Breast milk leptin concentrations and infant anthropometric indicators in SGA versus non-SGA breastfed infants born at term.

Leptin concentrations in breast milk can influence metabolic programming during the first months of life. Small for gestational age (SGA) newborns show a peculiar growth pattern after birth, which can lead to adulthood diseases. This study aims to assess an association between leptin concentration in mature breast milk and the infant anthropometric indicators of the SGA and the non-SGA groups, in addition, to comparing the hormone level between these groups. A longitudinal study was performed with mother-infant pairs. The maternal sociodemographic information was collected in the first 48 h postpartum. Breast milk was collected at one month postpartum and leptin concentrations were obtained by immunoassays. The infant anthropometric measurements were collected at three and six months postpartum and included weight, height (to body mass index-BMI calculated), triceps skinfold (TSF), and subscapular skinfold (SSF). The BMI for age (BMI/A), TSF, and SSF were calculated by Z-score indicators. Data from 67 mother-infant pairs (n = 16 SGA and n = 51 non-SGA) were analyzed. In univariate analyses, the breast milk of the SGA group had lower leptin concentrations than the non-SGA group (p = 0.006), however, after adjustment, there was no difference between groups (p = 0.181). In the SGA group, there was a significant association between leptin concentrations and lower SSF at six months in infants, after adjustment (p = 0.003). In the non-SGA group, the breast milk leptin was associated with lower BMI/A at three and six months in infants, after adjustment (p = 0.002 and p = 0.010, respectively). The association between breast milk leptin concentrations with SSF in the SGA group and BMI/A in the non-SGA group suggests that leptin may be a modulating factor in infant growth in the first months of life.

Consulta coletiva Saúde no Prato: uma (entre outras) possibilidade de formação/assistência no contexto da Atenção Primária à Saúde / Collective assistance Saúde no Prato: one (among others) possibilities of education/assistance in Primary Health Care context

Relatar a construção de uma experiência de formação/assistência no contexto da Atenção Primária em Saúde contemporânea é a proposta deste trabalho. ?Saúde no Prato? é uma modalidade coletiva de acompanhamento nutricional, com atuação interdisciplinar. Seu público alvo é composto por usuários de uma Unidade de Saúde adultos e idosos que necessitam de orientações sobre alimentação saudável. A experiência nessa modalidade de atendimento embasou a construção de um livro, o qual constitui um artefato pedagógico a ser utilizado futuramente em ações educativas. O relato tem o propósito de divulgar essa modalidade de atendimento, estimular a construção de novas propostas de trabalho em saúde que lancem mão de tecnologias leves e ação interdisciplinar, embasadas nos conceitos da Atenção Primária a Saúde.

The objective of this article is to describe the construction of an educational/assistance experience in the contemporary Primary Health Care context. We worked with an intervention called ?Saúde no Prato?, defined as a collective and interdisciplinary modality of nutritional treatment. The goal of this intervention is to work in a Health Unit environment with adult and elderly patients who need guidance on healthy nutrition. The experience in this assistance modality was the basis for assembling a book, constituting a teaching device to be used in future educational activities. The report intends to describe this assistance modality and stimulate the framing of new proposals for health intervention projects that make use of soft technology and interprofessional actions, based on Primary Health Care concepts.

Relato de experiência de atendimento conjunto entre odontologia e nutrição a crianças de 0 a 36 meses em uma unidade básica de saúde no município de Porto Alegre-RS / Report of joint service experience dentistry and nutrition for children 0 - 36 months in a basic health unit in the city of Porto Alegre - RS

Objetivo: Já está bem estabelecida a relação entre hábitos alimentares inadequados e a incidência de cárie. Estes são problemas preocupantes de saúde pública, passíveis de prevenção no contexto da Atenção Primária à Saúde. Objetivo: Este trabalho se propõe a relatar a experiência de atendimento conjunto entre odontologia e nutrição a crianças de 0 a 3 anos em uma unidade básica de saúde. Materiais e Métodos: Durante o atendimento em conjunto, abordou-se questões a respeito da higiene bucal, hábitos alimentares, controle da ingestão da sacarose e uso adequado do flúor. A abordagem dos atendimentos se deu através da educação em saúde, que possibilita a criação de vínculo, mantendo tom de diálogo, postura flexível, com possibilidade de troca, buscando desenvolver a autonomia.Resultados: Ao longo da experiência percebemos um significativo absenteísmo nos atendimentos, além de uso freqüente de mamadeira e chupeta, introdução precoce do açúcar e seu uso freqüente, influenciados possivelmente por fatores culturais, entre outros. Apesar das dificuldades encontradas, foi possível estabelecer um vínculo com as famílias, instigar a reflexão e empoderar os pais para adoção de hábitos mais saudáveis. A experiência do atendimento em conjunto proporcionou às profissionais envolvidas, um espaço de troca de saberes, da prática da interdisciplinaridade e de uma atuação mais integral. Conclusão: Acreditamos que esse formato de atendimento conjunto caracteriza-se como uma prática de cuidado viável e qualificada e que, por isso, deve ser estimulada nas equipes de saúde na Atenção Primária a Saúde.

Objective: It has been already well established the relationship between the inappropriate alimentary habits and the incidence of caries. These are serious public health problems that can bepreventable in the context of the primary health care. This workproposes to describe the experience in the treatment set between odontology and nutrition for children from 0 to 3 years of age in a basic health unit.Materials and Methods: During this treatment together we dealt withquestions about the oral hygiene, eating habits, control of ingest of sucrose and appropriate use of fluoride. The approach applied on the treatment was through health education. It allowed the establishment of a bonding, keeping tone of dialogue, flexible posture, with the possibility of exchange in order to develop autonomy. Results: During our experience we noticed a significant absenteeism in the treatment. Besides, the frequent use of baby bottles andpacifiers, the early introduction of sugar and its frequent use, possibly influenced by culture factors, among others. Despite the difficulties, we could established a relationship with the families, investigates the reflection and empower the parents to adopt healthier habits. The experience in care together provided in the professionals involved aspace for exchanging knowledge, to practice of interdisciplinarity and to act in a more integral form. Conclusion:We believe that this form of treatment set is characterized as a viable and qualified practical of care and thereforeshould be stimulated in the health teams of the primary health care.