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1.
Rev. enferm. UERJ ; 30: e64056, jan. -dez. 2022.
Artículo en Inglés, Portugués | LILACS-Express | LILACS | ID: biblio-1362171

RESUMEN

Objetivo: descrever a evolução temporal do pré-natal quanto o mês do início do pré-natal, vacinação e orientações sobre aleitamento materno nos anos de 1997, 2006 e 2016. Método: estudo transversal operacionalizado em bancos de dados da II, III e IV Pesquisa Estadual de Saúde e Nutrição. Foram descritas as variáveis: mês de início do pré-natal, doses da vacina antitetânica e orientação sobre o aleitamento materno recebidas no pré-natal. Protocolo de pesquisa aprovado pelo comitê de ética em pesquisa da instituição. Resultados: em 2016 observou-se aumento significativo do início precoce do pré-natal quando comparado a 1997 e 2006 (p<0,001). A vacinação antitetânica durante a gravidez apresentou um aumento significativo em 2006 e 2016 comparado a 1997, assim como a proporção de gestantes que receberam orientações sobre aleitamento materno durante o pré-natal (p<0,001). Conclusões: houve melhoria da assistência pré-natal quanto ao início precoce, vacinação antitetânica e orientações sobre aleitamento materno.


Objective: to describe the temporal evolution of prenatal care in terms of the month when prenatal care began, vaccination and guidelines on breastfeeding in 1997, 2006 and 2016. Method: cross-sectional study operationalized in databases of the II, III and IV State Health and Nutrition Survey. The variables were described: month when prenatal care began, doses of tetanus vaccine and guidance on breastfeeding received during prenatal care. Research protocol approved by the Research Ethics Committee. Results: in 2016 there was a significant increase in early prenatal care when compared to 1997 and 2006 (p<0.001). Tetanus vaccination during pregnancy showed a significant increase in 2006 and 2016 compared to 1997, as did the proportion of pregnant women who received guidance on breastfeeding during prenatal care (p<0.001). Conclusions: there was an improvement in prenatal care regarding early initiation, tetanus vaccination and guidelines on breastfeeding.


Objetivo: describir la evolución temporal de la atención prenatal en función del mes de inicio de la atención prenatal, vacunación y guías de lactancia materna en 1997, 2006 y 2016. Método: estudio transversal operacionalizado en bases de datos de la II, III y IV Encuesta Estatal de Salud y Nutrición. Las variables fueron descritas: mes de inicio de la atención prenatal, dosis de vacuna antitetánica y orientación sobre lactancia materna recibida durante la atención prenatal. Protocolo de pesquisa aprobado por el Comité de Ética en Investigación de la instituición. Resultados: en 2016 hubo un aumento significativo en la atención prenatal temprana en comparación con 1997 y 2006 (p <0,001). La vacunación contra el tétanos durante el embarazo mostró un aumento significativo en 2006 y 2016 en comparación con 1997, al igual que la proporción de mujeres embarazadas que recibieron orientación sobre la lactancia materna durante la atención prenatal (p <0,001). Conclusiones: hubo una mejora en la atención prenatal en cuanto a inicio temprano, vacunación antitetánica y guías de lactancia materna.

2.
Rev. urug. enferm ; 17(1): 1-20, jun. 2022.
Artículo en Español | LILACS, BDENF - Enfermería, BNUY | ID: biblio-1369095

RESUMEN

La anemia constituye un problema mayor de salud pública debido a sus múltiples consecuencias biológicas, económicas y sociales. La anemia por deficiencia de hierro es común en niños pequeños, debido a los altos requerimientos de hierro necesarios para su rápido crecimiento y desarrollo, particularmente durante los primeros dos años de vida. Con el objetivo de sintetizar el conocimiento actual sobre los determinantes sociales de la anemia ferropénica en niños, se realizó una revisión sistemática de los artículos originales sobre estudios cuantitativos publicados en las bases de datos PubMed Central (PMC), SCOPUS Elsevier y la Biblioteca Virtual en Salud (BVS) en el mes de febrero del año 2021, en la que fueron seleccionados 43 artículos. Se observa que los estudios abordan desde causas estructurales como el nivel socioeconómico, como aquellas subyacentes: saneamiento, condiciones habitacionales, hacinamiento, conocimiento materno, estado nutricional del niño, lactancia materna y alimentación complementaria, entre otras. Se advierte que hay escasez de estudios en América Latina que aborden la problemática desde la perspectiva de los determinantes sociales, resulta fundamental el profundizar en el estudio de la determinación de las causas para contar con información válida que permita tomar acciones tendientes a contribuir en la resolución de la problemática en Uruguay.


Anemia is a major public health problem due to its multiple biological, economic and social con-sequences. Iron deficiency anemia is common in young children, due to the high iron requirements necessary for their rapid growth and development, particularly during the first two years of life. With the aim of synthesizing the current knowledge on the social determinants of iron deficiency anemia in children, a systematic review of the original articles on quantitative studies published in the PubMed Central (PMC), SCOPUS Elsevier and the Virtual Library in Health (VHL) in the month of February of the year 2021, in which 43 articles were selected. It is observed that the studies address from structural causes such as socioeconomic level, as well as those underlying: sanitation, housing conditions, overcrowding, maternal knowledge, nutritional status of the child, breastfeeding and complementary feeding, among others. It is noted that there is a lack of studies in Latin America that address the problem from the perspective of social determinants, it is essential to deepen the study of the determination of the causes to have valid information that allows taking actions aimed at contributing to the resolution of the problem in Uruguay.


A anemia é um importante problema de saúde pública devido às suas múltiplas consequências biológicas, econômicas e sociais. A anemia por deficiência de ferro é comum em crianças pequenas, devido às altas necessidades de ferro necessárias para seu rápido crescimento e desenvolvimento, principalmente durante os dois primeiros anos de vida. Com o objetivo de sintetizar o conhecimento atual sobre os determinantes sociais da anemia ferropriva em crianças, uma revisão sistemática dos artigos originais sobre estudos quantitativos publicados no PubMed Central (PMC), SCOPUS Elsevier e na Biblioteca Virtual em Saúde (BVS) em o mês de fevereiro do ano de 2021, no qual foram selecionados 43 artigos. Observa-se que os estudos abordam desde causas estruturais como nível socioeconômico, como também as subjacentes: saneamento básico, condições de moradia, superlotação, conhecimento materno, estado nutricional da criança, aleitamento materno e alimentação complementar, entre outras. Nota-se que há carência de estudos na América Latina que abordem o problema sob a ótica dos determinantes sociais, é imprescindível aprofundar o estudo da determinação das causas para ter informações válidas que permitam tomar ações que visem contribuir para a resolução do problema no Uruguai.


Asunto(s)
Humanos , Factores Socioeconómicos , Niño , Anemia Ferropénica , Nutrición del Niño , Nutrición del Lactante , Determinantes Sociales de la Salud , Factores Sociales , Lactante
3.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-48784

RESUMEN

No mês em comemoração ao Dia Mundial de Doação de Leite Humano – 19 de maio o Ministério da Saúde lançou a Campanha Nacional de Doação de Leite Humano. Com o tema “Doe leite materno e receba a gratidão de uma vida”.


Asunto(s)
Promoción de la Salud , Bancos de Leche , Extracción de Leche Materna , Leche Humana , Lactancia Materna
4.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-48782

RESUMEN

A Rede Global de Bancos de Leite Humano- rBLH em comemoração ao Dia Mundial de Doação de Leite Humano - 19 de maio disponibiliza agenda com os eventos que estarão acontecendo em todo país no mês de maio.


Asunto(s)
Promoción de la Salud , Bancos de Leche , Leche Humana , Lactancia Materna
5.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-48783

RESUMEN

Artigo publicado fruto da Iniciação Científica 2020, com graduandos de medicina, da Universidade de Vila Velha, coordenado pelas Profª. Dra. Mônica Barros de Pontes e Wanêssa Lacerda Poton, apresenta avaliação da sapiência à prática de ações de incentivo à amamentação de médicos, enfermeiros e técnicos de enfermagem que atuam na atenção primária.


Asunto(s)
Lactancia Materna , Personal de Salud , Atención Primaria de Salud , Promoción de la Salud , Brasil
6.
J Health Popul Nutr ; 41(1): 16, 2022 05 03.
Artículo en Inglés | MEDLINE | ID: mdl-35505386

RESUMEN

BACKGROUND: The purpose of the project was to improve newborn health in neonatal care units in a low resource area with high neonatal mortality, predominantly by better nutrition and educational exchange of health care workers. METHOD: A fourfold program to make human milk production and distribution feasible and desirable. 1 Education to enlighten health care workers and parents to the excellence of human milk. 2 Lactation counselling to address the various challenges of breastfeeding. 3 Improving infants´ general condition. 4 Infrastructure alterations in the hospital. A collaboration between hospitals in India and Norway. RESULTS: The number of infants receiving human milk increased pronouncedly. Systematic, professional lactation counselling, the establishment of a milk bank, and empowerment of nurses was perceived as the most important factors. CONCLUSIONS: It is possible to greatly improve nutrition and the quality of newborn care in low/middle income settings by optimising human resources. Viable improvements can be obtained by long-term health partnership, by involving all hierarchal levels and applying locally developed customized methods.


Asunto(s)
Lactancia Materna , Salud del Lactante , Femenino , Hospitales , Humanos , Renta , Lactante , Recién Nacido , Pobreza
9.
BMC Pregnancy Childbirth ; 22(1): 380, 2022 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-35501834

RESUMEN

BACKGROUND: The World Health Organization recommends exclusive breastfeeding for the first 6 months of an infant's life and continued breastfeeding for 2 years. The global rate of exclusive breastfeeding is low at 33%. Thus, it is important to identify philosophical and theory-based strategies that can promote exclusive breastfeeding. The aim of the study was to identify philosophical schools of thought and theories used in research on promoting the practice of exclusive breastfeeding. METHODS: A scoping review using Arksey and O'Malley's framework explored the phenomenon of exclusive breastfeeding practice promotion. Searches were conducted using CINAHL Plus full-text, PubMed, APA PsycInfo, and Academic Search Premier. Search terms included theory, philosophy, framework, model, exclusive breastfeeding, promotion, support, English, and publication between 2001-2022. RESULTS: The online search yielded 1,682 articles, however, only 44 met the inclusion criteria for the scoping review. The articles promoting exclusive breastfeeding used pragmatism (n = 1) or phenomenology (n = 2) philosophies and theories of self-efficacy (n = 10), theory of planned behaviour (n = 13), social cognitive theories (n = 18) and represented 16 countries. Theories of self-efficacy and planned behaviour were the most used theories. CONCLUSIONS: This review suggests that theories and models are increasingly being used to promote exclusive breastfeeding. Orienting exclusive breastfeeding programmes within theoretical frameworks is a step in the right direction because theories can sensitize researchers and practitioners to contextually relevant factors and processes appropriate for effective exclusive breastfeeding strategies. Future research should examine the efficacy and effectiveness of theory-informed exclusive breastfeeding programmes over time. Such information is important for designing cost-effective EBF programmes.


Asunto(s)
Lactancia Materna , Autoeficacia , Lactancia Materna/psicología , Femenino , Humanos , Lactante , Filosofía , Organización Mundial de la Salud
10.
Int Breastfeed J ; 17(1): 34, 2022 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-35501877

RESUMEN

BACKGROUND: Breastfeeding is crucial for the preterm infants. Breast milk is not only food but also medicine. Few studies have focused on the longitudinal effects of exclusive breastfeeding outcome of preterm infants separated from their mothers after discharge, especially in Shanghai. We aimed to examine the exclusive breastfeeding rate and duration amongst first time mothers of preterm infants after discharge and its determinants. METHODS: Analyses were based on 500 preterm infants separated from their mothers in a tertiary maternity and infant-specialized hospital in Shanghai from September 2018 to September 2019.The Socio-demographic characteristics, breastfeeding knowledge questionnaire, breastfeeding self-efficacy short form scale, Edinburgh postpartum depression scale and breastfeeding family support scale were used for the investigation and the exclusive breastfeeding rate of premature infants was followed up on 1 month, 3 months and 6 months after discharge. The changing trend of breastfeeding knowledge, breastfeeding self-efficacy, postpartum depression and family support were measured by ANOVA at different stages. Using the chi-square test and multiple logistic regression, factors impacting the breastfeeding rate of preterm infants at three time intervals after discharge were investigated. The Kaplan Meier survival curve and cox regression model were used to analyze the determinants of exclusive breastfeeding duration of premature infants after discharge. RESULTS: Exclusive breastfeeding rates were 19.0, 17.2 and 10.4% at 1 month, 3 months and 6 months after discharge of preterm infants, respectively. The average length of exclusive breastfeeding duration was(3.69 ± 1.80)months. Finally, type of delivery (adjusted odds ratio [AOR] 1.564; 95% confidence interval [CI] 0.513,3.116), gestational age(AOR 0.612, 95% CI 0.236, 3.418), maternal family support (AOR 6.125,95% CI 6.359, 98.452) were discovered to be independent predictors on the exclusive breastfeeding rate at 6 months after preterm infants were discharged. Through the cox regression model, we found that a maternal planned pregnancy (HR 0.681, 95%CI 0.531,0.873), delivering breast milk during hospitalization (HR 0.797, 95%CI 0.412,2.288), NICU feeding mode during hospitalization (HR 1.221, 95%CI 0.128,1.381) and family support (HR 0.561, 95%CI 0.004,2.428) were significantly associated with the exclusive breastfeeding duration after discharge. CONCLUSIONS: The exclusive breastfeeding outcome of premature infants was affected by many factors, so we should focus on the three levels of individual, family, society and design targeted intervention measures to increase the exclusive breastfeeding rate and prolong exclusive breastfeeding duration.


Asunto(s)
Lactancia Materna , Depresión Posparto , China/epidemiología , Estudios de Cohortes , Depresión Posparto/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Unidades de Cuidado Intensivo Neonatal , Estudios Longitudinales , Madres , Alta del Paciente , Embarazo
11.
Int Breastfeed J ; 17(1): 33, 2022 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-35501894

RESUMEN

BACKGROUND: Expression and storage of breastmilk is a strategy that ensures continued breast milk consumption in the event of temporary separation of an infant from the mother. However, many studies show that working mothers are unable to exclusively breastfeed for six months successfully. Working mothers are forced to wean early because of minimal support at the workplace, lack of knowledge on breast milk expression and lack of storage facilities. The 2017 Kenya Health Act mandates employers to provide lactation rooms for facilitation of breast milk expression in support of the lactating mother. This study analyses the knowledge attitude and practice of breast milk expression among working women in Kenya. METHODS: This was a cross sectional study done between December 2018 and February 2019. Study participants were 395 working women with infants aged six months and below, attending well baby clinics in two large public hospitals in Nairobi Kenya. A structured questionnaire with open and closed ended questions was used to establish the knowledge and practice while a Likert scale was used to explore attitudes of the mothers towards expression and storage of breast milk. RESULTS: Overall satisfactory knowledge on breast milk expression and storage was attained by only 34% of working mothers. Eighty four percent positively agreed that expression and storage of breast milk would help them achieve six months of exclusive breastfeeding. Challenges experienced were breast pain and cumbersome nature of expressing milk. Only 41% (161) were expressing breast milk either regularly or occasionally. The most common reason (24.7%) for expressing milk was to enable someone else feed the baby when they were at work. Most mothers (77%) expressed at home as the workplace did not seem to provide adequate equipment to facilitate breastmilk expression and storage. CONCLUSIONS: There is a substantial knowledge gap on expression and storage of breast milk. Working mothers have a good attitude towards attainment of exclusive breast milk feeding through expression of breast milk. The workplace does not have adequate facilities to support expression and storage of breast milk.


Asunto(s)
Extracción de Leche Materna , Lactancia Materna , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Lactante , Kenia , Lactancia , Madres
12.
An Pediatr (Engl Ed) ; 2022 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-35523686

RESUMEN

INTRODUCTION: In 2017, a worldwide survey was conducted on compliance with the practices promoted by Neo-BFHI (Baby-friendly Hospital Initiative expansion to neonatal wards). OBJECTIVE: To present the results of the Spanish wards that participated in the global survey and compare them with those obtained internationally. MATERIAL AND METHODS: Cross-sectional study through a survey on compliance with the Neo-BFHI ("Three basic principles", "Ten steps adapted to neonatal wards" and "the compliance with the International Code of Marketing of Breast-milk Substitutes" and subsequent relevant World Health Assembly resolutions). Compliance was calculated as the mean in each indicator and a final mean score for each neonatal unit. For the partial and final scores for each country and at the international level, the median was used. All scores ranged between 0 and 100. RESULTS: The response rate in Spain was 90%. The range of the national mean for neonatal wards were from 37 to 99, with no differences in the final score according to the level of care. The global score for Spain (72) is below the international median (77) and this also occurs in 8 of 14 items. The neonatal wards from BFHI designated hospitals, obtained a significantly higher mean global score, and in 9 of 14 items than the non-accredited ones. CONCLUSIONS: Both international and national results indicate an improvement in breast feeding practices in neonatal units. The benefits of the BFHI accreditation of maternity reach neonatal wards. Spain has several key points below the international score.

13.
Int Breastfeed J ; 17(1): 35, 2022 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-35527258

RESUMEN

BACKGROUND: Positive breastfeeding experiences positively influence subsequent attitudes towards breastfeeding, and increase mothers' confidence, self-efficacy, motivation and intention to breastfeed. However, the strategies that mothers find useful and effective for creating positive breastfeeding experiences remain largely unknown. The aim of our study was thus to describe experience-based knowledge from mothers about strategies for creating positive breastfeeding experiences. METHODS: The study followed a qualitative design involving the critical incident technique. Data were collected with an online survey containing open-ended questions that was administered to a Sweden-based parenting group on Facebook in September 2018. Ultimately, 340 incidents from 176 women were identified as offering strategies for creating positive breastfeeding experiences. Data from the written replies were extracted as textual units, condensed and categorised until categories were mutually exclusive, which resulted in six categories. RESULTS: Participating women were on average 31.2 years old and the median number of children per participant was two. Mothers' strategies for creating positive breastfeeding experiences generally included being calm and accepting that initiating breastfeeding takes time and can be difficult initially. Participants described feeling close to the baby by maintaining skin-to-skin contact and being present in the moment by taking time to appreciate the child and the breastfeeding situation, and temporarily forgetting about the world and simply being with the child in the here and now. Participants advocated baby-led breastfeeding and following correct techniques. They also described the importance of keeping an effortless mindset about breastfeeding to prevent perceiving breastfeeding as a compulsion. Mothers described acquiring knowledge about breastfeeding so that they could be prepared if breastfeeding problems occurred and getting support from professionals and family was described as significant for having a positive breastfeeding experience. Caring for oneself and one's body, with aids if necessary, were described as important strategies, as were having a positive attitude and a strong desire to breastfeed. CONCLUSION: Because positive breastfeeding experiences and support are predictors of future breastfeeding initiation and duration, assisting women in creating positive breastfeeding experiences is important. Asking mothers to formulate strategies that they find useful could facilitate breastfeeding by making their approaches more conscious and visible.


Asunto(s)
Lactancia Materna , Madres , Adulto , Niño , Femenino , Humanos , Intención , Masculino , Encuestas y Cuestionarios , Suecia
14.
J Clin Pediatr Dent ; 46(2): 75-85, 2022 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-35533221

RESUMEN

OBJECTIVE: To systematically assess systematic reviews and meta-analyses investigating the association of breastfeeding with ECC. STUDY DESIGN: A systematic search was carried out from MEDLINE® (PubMed), EMBASE, the Cochrane Central Database, OVID, Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports and Epistemonikos Databases up to November 2019. Data extraction was carried out by two investigators. ROBIS tool was used for quality assessment of included systematic reviews. RESULTS: Four systematic reviews were found assessing the correlation of breastfeeding with ECC. Findings were grouped into four categories, according to the duration, frequency, pattern, and comparison of feeding habits. Two systematic reviews assessing duration of breastfeeding above the age of 12 months had odds ratios of 1.86 and 1.99, showing positive correlation with ECC while nocturnal breastfeeding showed highest odds ratio of 7.14. Of the four included reviews, three had low risk of bias and one had unclear risk of bias. CONCLUSIONS: Breastfeeding beyond the age of 12 months, accompanied by nocturnal feeding, had a positive association with ECC. Further research is warranted for assessment of diurnal and nocturnal sleep-time breastfeeding habits, together with the role of enamel defects (hypoplasia), and the risk of ECC.


Asunto(s)
Lactancia Materna , Caries Dental , Preescolar , Caries Dental/epidemiología , Caries Dental/etiología , Susceptibilidad a Caries Dentarias , Femenino , Humanos , Lactante , Revisiones Sistemáticas como Asunto
15.
Br J Hosp Med (Lond) ; 83(4): 1-9, 2022 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-35506733

RESUMEN

This article discusses the nutritional needs of moderate and late preterm infants (born between 32+0weeks and 36+6weeks' gestation) and makes recommendations for best practice both while these infants are in hospital and when they are discharged into the community. These recommendations were derived following a roundtable meeting of a group comprising two neonatologists, three paediatric dietitians, a health visitor/paediatric nurse and a midwife practitioner. The meeting and medical writing assistance was sponsored by Nutricia. None of the participants accepted honoraria for their contributions to the discussion.


Asunto(s)
Lactancia Materna , Recien Nacido Prematuro , Niño , Femenino , Hospitales , Humanos , Lactante , Recién Nacido , Alta del Paciente
16.
Andes Pediatr ; 93(1): 43-52, 2022 Feb.
Artículo en Español | MEDLINE | ID: mdl-35506775

RESUMEN

OBJECTIVE: to analyze the associations between breastfeeding duration and mixed feeding (breast milk and formula) with obesity, cardiometabolic risk (WHtR), body fat, and dietary and physical activity risk behaviors in children and adolescents. SUBJECTS AND METHOD: cross-sectional study carried out with 1,467 students in Costa Rica. An interview was conducted with parents and children to gather information on socioeconomic status, education, dietary and physical activity risk behaviors of the youth, including breastfeeding duration and mixed feeding. Body mass index, waist circumference, and body fat were assessed by bioelectrical impedance analysis and cardiometabolic risk was mea sured with the waist-to-height ratio (WHtR ≥ 0.5) by trained personnel. Descriptive statistics and logistic regression models were applied. RESULTS: the average age was 11.4 ± 2.6 years and 50.9% were male. 55.5% of the population was middle class; 60% were sedentary, and 16% presented obesity. Around 20% were breastfed without the introduction of formula before 6 months, 13% were never breastfed, and more than 60% were breastfed for ≥ 6 months. Those children who were fed only with breast milk or in combination with formula for ≥ 6 months presented a lower percentage of obesity than those who received formula feeding only (60.8 vs 39.2; p < 0.005). Children with cardiometa bolic risk (WHtR ≥ 0.50), unhealthy diet, sedentary lifestyle, and who were fed only with formula are at higher risk of developing obesity (OR = 18.8, 95% CI 13.2-26.0). CONCLUSIONS: these results are consistent with other studies and reinforce the evident protection of breastfeeding against the development of obesity.


Asunto(s)
Lactancia Materna , Enfermedades Cardiovasculares , Adolescente , Niño , Costa Rica/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Obesidad/epidemiología , Obesidad/prevención & control
17.
BMJ Open ; 12(5): e057482, 2022 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-35508343

RESUMEN

INTRODUCTION: Docosahexaenoic acid (DHA), an omega-3 fatty acid, is important for brain development with possible implications in neurodevelopmental outcomes. In the two-arm, randomised, double-blind, placebo-controlled Maternal Omega-3 Supplementation to Reduce Bronchopulmonary Dysplasia in Very Preterm Infants trial, very preterm infants (<29 weeks' gestation) were supplemented in high doses of DHA or placebo until they reached 36 weeks' postmenstrual age. We propose a long-term neurodevelopmental follow-up of these children. This protocol details the follow-up at 5 years of age, which aims to (1) confirm our long-term recruitment capacity and (2) determine the spectrum of neurodevelopmental outcomes at preschool age following neonatal DHA supplementation. METHODS AND ANALYSIS: This long-term follow-up involves children (n=194) born to mothers (n=170) randomised to DHA (n=85) or placebo (n=85) from the five sites in Quebec when they will be 5 years' corrected age. The primary outcome measure is related to the long-term recruitment capacity, which we determined as successful if 75% (±10%, 95% CI) of the eligible children consent to the 5-year follow-up study. Interviews with mothers will be conducted to assess various aspects of neurodevelopment at preschool age (executive functions, behavioural problems, global development and health-related quality of life), evaluated with standardised neurodevelopmental questionnaires. In addition, a semistructured interview conducted in a subset of the mothers will be used to determine their acceptability and identify barriers and enablers to their eventual participation to the next phase of the trial. This follow-up study will require approximately 22 months to be completed. ETHICS AND DISSEMINATION: This study was approved by the CHU de Québec-Université Laval Research Ethics Board (MP-20-2022-5926). Mothers will provide informed consent before participating in this study. Findings will be disseminated through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER: NCT02371460.


Asunto(s)
Ácidos Docosahexaenoicos , Enfermedades del Prematuro , Encéfalo , Lactancia Materna , Niño , Preescolar , Suplementos Dietéticos , Ácidos Docosahexaenoicos/uso terapéutico , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto
19.
Arch Argent Pediatr ; 120(3): 152-157, 2022 Jun.
Artículo en Español, Inglés | MEDLINE | ID: mdl-35533116

RESUMEN

INTRODUCTION: Breastfeeding reduces the risk for morbidity and mortality in children and also provides environmental and financial advantages. Breastfeeding monitoring is critical for public policies. OBJECTIVES: The objectives of this study were to estimate the prevalence of breastfeeding in the population seeking care in the public sector, compare this prevalence to data from 2015, and assess associated outcome measures. POPULATION AND METHODS: Cross-sectional, observational study. A structured questionnaire was used to collect intake and sociodemographic data from infants aged < 6 months (n = 15 322) and 12-15 months (n = 3243) who sought care from public sector health care providers spontaneously between August and September 2017. RESULTS: The prevalence of exclusive breastfeeding among infants < 6 months was 53.5% (95% confidence interval [CI]: 52.7-54.3); and at 4 and 6 months, 51.5% (95% CI: 49.7-53.4) and 41.7% (95% CI: 39.8-43.5), respectively. The prevalence of exclusive breastfeeding at 4 and 6 months increased compared to 2015 (p < 0.001). The prevalence of breastfeeding among infants aged 12-15 months was 77.8% (95% CI: 76.4-79.3). The following variables were independently associated with a lower frequency of exclusive breastfeeding (< 6 months old) and breastfeeding: older age, lower level of maternal education, delivery via C-section, low birth weight, initial breastfeeding after the first hour, and separation of the mother-child dyad ≥ 4 hours a day. CONCLUSIONS: Exclusive breastfeeding at 6 months and continued breastfeeding showed certain improvement, but the rate of breastfed infants is still below desirable levels.


Introducción. La lactancia materna (LM) reduce el riesgo de morbimortalidad en niños, además, provee ventajas medioambientales y económicas. El monitoreo de su práctica es indispensable para las políticas públicas. OBJETIVOS: Los objetivos de este trabajo fueron estimar la prevalencia de LM en la población que demanda al sector público, comparar la prevalencia con datos del 2015 y evaluar variables de interés asociadas. Población y métodos. Estudio transversal observacional. Mediante un cuestionario estructurado, se relevó información de ingestión y datos sociodemográficos de lactantes <6 meses (n = 15 322) y de entre 12 y 15 meses (n = 3243) que concurrieron en forma espontánea a efectores del sector público entre agosto y septiembre de 2017. RESULTADOS: La prevalencia de LM exclusiva (LME) en <6 meses fue del 53,5 % (intervalo de confianza del 95 % [IC95%]: 52,7-54,3); al cuarto y sexto mes, del 51,5 % (IC95%: 49,7-53,4) y del 41,7 % (IC95%: 39,8-43,5) respectivamente. La prevalencia de LME al cuarto y al sexto mes aumentaron en relación con el 2015 (p <0,001). La prevalencia de LM en niños de 12 a 15 meses fue del 77,8 % (IC95%: 76,4-79,3). Las siguientes variables se asociaron en forma independiente con menor frecuencia de LME (en <6 meses) y LM: mayor edad del niño, menor nivel educativo materno, parto por cesárea, bajo peso al nacer, puesta al pecho después de la primera hora y separación de la díada madre-hijo/a ≥4 horas diarias. CONCLUSIONES: La LME al sexto mes y la LM continuada muestran cierta mejora, pero aún la proporción de lactantes amamantados no logra alcanzar niveles deseables.


Asunto(s)
Lactancia Materna , Salud Pública , Argentina/epidemiología , Estudios Transversales , Femenino , Humanos , Lactante , Prevalencia , Sector Público
20.
Arch Argent Pediatr ; 120(3): 187-194, 2022 Jun.
Artículo en Español, Inglés | MEDLINE | ID: mdl-35533121

RESUMEN

INTRODUCTION: Introduction. The evidence about the effectiveness of fathers' or partners' involvement in breastfeeding interventions to promote initiation, duration, and exclusiveness rates has increased in recent years. OBJECTIVES: To identify the perspectives and assessments of breastfeeding among partners of breastfeeding women and develop information to create adequate interventions that favor the inclusion of fathers in care spaces and in the support of breastfeeding. MATERIAL AND METHODS: Qualitative study with a grounded theory design. Four focus groups were held with fathers. Data were processed defining free flow analysis units, coded in 2 levels, an open code, with emerging categories, and such categories grouped into 5 main topics. RESULTS: A total of 16 fathers participated. Five main topics were identified: fathers' knowledge about breastfeeding, feelings towards breastfeeding, partner's involvement in breastfeeding, development of the concept of fatherhood, breastfeeding in society. Breastfeeding was positively assessed. Although breastfeeding support was considered a shared family responsibility, there were not enough co-participation actions identified. Participants expressed their desire to play a more involved fatherhood role; however, they stated that these transformations are not supported at workplaces. CONCLUSIONS: The evidence showed a positive assessment of breastfeeding, adequate knowledge, and concern about difficulties. Breastfeeding support was considered a shared responsibility, but not enough specific coparticipation actions were mentioned.


Introducción. En los últimos años, creció la evidencia sobre la efectividad de la inclusión de los padres o las parejas en las intervenciones que promueven la lactancia para mejorar las tasas de iniciación, duración y exclusividad. Objetivos. Identificar perspectivas y valoraciones sobre la lactancia en las parejas de las personas que amamantan, y generar información que permita la creación de intervenciones apropiadas que favorezcan la incorporación de los padres en los espacios de cuidado y en el sostén de la lactancia. Materiales y métodos. Estudio cualitativo, con diseño de teoría fundamentada. Se realizaron 4 grupos de enfoque con padres. Los datos fueron procesados definiendo unidades de análisis por flujo libre, codificadas en dos planos, una codificación abierta, en categorías que emergieron y la agrupación de las categorías en cinco temas principales. Resultados. Participaron 16 padres. Se identificaron 5 temas principales: conocimiento de los padres sobre la lactancia, sentimientos frente a la lactancia, participación de la pareja en la lactancia, construcción de la idea de paternidad, lactancia en la sociedad. La lactancia recibió una valoración positiva. Si bien se consensuó una responsabilidad familiar compartida en su sostén, no se identificaron acciones suficientes de coparticipación. Los participantes manifestaron el deseo de ejercer una paternidad más comprometida, sin embargo, relataron que los entornos laborales no acompañan estas transformaciones. Conclusión. Se evidenciaron valoraciones positivas hacia la lactancia, conocimientos adecuados y preocupación por las dificultades. Se asumió una responsabilidad compartida en su sostén, pero faltaron en los relatos la mención de acciones concretas de coparticipación.


Asunto(s)
Lactancia Materna , Padre , Ingestión de Alimentos , Emociones , Femenino , Humanos , Masculino , Embarazo , Investigación Cualitativa
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