74,6% foi anti-HVA IgM reagente. A prevalência de anti-HVA IgG foi maior entre as crianças mais velhas, meninas, aquelas que brincavam em córregos, sem esgoto em sua moradia, de pais com baixa instrução, de baixa renda familiar e aquelas que não eram moradoras da Orla...

Viral hepatitis are still a concern in the public health level in Brazil and around the Word, due both to the number of affected subjects and the possibility of complication in the acute and chronic forms. According to the World Health organization (WHO), 170 million people are chronic carriers of hepatitis C and 350 million chronic carriers of hepatitis B. In Brasil, the estimate of people with chronic hepatitis B is approximately 600 thousand people and chronic hepatitis C, 1,5 million. It has been confirmed in the country, in 2010, 5943 cases of acute hepatitis A. The The aim of this study was to learn the prevalence of serological markers of hepatitis A, B and C virus in children and teenagers enrolled at the municipal education network in the city of Santos, to learn molecular aspects of hepatitis B and C, identifying the genotype of the two agents and to study the acquisition mode in cases with positive serology. Cross-sectional study carried out over the period from June 28 to December 14, 2007, in which 4680 fingerprick blood samples were collected; at the same time, a survey questionnaire was applied to the family members of the children and teenagers. The serological tests were performed using the ELISA technique. The molecular analysis was performed using the technique of polymerase chain reaction "in House". Age of the population studied ranged from 7 months to 18 years and 1 month. . The general prevalence of serological markers anti-HAV IgG reagent was 9.7% and between them 74,7% was anti-HAV IgM reagent. There was higher prevalence among older children, females, those who used to play in streams near their home, the absence of a sewage system in home, parents with low education, low household income and among those who did not live in the seashore. The prevalence of anti-HAV IgM was not different between the categories, except for the age (peak in the early years and subsequent fall) and lower on the Hills and Northweast Zone. ...

A widening gap? The political and social organization of childcare in Argentina.

This article examines how social policies and programmes implemented in Argentina shape the political and social organization of childcare. The author seeks to analyse how welfare institutions are currently responding to emerging needs, and to what extent they facilitate the defamilialization of childcare for different social classes. Because Argentina lacks a truly unified 'care policy', four different kinds of facilities and programmes are examined: employment-based childcare services; pre-school schemes; social assistance care services; and poverty reduction strategies. It is argued that far from offering equal rights and services with a universalist cast, these 'caring' institutions reflect the ethos of the current welfare model in Argentina: a fragmented set of social policies based on different assumptions for different social groups, which in turn filter down to the social organization of childcare.

Stratified familialism: the care regime in India through the lens of childcare.

This article explores the political and social economy of care in India through a focus on childcare practices, from the viewpoint of the care giver ­ a perspective frequently ignored or touched on only generally in earlier discussions on development or social policy. It is argued that the care regime is an ad hoc summation of informal, stratified practices. It is shaped by the institutional context, in particular the economic and social inequalities of work and livelihoods, as well as trends and absences in state economic and social policy. Central to the dynamics of care practices in India is the ideology of gendered familialism in public discourse and policy, which reiterates care as a familial and female responsibility and works to devalue and diminish the dimensions of care. By delineating the range of institutions through which everyday childcare practices are organized, this contribution draws out the differentiations and actualities of stratified familialism and care. At one end of the spectrum are those who have the possibility to retain familial carers at home and supplement them with paid and other institutional carers; at the other are those who are neither able to retain family members at home nor fill the care gap through formal institutions.

Putting two and two together? Early childhood education, mothers' employment and care service expansion in Chile and Mexico.

In recent years, several middle-income countries, including Chile, Mexico and Uruguay, have increased the availability of early childhood education and care (ECEC) services. These developments have received little scholarly attention so far, resulting in the (surely unintended) impression that Latin American social policy is tied to a familialist track, when in reality national and regional trends are more varied and complex. This article looks at recent efforts to expand ECEC services in Chile and Mexico. In spite of similar concerns over low female labour force participation and child welfare, the approaches of the two countries to service expansion have differed significantly. While the Mexican programme aims to kick-start and subsidize home- and community-based care provision, with a training component for childminders, the Chilean programme emphasizes the expansion of professional ECEC services provided in public institutions. By comparing the two programmes, this article shows that differences in policy design have important implications in terms of the opportunities the programmes are able to create for women and children from low-income families, and in terms of the programmes' impacts on gender and class inequalities. It also ventures some hypotheses about why the two countries may have chosen such different routes.

Síndrome de Burnout em professores de educação pré-escolar / Burnout Syndrome in preschool teachers

Professores, atualmente, estão mais expostos a diversos estressores ocupacionais que, se persistentes, podem levar à síndrome de burnout, fenômeno psicossocial constituído por três dimensões: Exaustão Emocional, Despersonalização e Baixa Realização Profissional. O objetivo deste estudo foi verificar a existência de associação entre as dimensões da síndrome de burnout e variáveis demográficas, laborais e psicossociais em uma amostra de 34 professores de educação pré-escolar da cidade de Porto Alegre. Foram utilizados como instrumentos de pesquisa o Maslach Burnout Inventory e um questionário de dados sociodemográficos e laborais para as demais variáveis. Resultados revelam baixos índices nas dimensões de exaustão emocional e despersonalização e alto índice na dimensão de realização profissional. Com relação às variáveis demográficas somente a variável ter companheiro associou-se à dimensão de exaustão emocional, sendo que as professoras que possuem companheiro apresentaram média mais elevada. Nas variáveis laborais e psicossociais, resultados obtidos através da prova de correlação de Pearson e t de Student evidenciam que quanto maior a carga horária, o número de alunos atendidos diariamente, o tempo de docência e o pensamento de mudar de profissão, maior é a exaustão emocional. Já a realização profissional diminui à medida que aumenta a frequência do pensar em mudar de profissão (AU)

Síndrome de burnout em professores de educação pré-escolar / Burnout syndrome in preschool teachers

Professores, atualmente, estão mais expostos a diversos estressores ocupacionais que, se persistentes, podem levar à síndrome de burnout, fenômeno psicossocial constituído por três dimensões: Exaustão Emocional, Despersonalização e Baixa Realização Profissional. O objetivo deste estudo foi verificar a existência de associação entre as dimensões da síndrome de burnout e variáveis demográficas, laborais e psicossociais em uma amostra de 34 professores de educação pré-escolar da cidade de Porto Alegre. Foram utilizados como instrumentos de pesquisa o Maslach Burnout Inventory e um questionário de dados sociodemográficos e laborais para as demais variáveis. Resultados revelam baixos índices nas dimensões de exaustão emocional e despersonalização e alto índice na dimensão de realização profissional. Com relação às variáveis demográficas somente a variável ter companheiro associou-se à dimensão de exaustão emocional, sendo que as professoras que possuem companheiro apresentaram média mais elevada. Nas variáveis laborais e psicossociais, resultados obtidos através da prova de correlação de Pearson e t de Student evidenciam que quanto maior a carga horária, o número de alunos atendidos diariamente, o tempo de docência e o pensamento de mudar de profissão, maior é a exaustão emocional. Já a realização profissional diminui à medida que aumenta a frequência do pensar em mudar de profissão.

Nowadays, teachers are more exposed to several occupational stress factors, which if persistent may lead to Burnout Syndrome, a psychosocial phenomenon constituted by three dimensions: emotional exhaustion, depersonalization and reduced professional achievement. The aim of this study was to verify the existence of association among the Burnout Syndrome dimensions and demographic, labor and psychosocial variables in a sample of 34 preschool teachers in the city of Porto Alegre, Brazil. The MBI – Maslach Burnout Inventory – was used along with a questionnaire to assess other socio- -demographic and labor variables. The results revealed low rates of the emotional exhaustion and depersonalization dimensions, and a high rate of Professional Achievement. As for demographic variables, only "having a partner" associated to the emotional exhaustion dimension, in which the teachers who have partners presented a higher mean. Regarding labor and psychosocial variables, results obtained using Pearson’s correlation and the Student's t-test showed that as working hours, number of students who are taken care of daily, time of teaching practice and thoughts of changing career increase, the emotional exhaustion increases as well. Professional achievement decreases as the frequency of thinking of changing career increases.

Emergency preparedness--an early childhood educator's perspective.

As early childhood educators who participated in the discussion of optimal scene management involving children and families in the event of a radiological/nuclear event, the authors would suggest consideration be given to the formal preparation for evacuation of educators and families and how to ensure that families are provided factual and updated information.

Uma revisão das ações de nutrição e do papel do nutricionista em creches / A review of nutrition actions and the role of dieticians in daycares

As creches são uma realidade na vida de grande parcela das crianças brasileiras em idade pré-escolar, sendo que nelas permanecem por um longo período. A demanda por esse serviço tende a aumentar com a participação cada vez mais ativa da mulher no mercado de trabalho. Assim o objetivo desse estudo foi revisar a literatura publicada a partir de 1998, disponível nas bases de dados MedLine, SciELO, Lilacs e Science Direct. Foram selecionados artigos de estudos experimentais, revisão bibliográfica, livros, teses e boletins de comitês de saúde, sobre as ações desenvolvidas em creches no contexto atual das crianças brasileiras e sobre a atuação do nutricionista nesta instituição. A pesquisa revelou a dualidade vivida pelos educadores entre o cuidar e o educar. Destaca a importância da instituição na formação de hábitos alimentares e discute a necessidade de aprofundamento nas questões ligadas à educação alimentar, no sentido de proporcionar à criança o conhecimento e a autonomia na escolha de alimentos. Entre as principais carências nutricionais apresentadas pelas crianças frequentadoras de creches públicas destaca-se a anemia ferropriva, sendo que a alimentação oferecida nas creches tem mostrado deficiências de cálcio, ferro, vitamina A, fibras e energia. Finalmente, apresenta os principais desafios do nutricionista neste segmento e a necessidade de sua constante atualização sobre o quadro epidemiológico da nutrição para as faixas etárias que atende, bem como as prioridades estabelecidas pela Política Nacional de Alimentação e Nutrição vigente e normas emitidas pelos órgãos de referência para esta área. Ao nutricionista cabe considerar, além das necessidades nutricionais da criança, o viés educativo e de formação de hábitos alimentares.

Daycares are a reality for most Brazilian preschoolers. Children remain in daycares for long periods of time. The demand for this kind of service tends to increase since the participation of women in the labor market is increasing. Thus, the objective of this study was to review the literature published since 1998 available at the MedLine, SciELO, Lilacs and Science Direct databases on the actions developed in daycares in the current context of Brazilian children and on the role of the dietician in this institution. Articles on experimental studies, literature reviews, books, theses and bulletins from health committees were included. The research revealed the duality experienced by educators between caring and educating. It stresses the importance of the institution in the formation of food habits and discusses the need for further education on food-associated issues, giving children knowledge and autonomy for making food choices. One of the main nutritional deficiencies found in children who attend public daycares is iron-deficiency anemia. Moreover, the foods offered in these daycares are low in calcium, iron, vitamin A, fibers and energy. Finally, the study presents the main challenges dieticians will have to face in this segment and the need they will have to constantly update their knowledge on the epidemiological nutrition picture of the age groups they work with, as well as the priorities established by the National Food and Nutrition Policy and norms issued by the reference departments in this area. The dietician needs to consider not only the nutritional requirements of the children but also the nature of education and formation of food habits.