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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46792

RESUMO

Estudos apontam que apoio social e afetivo do pai aumenta o tempo de amamentação. A presença do pai no dia a dia da família aumenta em até 75% as chances de a mãe amamentar o bebê até os seis meses de vida, e mais do que dobra a expectativa dela em continuar amamentando a criança até o primeiro ano. As perspectivas fazem parte de um estudo que será apresentado no 15º Encontro Nacional de Aleitamento Materno (XV ENAM), entre 11 a 15 de novembro, no Rio.


Assuntos
Afeto , Apoio Social , Relações Familiares , Relações Pai-Filho , Aleitamento Materno , Leite Humano ,
2.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46768

RESUMO

O objetivo da IBFAN é coordenar esforços de proteção ao aleitamento materno, compartilhar informações e aumentar a consciência mundial sobre a importância da amamentação e os perigos potenciais da alimentação artificial na infância. Ela atua também para sensibilizar as autoridades internacionais (especialmente OMS e UNICEF) e nacionais quanto à implementação do código internacional de comercialização de substitutos do leite materno e das resoluções a ele relacionadas.


Assuntos
Aleitamento Materno , Alimentação Artificial , Saúde do Lactente , Lactente , Alimentos Infantis
3.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46743

RESUMO

O leite materno gera inúmeros benefícios para mãe e filho. Além do valor nutritivo para os bebês, ele protege as crianças contra infecções, alergias, algumas doenças crônicas e cânceres infantis.


Assuntos
Aleitamento Materno , Saúde do Lactente , Leite Humano
4.
; FIOCRUZ.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46722

RESUMO

O Centro de Referência Nacional de Bancos de Leite Humano (BLH) e o Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF/Fiocruz) irão participar da campanha Agosto Dourado que, em 2019, promove a amamentação no Brasil com base no slogan Empoderar mães e pais, favorecer a amamentação: hoje e para o futuro!.


Assuntos
Promoção da Saúde , Saúde Materno-Infantil , Leite Humano , Aleitamento Materno
5.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46723

RESUMO

Campanha da Semana Mundial do Aleitamento Materno - SMAM 2019, que tem como tema empoderar mães e pais, para favorecer a amamentação, hoje e sempre.


Assuntos
Leite Humano , Promoção da Saúde , Saúde Materno-Infantil , Aleitamento Materno
6.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46724

RESUMO

Folheto da campanha da Semana Mundial do Aleitamento Materno - SMAM 2019, que tem como tema: Empoderar mães e pais, favorecer a amamentação. Hoje e para o futuro!.


Assuntos
Folhetos , Promoção da Saúde , Serviços de Saúde Materno-Infantil , Política de Saúde , Equidade de Gênero , Aleitamento Materno , Leite Humano
7.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46726

RESUMO

A campanha traz como mensagem central a relevância do apoio e do incentivo à família que está amamentando e mostra a importância deste momento para o bebê. Também reforça a necessidade do aleitamento materno até os dois anos ou mais, sendo de forma exclusiva até os 6 meses de vida do bebê. A veiculação da campanha ocorre entre os dias 1º e 15 de agosto.


Assuntos
Leite Humano , Promoção da Saúde , Serviços de Saúde Materno-Infantil , Aleitamento Materno
8.
Zhen Ci Yan Jiu ; 44(6): 434-8, 2019 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-31368267

RESUMO

OBJECTIVE: To investigate the efficacy of acupoint injection of Ropivacaine for labor analgesia and its effect on breastfeeding and prolactin secretion. METHODS: A total of 80 primipara who asked to receive labor analgesia were randomized into epidural analgesia group (n=35) and acupoint injection group (n=36), and other 36 primipara who refused to receive labor analgesia were subjected to the control group. The labor analgesia began to be performed when the puerpera's uterine orifice opened about ≥3 cm (the first stage of labor), including puerpera controlled epidural analgesia (PCEA, Sufentainil + 0.1% Ropivacaine hydrochloride, 5 µg/mL at L3-L4 interspace, till the birth of fetus) or acupoint injection of Ropivacaine (0.2%, 1 mL/acupoint) at bilateral Hegu (LI4) and Sanyinjiao (SP6). The delivery situations such as the duration of labor, and number of cases who used oxytocin, obstetric-forceps-aided delivery, cesarean delivery were recorded. The serum prolactin concentration was assayed by using ELISA. The visual analogue scale (VAS) scores at the time points of T0 (about 3 cm widening of the orifice of uterus and before performing analgesia), T1 (30 min after labor analgesia), T2(about 10 cm widening of the orifice of uterus) and T3(coming out of fetal head). The duration of labor, ratio of use of oxytocin, onset time of breastfeeding, and times of breastfeeding within 24 postpartum hours were recorded accordingly. RESULTS: The VAS scores at time-points of T1, T2 and T3 were significantly lower in both epidural analgesia and acupoint injection groups in comparison with their own T0 and the control group (P<0.05), and were also considerably higher in the acupoint injection group than in the epidural analgesia group (P<0.05). The duration of the 2nd stage of labor (from complete opening of the uterus orifice to complete birth of the fetus) was significantly longer, (P<0.05) and the number of oxytocin-using puerpera was obviously bigger in the epidural analgesia group than in the control group (P<0.05). After partum, the 1st breastfeeding time was obviously earlier and the frequency of breastfeeding notably increased in both epidural analgesia and acupoint injection groups than in the control group (P<0.05), the serum prolactin content was remarkably higher in the acupoint injection group than in the epidural analgesia group (P<0.05). No significant differences were found between the acupoint injection and the control groups in the duration of the 1st and 2nd stages of labor, and in the numbers of oxytocin-using puerpera, obstetric forceps-aided birth and cesarean delivery (P>0.05), and between the epidural analgesia group and control group in the serum prolactin levels (P>0.05).. CONCLUSION: Injection of Ropivacaine at LI4 and SP6 is effective for labor analgesia and raising prolactin level, and favorable to breastfeeding in the early postpartum period.


Assuntos
Pontos de Acupuntura , Analgesia Obstétrica , Analgesia por Acupuntura , Anestésicos Locais , Aleitamento Materno , Feminino , Humanos , Gravidez , Prolactina , Ropivacaina
9.
MMWR Morb Mortal Wkly Rep ; 68(34): 745-748, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31465319

RESUMO

Surveillance of U.S. breastfeeding duration and exclusivity has historically reported estimates among all infants, regardless of whether they had initiated breastfeeding. These surveillance estimates have consistently shown that non-Hispanic black (black) infants are less likely to breastfeed, compared with other racial/ethnic groups.* Less is known about disparities in breastfeeding duration when calculated only among infants who had initiated breastfeeding, compared with surveillance estimates based on all infants. CDC analyzed National Immunization Survey-Child (NIS-Child) data for infants born in 2015 to describe breastfeeding duration and exclusivity at ages 3 and 6 months among all black and non-Hispanic white (white) infants, and among only those who had initiated breastfeeding. When calculated among all infants regardless of breastfeeding initiation, breastfeeding differences between black and white infants were 14.7 percentage points (95% confidence interval [CI] = 10.7-18.8) for any breastfeeding at age 3 months and were significantly different for both any and exclusive breastfeeding at both ages 3 and 6 months. Among only infants who had initiated breastfeeding, the magnitude of black-white differences in breastfeeding rates were smaller. This was most notable in rates of any breastfeeding at 3 months, where the percentage point difference between black and white infants was reduced to 1.2 (95% CI = -2.3-4.6) percentage points and was no longer statistically significant. Black-white disparities in breastfeeding duration result, in part, from disparities in initiation. Interventions both to improve breastfeeding initiation and to support continuation among black mothers might help reduce disparities.


Assuntos
Afro-Americanos/psicologia , Aleitamento Materno/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Mães/psicologia , Adulto , Afro-Americanos/estatística & dados numéricos , Aleitamento Materno/psicologia , Aleitamento Materno/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Humanos , Lactente , Mães/estatística & dados numéricos , Fatores de Tempo , Estados Unidos , Adulto Jovem
10.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(8): 777-782, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31416502

RESUMO

OBJECTIVE: To explore the effect of feeding initiation with different formulas on the growth, development, and feeding tolerance in very low birth weight infants. METHODS: A total of 86 preterm infants with a gestational age of <34 weeks and a birth weight of <1 500 g were divided into three groups according to their feeding initiation formulas: standard preterm formula feeding group (SPF group; n=31), extensively hydrolyzed protein formula feeding group (eHF group; n=27), and breastfeeding group (control group; n=28). Comparisons were made between the groups in terms of growth indices, feeding condition, blood biochemistry, length of hospital stay, and incidence rates of feeding intolerance, sepsis, necrotizing enterocolitis (NEC), and extrauterine growth retardation (EUGR). RESULTS: There were no significant differences among the above three groups in body weight, head circumference, and rate of increase in body length measured during hospitalization, as well as length of hospital stay and EUGR incidence rate at discharge (P>0.05). The SPF and eHF groups had a significantly shorter transition time from meconium to yellow stool than the control group (P<0.01). The SPF group had a significantly shorter time to standard enteral feeding than the eHF and control groups (P<0.01), with no significant difference observed between the latter two groups. The SPF group had a significantly lower serum prealbumin level than the eHF and control groups (P<0.01). The SPF and eHF groups had a significantly higher hemoglobin level at discharge than the control group (P<0.01). The percentage of eosinophils at discharge was significantly lower in the eHF group than in the SPF group (P<0.01). No significant differences were found among the three groups regarding the incidence rates of feeding intolerance, sepsis, and NEC (P>0.05). CONCLUSIONS: Both eHF and SPF can be used for feeding initiation for very low birth weight preterm infants with a gestational age of <34 weeks without increasing the incidence rate of EUGR.


Assuntos
Aleitamento Materno , Nutrição Enteral , Enterocolite Necrosante , Humanos , Lactente , Recém-Nascido , Recém-Nascido de muito Baixo Peso
11.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(4): 711-715, 2019 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-31420627

RESUMO

OBJECTIVE: To explore the effect of breastfeeding promotion strategies on neonatal clinical outcomes of preterm infants during hospitalization in the neonatal intensive care unit (NICU). METHODS: We developed breastfeeding promotion strategies, including the establishment of a multidisciplinary breastfeeding steering team, breastfeeding support of families and society, family-integrated care, kangaroo mother care, donor human milk bank, and so on. Preterm infants meeting the inclusion standard, less than 32 weeks gestational age, who were admitted to NICU from November 2015 to February 2017 were enrolled, and the eligible infants were divided into two groups (control group and intervention group) before and after policy implementation. The data of preterm infants including breastfeeding related outcomes (time to initiation of enteral feeding, time to initiation of breastfeeding, time to achieve full breastfeeding, time to achieve full enteral feeding and rate of breastfeeding), growth (extrauterine growth restriction) and complications were compared between the two groups. RESULTS: One hundred and twenty-three preterm infants were enrolled, including 61 in the control group and 62 in the intervention group. There were no significant differences in gender, gestational age, birth weight, intrauterine growth retardation (IUGR) and admission disease status between the two groups (P>0.05). Compared with the control group, there were significantly earlier time to initiation of enteral feeding [15.37 (10.00, 22.13) h vs. 20.25 (12.88, 26.33) h, P<0.01], time to achieve full breastfeeding [91.00 (69.75, 103.00) h vs. 94.00 (80.37, 118.75) h, P=0.04], and time to achieve full enteral feeding [12 (11, 15) d vs. 14 (12, 18) d, P<0.01] in the intervention group. Otherwise, there were no significant differences in time to initiation of breastfeeding, hospital stay, extrauterine growth restriction (EUGR) occurance rate of weight, the rate of breastfeeding, motality, and the incidence of complications including feeding intolerance, neonatal necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) (P>0.05). CONCLUSION: The breastfeeding promotion strategie was a quality improvement of ordinary breastfeeding protocol. It had significantly reduced time to initiation of enteral feeding, time to achieve full breastfeeding and time to achieve full enteral feeding for preterm infants in NICU. Further research is needed to confirm whether the strategies can improve the breastfeeding rate and reduce the occurrence of the complications, such as NEC, BPD, and ROP.


Assuntos
Aleitamento Materno , Enterocolite Necrosante , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Método Canguru
12.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46663

RESUMO

O ENANI é uma pesquisa científica domiciliar com crianças menores de cinco anos que tem como objetivo estimar e avaliar parâmetros relacionados às práticas de aleitamento materno, ao consumo alimentar, ao estado nutricional antropométrico e à epidemiologia das deficiências de micronutrientes, segundo macrorregiões do país, zonas rural e urbana, faixa etária e sexo.


Assuntos
Leite Humano , Nutrição do Lactente , Políticas Públicas de Saúde , Aleitamento Materno , Antropometria , Gravidez , Micronutrientes/deficiência , Estado Nutricional , Visita Domiciliar , Brasil
13.
Ceska Gynekol ; 84(3): 201-207, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31324110

RESUMO

OBJECTIVE: To compare the performance of obstetrical interventions and maternal and perinatal outcomes between vaginal and cesarean delivery routes in pregnant women at normal risk. Type of article: Original article. Desing: Cross-sectional study with 421 participants admitted for spontaneous or induced labor with full-term singleton gestations and fetuses weighing between 2,500 and 4,499 g. SETTING: Maternal Fetal-Medicine Service, Assis Chateaubriand Maternity, Federal University of Ceará (UFC), Fortaleza-CE, Brazil. METHODS: The instrument of data collection was divided into socio-demographic, clinical, and obstetric characteristics; data of labor and delivery; maternal morbidity; maternal outcome and perinatal outcomes. Pearsons chi-square test and Fishers exact test were used to verify associations between the groups. RESULTS: The mean age was 22.8 ± 6.0 (vaginal) and 22.9 ± 4.9 (cesarean section). Overall, 44.5% of vaginal deliveries and 85.5% of cesarean sections were monitored electronically (p < 0.001). Immediate skin-to-skin contact (84.1%) and first-hour breastfeeding (80.4%) were more frequent in vaginal deliveries compared with cesarean deliveries (27% vs. 61.0%, p < 0.001). The prevalence of puerperal infections was 1.2% (vaginal) and 5.0% (cesarean section) with a p value of 0.02; 40% of cesarean-delivered newborns and 9.7% of vaginally-delivered newborns were referred to the neonatal intensive care unit (p < 0.001). CONCLUSION: The cesarean section was associated with a lower frequency of useful practices, a higher frequency of harmful practices, worse neonatal outcomes, and a higher rate of postpartum infections.


Assuntos
Cesárea/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Brasil/epidemiologia , Aleitamento Materno/estatística & dados numéricos , Estudos Transversais , Parto Obstétrico/métodos , Feminino , Humanos , Recém-Nascido , Trabalho de Parto Induzido , Gravidez , Resultado da Gravidez , Infecção Puerperal/epidemiologia
15.
Tegucigalpa; s.n; jun. 27, 2019. 72 p. ilus, tab, graf.
Tese em Espanhol | LILACS | ID: biblio-1015482

RESUMO

OBJETIVO: Relacionar los conocimientos, actitudes y prácticas de lactancia materna en las mujeres que ingresan a la sala de puerperio normal del bloque materno infantil, hospital escuela universitario, Tegucigalpa, Honduras, agosto a diciembre 2017. DISEÑO METODOLÓGICO: Estudio descriptivo de corte transversal, la muestra estuvo conformada de 100 mujeres que ingresan a la sala de puerperio normal agosto ­ diciembre 2017. La técnica utilizada fue la aplicación de una encuesta, mediante un procesamiento y análisis de datos con resultados expresados en tablas y gráficos. RESULTADOS: el 68% siendo en su mayoría procedían de zona rural de 19- 25 años. Así mismo al número de hijos 36% tienen tres. El 40% con una escolaridad primaria completa. CONCLUSIÓN: en su mayoría las mujeres son jóvenes entre 19 - 25 años, con 1 hijo, de educación primaria y de la zona rural. Respecto a los conocimientos la mayoría de la mujeres tuvieron conocimientos de los beneficios de lactancia materna, el tiempo de la lactancia, y las posiciones de amamantamiento. Sobre las actitudes ellas presentaron una actitud favorable respecto a las técnicas de extracción de la leche y de amamantamiento y finalmente refirieron tener buenas prácticas en cuanto a técnicas de posición


Assuntos
Humanos , Aleitamento Materno , Lactação , Conhecimentos, Atitudes e Prática em Saúde , Epidemiologia Descritiva , Estudos Transversais
16.
Rev. Bras. Saúde Mater. Infant. (Online) ; 19(2): 311-321, Apr.-June 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1013146

RESUMO

Abstract Objectives: to assess the use of pacifier and feedingbottle and their determinants in children from a municipality of Southwest Bahia. Methods: a cross-sectional study was performed with 354 children younger than 12 months old. The event was categorized in: exclusive use of pacifier, exclusive use of feeding bottle,use of pacifier and feeding bottle, and not use any of them. Multinomial analysis with logistic regression was applied, and those who did not use any artificial nipples were thereference variable. Results: it was observed that 11.9% of the children exclusively used pacifiers, 21.2% only use bottles and 32.8% used both of them. The following factors were associated with the exclusive use of pacifiers: low maternal schooling level (eight or less years of education), lack of previous experience with breastfeeding, difficulty in postpartum breastfeeding, and lack of incentive to breastfeeding in puericulture. The exclusive use of feeding bottle was associated with unmarried mothers, aged 35 years old or older, and with less years of education (eight or less years). Women who worked outside home and had difficulty in breastfeeding had greater chance of giving both artificial nipples to the children. Conclusions: the findingspresent different featuresrelated to the exclusive or combined use of pacifiers and feeding bottles, being important to direct health professionals conducts towards mothers' orientation.


Resumo Objetivos: avaliar o uso de chupeta e mamadeira e seus determinantes em crianças de um município da região Sudoeste da Bahia. Métodos: estudo transversal realizado com 354 crianças menores de 12 meses. O evento foi categorizado em uso de chupeta exclusivo, uso de mamadeira exclusiva, uso de chupeta e mamadeira e não faz uso de ambas. Empregou-se análise multinomial com regressão logística tendo os que não usavam bicos artificiais como variável de referência. Resultados: observou-se que 11,9% das crianças faziam uso exclusivo de chupeta, 21,2% de mamadeira, 32,8% de ambos. Estiveram associadas ao uso exclusivo de chupeta: uma menor escolaridade materna (oito ou menos anos de estudo), ausência de experiência anterior com amamentação, dificuldade de amamentar no pós-parto e falta de incentivo à amamentação na puericultura. O uso exclusivo de mamadeira foi associado a mães sem companheiro, com idade de 35 anos ou mais e com menor escolaridade (oito ou menos anos de estudo). Mulheres que trabalhavam fora do lar e que tiveram dificuldade de amamentar apresentaram maior chance de fazerem uso de ambos os bicos artificiais. Conclusões: os resultados mostram características diferentes em relação ao uso exclusivo ou conjunto de bicos e mamadeiras, sendo importantes para direcionar as condutas dos profissionais de saúde para as orientações as mães.


Assuntos
Criança , Estudos Epidemiológicos , Cuidado da Criança , Chupetas/estatística & dados numéricos , Mamadeiras , Brasil , Aleitamento Materno , Estudos Transversais , Período Pós-Parto
17.
MMWR Morb Mortal Wkly Rep ; 68(22): 489-493, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31170123

RESUMO

Breast milk is the optimal source of infant nutrition. For the nearly one in 10 infants born prematurely in the United States annually (1), breast milk is especially beneficial, helping prevent sepsis and necrotizing enterocolitis and promoting neurologic development (2). National estimates of newborn feeding practices by gestational age have not been available previously. CDC analyzed 2017 birth certificate data from 48 states and the District of Columbia (3,194,873; 82.7% of all births) to describe receipt of breast milk among extremely preterm (20-27 weeks), early preterm (28-33 weeks), late preterm (34-36 weeks), and term (≥37 weeks) infants with further stratification by maternal and infant characteristics. The prevalence of infants receiving any breast milk was 83.9% overall and varied by gestational age, with 71.3% of extremely preterm infants, 76.0% of early preterm infants, 77.3% of late preterm infants, and 84.6% of term infants receiving any breast milk. Disparities in receipt of breast milk by several sociodemographic factors, including maternal race/ethnicity, were noted across gestational age groups. These estimates suggest that many infants, particularly infants at high risk for medical complications, might not be receiving breast milk. Efforts are needed to increase the implementation of existing evidence-based policies and practices that support breast milk feeding, particularly for medically fragile infants (2,3).


Assuntos
Aleitamento Materno/estatística & dados numéricos , Idade Gestacional , Leite Humano , Feminino , Humanos , Lactente Extremamente Prematuro , Recém-Nascido , Recém-Nascido Prematuro , Nascimento a Termo , Estados Unidos
18.
Invest. educ. enferm ; 37(2): [E09], 15-06-2019. Tab 1
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1007630

RESUMO

Abstract Purpose. To know the perceptions of mothers and health professionals in relation to the care provided and received during breastfeeding at primary health care level. Methods. A qualitative exploratory study was conducted with breastfeeding mothers (10) and primary health care professionals (24). Data was gathered through indepth interviews and focus groups. Data analysis was performed through thematic content analysis. The rigor of the study was ensured by the Guba and Lincoln criteria for qualitative research. Ethical aspects were addressed through the informed consent process, confidentiality, and methodological rigor. Results. The experience of providing/receiving breastfeeding support was revealed as a dynamic, multidimensional care and support process, through three central themes: 1. Influence of previous care and support experiences during the breastfeeding process; 2. Importance of the context within which care is framed; and 3. Addressing emotions to establish trust between professionals and mothers. Conclusion. The study findings contribute to further understanding a complex phenomenon, such as breastfeeding support and care for mothers/families, from the experience of the actors involved, deepening the experiences of both in integrated manner. In addition, the relational, organizational, and contextual dimensions that influence support, and that should guide care, are also highlighted.


Resumen Objetivo. Conocer las percepciones de madres y profesionales de salud en relación con los cuidados que se brindan y que reciben durante el proceso de amamantamiento en el nivel primario de atención. Métodos. Estudio cualitativo exploratorio realizado en Santiago (Chile) con la participación de 10 madres en proceso de lactancia y 24 profesionales de la salud. La recolección de datos se realizó a partir de entrevistas en profundidad y grupos focales. El análisis de la información se obtuvo mediante el análisis de contenido temático. El rigor de la investigación se guardó con los criterios de Guba y Lincoln. Los aspectos éticos se abordaron mediante el proceso de consentimiento informado, confidencialidad y rigor metodológico. Resultados. La experiencia de brindar y recibir apoyo durante el proceso de amamantamiento se develó como un proceso de cuidado y apoyo dinámico, multidimensional, a partir de tres temas centrales: Influencia de las experiencias previas de cuidado y apoyo durante el proceso de amamantamiento; Importancia del contexto en el que se enmarca el cuidado; y Abordaje de las emociones para el establecimiento de la confianza entre profesionales y madres. Conclusión. Las percepciones de madres y profesionales de salud en relación a los cuidados que se brindan y que reciben durante el proceso de amamantamiento son un fenómeno con dimensiones contextuales, organizacionales y relacionales que influyen en el apoyo, por lo que deberían orientar el cuidado.


Resumo Objetivo. Conhecer as percepções de mães e profissionais de saúde em relação aos cuidados que se brindam e recebem durante o processo de amamentação no nível primário de atenção. Métodos. Estudo qualitativo exploratório realizado em Santiago (Chile) com a participação de 10 mães em processo de amamentação e 24 profissionais da saúde. O recolhimento de dados se realizou através de entrevistas em profundidade e grupos focais. A análise da informação se obteve através da análise de conteúdo temático. O rigor da investigação se cautelou por meio dos critérios de Guba e Lincoln. Os aspectos éticos se abordaram mediante o processo de consentimento informado, confidencialidade e rigor metodológico. Resultados. A experiência de brindar e receber apoio durante o processo de amamentação se revelou como um processo de cuidado e apoio dinâmico, multidimensional, através de três temas centrais: Influência das experiências prévias de cuidado e apoio durante o processo de amamentação; Importância do contexto no qual se enquadra o cuidado; e Abordagem das emoções para o estabelecimento da confiança entre profissionais e mães. Conclusão. As percepções de mães e profissionais de saúde em relação aos cuidados que se brindam e recebem durante o processo de amamentação são um fenômeno com dimensões contextuais, organizacionais e relacionais que influem no apoio e que deveriam orientar o cuidado.


Assuntos
Humanos , Aleitamento Materno , Pesquisa Qualitativa , Enfermagem de Atenção Primária
19.
Medicine (Baltimore) ; 98(23): e15841, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31169687

RESUMO

OBJECTIVE: The aim of the study was to determine whether exclusive breastfeeding or exclusive formula feeding is more cost-effective when a Canadian mother with HIV is adherent to antiretroviral therapy and has full virologic suppression. DESIGN: Current Canadian guidelines recommend that mothers with HIV practice exclusive formula feeding. This contradicts the updated World Health Organization (WHO) guidelines which recommend that mothers with HIV should breastfeed for ≥12 months while receiving support for antiretroviral therapy adherence. Due to the economic and health risks and benefits associated with each modality, there remains expert disagreement on whether the WHO recommendations should be adopted in high-income countries. METHODS: A microsimulation model was developed to estimate lifetime costs and effectiveness (i.e., infant's quality-adjusted life years) of a hypothetical group of 1,000,000 initially healthy, HIV-negative infants, if the mother with HIV was on antiretroviral therapy with full virologic suppression and either exclusive breastfeeding or exclusive formula feeding. The model was developed from the economic perspective of the Ontario Ministry of Health, taking into account direct costs associated with infant feeding modality as well as related indirect costs born out of the child's lifetime health outcomes. Uncertainties related to model parameters were evaluated using one-way and probabilistic sensitivity analyses. RESULTS: In comparison to exclusive formula feeding, exclusive breastfeeding was the dominant feeding modality (i.e., less costly and more effective) yielding cost-savings of $13,812 per additional quality-adjusted life year gained. Neither one-way nor probabilistic sensitivity analyses altered the conclusions. CONCLUSIONS: Despite the risk of HIV transmission, exclusive breastfeeding was more cost-effective than exclusive formula feeding. These findings merit review of current infant feeding guidelines for mothers with HIV living in high-income countries.


Assuntos
Antirretrovirais/uso terapêutico , Aleitamento Materno/economia , Fórmulas Infantis/economia , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Mães , Resposta Viral Sustentada , Antirretrovirais/administração & dosagem , Canadá , Simulação por Computador , Análise Custo-Benefício , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Metanálise como Assunto , Modelos Econométricos , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Anos de Vida Ajustados por Qualidade de Vida , Literatura de Revisão como Assunto
20.
Rev. neurol. (Ed. impr.) ; 68(11): 468-479, 1 jun., 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-180792

RESUMO

La reunión Post-ECTRIMS se celebró por undécimo año consecutivo el pasado octubre de 2018 en Madrid, con el objetivo de analizar los avances en esclerosis múltiple destacados en el último congreso anual ECTRIMS. Fruto de esta reunión, formada por los líderes de opinión en esclerosis múltiple de ámbito nacional, se presentan dos artículos de revisión. En esta segunda parte, se incluye el creciente número de evidencias que confirman la seguridad de la exposición a los tratamientos modificadores de la enfermedad en mujeres que planifican un embarazo, y el efecto beneficioso de la lactancia, siempre y cuando la enfermedad no esté muy activa. Se abordan los datos que muestran cómo la aplicación de los criterios de McDonald de 2017 en población pediátrica ha mejorado considerablemente el diagnóstico en comparación con los criterios anteriores. En cuanto a la esclerosis múltiple progresiva, los resultados de los fármacos neuroprotectores son poco concluyentes, pero se proponen biomarcadores para mejorar la evaluación de la respuesta terapéutica. Los estudios sobre tratamientos de reparación de la mielina sugieren que la remielinización en la esclerosis múltiple es posible. De igual manera, se exponen indicios favorables sobre el trasplante de células madre hematopoyéticas, siempre que se seleccione adecuadamente a los pacientes. Por otro lado, se revisan las similitudes y diferencias de las recomendaciones de las nuevas guías de práctica clínica publicadas. Por último, los resultados positivos de la rehabilitación cognitiva y motora con el uso de las nuevas tecnologías vaticinan la incorporación sistemática de estas herramientas en el tratamiento de la enfermedad en un futuro próximo


The Post-ECTRIMS Meeting was held for the eleventh consecutive year in October 2018 in Madrid, with the aim of analysing the advances made in multiple sclerosis that were highlighted at the latest ECTRIMS annual congress. Based on the issues discussed at this meeting, attended by the nation’s foremost opinion leaders on multiple sclerosis, two review articles are presented. This second part includes the growing body of evidence confirming the safety of exposure to disease-modifying treatments in women planning a pregnancy, and the beneficial effect of breastfeeding, provided that the disease is not very active. It addresses data showing how the application of the 2017 McDonald criteria in the paediatric population has significantly improved diagnosis compared to the previous criteria. With regard to progressive multiple sclerosis, the results of neuroprotective drugs are inconclusive, but biomarkers are proposed to improve the evaluation of the therapeutic response. Studies on myelin repair treatments suggest that remyelination in multiple sclerosis is possible. Likewise, there are favourable indications for haematopoietic stem cell transplantation, provided that patients are selected appropriately. On the other hand, we also conduct a review of the similarities and differences of the recommendations in the new clinical practice guidelines. Finally, the positive results of cognitive and motor rehabilitation with the use of new technologies point to the systematic incorporation of these tools in the treatment of the disease in the near future


Assuntos
Humanos , Criança , Esclerose Múltipla/epidemiologia , Fármacos Neuroprotetores/uso terapêutico , Transplante de Células-Tronco/tendências , Resultado do Tratamento , Esclerose Múltipla/complicações , Esclerose Múltipla/reabilitação , Sociedades Médicas/normas , Farmacovigilância , Planejamento Familiar , Complicações na Gravidez , Aleitamento Materno , Transtornos Neurológicos da Marcha/reabilitação , Necessidades e Demandas de Serviços de Saúde
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