Motivos del abandono temprano de la lactancia materna exclusiva: un problema de salud pública no resuelto en la ciudad de Medellín / Reasons for abandoning early exclusive breastfeeding: an unsolved public health problem in Medellín

OBJETIVO :identificar los motivos del abandono temprano de la lactancia materna exclusiva en la ciudad de Medellín en el año 2011. METODOLOGIA: se realizó un estudio descriptivo transversal con una confianza del 95% para una muestra de 303 madres con hijos menores de 24 meses, inscritos en uno de los programas sociales de la alcaldía de Medellín que habían abandonado la lactancia materna exclusiva antes de los seis meses. Se aplicó una encuesta estructurada sobre las madres, sus hijos, los motivos para el abandono temprano y los alimentos introducidos. Se describieron frecuencias y evaluaron asociaciones con los motivos y edad de abandono de la lactancia materna exclusiva. RESULTADOS el abandono temprano ocurrió principalmente antes de los cuatro meses de edad del niño(a). Los principales motivos estuvieron relacionados con problemas para la producción láctea, rechazo del bebé, actividades u ocupaciones de la madre y el estado de salud. Los alimentos reportados como reemplazo o complementarios a la leche materna, fueron principalmente fórmulas infantiles. CONCLUSION los motivos de abandono temprano han cambiado, porque ahora es clave que la madre tenga el conocimiento necesario para aumentar la producción de leche materna, la orientación por parte de personal entrenado y que le brinden a esta las condiciones laborales que se lo permitan.

OBJECTIVE: to identify the reasons for the early abandonment of exclusive breastfeeding in the city of Medellin in 2011. METHODOLOGY an ethnographic study whose participants were 20 mothers of children with Down's syndrome. Data were collected using semi-structured interviews and field observations. Similarly, this study included a categorical analysis and a literature review. RESULTS : early abandonment occurred mainly before the child was four months old. The main reasons were related to milk production problems, baby rejection, the mother's activities or occupations, and her health status. Additionally, the participants reported the use of infant formulas as substitutes or supplements to breast milk. CONCLUSION: the reasons for early abandonment of breastfeeding have changed; this is why mothers must have the knowledge needed to increase breast milk production, the assistance of qualified personnel, and the working conditions allowing them to attend to these needs.

Establecimiento de las condiciones de la mezcla de la pulpa de banano (Musa paradisiaca L) para someter a secado por aspersión / Establishing of the conditions of the blend of pulp with banana (Musa paradisiaca L) to submit spray dryng

El secado por aspersión es uno de los métodos más empleados para deshidratar alimentos y prolongar su vida útil. En este trabajo se pretende determinar las cantidades óptimas de maltodextrina y goma acacia a utilizar para maximizar ºBrix y minimizar la viscosidad en pulpa de banano para su posterior secado por aspersión. La maltodextrina es significativa tanto para el contenido en ºBrix como para la viscosidad, pero a esta última también la afecta la interacción entre maltodextrina y goma acacia. Es necesario encontrar un equilibrio entre el máximo de ºBrix y una mínima viscosidad, pues una viscosidad baja permite una mejor fluidez de la mezcla en el sistema de atomización (disco o difusor), y una alta concentración de sólidos totales incrementa el rendimiento del producto final. La combinación que genera la mejor respuesta es 39,95 g maltodextrina con 3,29 g de goma arábiga. Con esta combinación de tratamientos se encuentra el punto donde los ºBrix son máximos y la viscosidad es mínima encontrándose un valorde 46,44 ºBrix y 634,59 cP respectivamente.

Comparing serologic response against enteric pathogens with reported diarrhea to assess the impact of improved household drinking water quality.

We evaluated enteric infection serology as an alternative outcome measure to diarrhea prevalence in a randomized controlled trial of household-based drinking water treatment; 492 households were randomly assigned to 5 household-based water treatment interventions or control. Individuals were followed weekly over 52 weeks to measure diarrhea prevalence. Study subjects of age

Reducing diarrhoea in Guatemalan children: randomized controlled trial of flocculant-disinfectant for drinking-water.

OBJECTIVE: To examine the effect of a new point-of-use treatment for drinking-water, a commercially developed flocculant-disinfectant, on the prevalence of diarrhoea in children. METHODS: We conducted a randomized controlled trial among 514 rural Guatemalan households, divided into 42 neighbourhood clusters, for 13 weeks, from 4 November 2002 through 31 January 2003. Clusters assigned to water treatment with the flocculant-disinfectant were compared with those using their usual water-handling practices. The longitudinal prevalence of diarrhoea was calculated as the proportion of total days with diarrhoea divided by the total number of days of observation. The prevalence of diarrhoea was compared using the Wilcoxon rank-sum test. FINDINGS: The 1702 people in households receiving the disinfectant had a prevalence of diarrhoea that was 40% lower than that among the 1699 people using standard water-handling practices (0.9% versus 1.5%; P = 0.001). In households using the flocculant-disinfectant, children < 1 year of age had a 39% lower prevalence of diarrhoea than those in households using their standard practices (3.7% versus 6.0%; P = 0.005). CONCLUSION: In settings where families rarely treat drinking-water, we introduced a novel flocculant-disinfectant that reduced the longitudinal prevalence of diarrhoea, especially among children aged < 1 year, among whom diarrhoea has been strongly associated with mortality. Successful introduction and use of this product could contribute to preventing diarrhoeal disease globally.

Prevalence of infection with waterborne pathogens: a seroepidemiologic study in children 6-36 months old in San Juan Sacatepequez, Guatemala.

Water and sanitation interventions in developing countries have historically been difficult to evaluate. We conducted a seroepidemiologic study with the following goals: 1) to determine the feasibility of using antibody markers as indicators of waterborne pathogen infection in the evaluation of water and sanitation intervention projects; 2) to characterize the epidemiology of waterborne diarrheal infections in rural Guatemala, and 3) to measure the age-specific prevalence of antibodies to waterborne pathogens. Between September and December 1999, all children 6-36 months of age in 10 study villages were invited to participate. We collected sufficient serum from 522 of 590 eligible children, and divided them into six-month age groups for analysis (6-12, 13-18, 19-24, 25-30, and 31-36 months). The prevalence of antibodies was lowest in children 6-12 months old compared with the four older age groups for the following pathogens: enterotoxigenic Escherichia coli (48%, 81%, 80%, 77%, and 83%), Norwalk virus (27%, 61%, 83%, 94%, and 94%), and Cryptosporidium parvum (27%, 53%, 70%, 67%, and 73%). The prevalence of total antibody to hepatitis A virus increased steadily in the three oldest age groups (40%, 28%, 46%, 60%, and 76%). In contrast, the prevalence of antibody to Helicobacter pylori was relatively constant in all five age groups (20%, 19%, 21%, 25%, and 25%). Serology appears to be an efficient and feasible approach for determining the prevalence of infection with selected waterborne pathogens in very young children. Such an approach may provide a suitable, sensitive, and economical alternative to the cumbersome stool collection methods that have previously been used for evaluation of water and sanitation projects.

A randomized controlled trial of household-based flocculant-disinfectant drinking water treatment for diarrhea prevention in rural Guatemala.

We conducted a study to determine if use of a new flocculant-disinfectant home water treatment reduced diarrhea. We randomly assigned 492 rural Guatemalan households to five different water treatment groups: flocculant-disinfectant, flocculant-disinfectant plus a customized vessel, bleach, bleach plus a vessel, and control. During one year of observation, residents of control households had 4.31 episodes of diarrhea per 100 person-weeks, whereas the incidence of diarrhea was 24% lower among residents of households receiving flocculant-disinfectant, 29% lower among those receiving flocculant-disinfectant plus vessel, 25% lower among those receiving bleach, and 12% lower among households receiving bleach plus vessel. In unannounced evaluations of home drinking water, free chlorine was detected in samples from 27% of flocculant-disinfectant households, 35% of flocculant-disinfectant plus vessel households, 35% of bleach households, and 43% of bleach plus vessel households. In a setting where diarrhea was a leading cause of death, intermittent use of home water treatment with flocculant-disinfectant decreased the incidence of diarrhea.