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1.
Cien Saude Colet ; 24(5): 1821-1829, 2019 May 30.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31166515

RESUMO

This article seeks to identify the factors associated with a longer duration of breastfeeding. A nested case-control study was carried out with a cohort of mothers for about two years after they gave birth to their children in the two largest public maternity hospitals in João Pessoa - PB. Mothers who breastfed up to 15 months were considered as cases (n = 55) and those who breastfed for more than 15 months (n = 48) were considered controls. The exposure variables were maternal socioeconomic characteristics, gestational characteristics, birth characteristics and early introduction of food. The Chi-Square test was applied to select the independent variables (p-value <= 0.20) to be entered into a multiple logistic regression model, with only those with a p-value <= 0.05 being kept in the final model. The early introduction of infant formula (OR = 4.71, CI95%: 1.76 - 12.63), other milks (OR = 3.25, CI95%: 1.27 - 8.31) and having less than six prenatal consultations (OR = 2.73, CI95%: 1.04 - 7.07) were risk factors for a shorter breastfeeding duration. The early introduction of infant formulas or other milks may be an important indicator for the adoption of appropriate breastfeeding promotion and support actions to achieve the WHO target of breastfeeding for two years or longer.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Fórmulas Infantis/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Fatores de Risco , Fatores Socioeconômicos , Fatores de Tempo , Adulto Jovem
3.
MCN Am J Matern Child Nurs ; 44(3): 157-163, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30882766

RESUMO

PURPOSE: The purpose of this study was to explore maternal child nurses' knowledge and beliefs about using pasteurized donor human milk (PDHM) to treat newborns with hypoglycemia. Pasteurized donor human milk has been used for decades in neonatal intensive care units, but its use is relatively new in the well-baby population. STUDY DESIGN AND METHODS: Focus groups of maternal child nurses were conducted to explore this topic. RESULTS: Six focus groups that included a total 20 nurses were held. Four themes were identified: 1) nurses presumed safety of PDHM but lacked knowledge, 2) nurses' role as patient-family advocate, 3) nurses' logistical concerns about implementation of PDHM, and 4) nurses lacked clarity on formal milk sharing versus PDHM. CLINICAL IMPLICATIONS: As the use of PDHM increases for well babies, nurses will need more education about PDHM, its safety profile, its use in breastfeeding support and protection of the infant microbiome, and how PDHM differs from informal milk sharing. Nurses play an important role in helping parents weigh risks and benefits of using PDHM or formula when supplementation is needed during the hospital stay. It is important that nurses feel confident in their own knowledge and ability to address parental concerns so they can advocate for their patients and support parental decision-making.


Assuntos
Hipoglicemia/dietoterapia , Fórmulas Infantis/estatística & dados numéricos , Leite Humano/metabolismo , Pasteurização , Aleitamento Materno/métodos , Competência Clínica , Grupos Focais/métodos , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/organização & administração , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Bancos de Leite/estatística & dados numéricos , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/normas , Pesquisa Qualitativa
4.
Rev Esc Enferm USP ; 53: e03422, 2019 Jan 21.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30673052

RESUMO

OBJECTIVE: To analyze the survival of exclusive breastfeeding and the factors associated with its cessation in the first month among pairs seen by a lactation consulting team. METHOD: This is a prospective cohort conducted with mother-infant pairs treated at the Hospital de Clínicas of Porto Alegre. RESULTS: The sample consisted of 150 pairs. The survival curve indicates that 52.9% of the children remained on exclusive breastfeeding. The hierarchical model was constructed in four levels, and the factors associated with the cessation of exclusive breastfeeding were the milk supplementation during hospitalization, breast problems after hospital discharge and use of pacifiers. CONCLUSION: Awareness of these factors favors the early detection of pairs that may be predisposed to cessation of exclusive breastfeeding, who require greater support, dedication and care.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Lactação , Chupetas/estatística & dados numéricos , Estudos de Coortes , Consultores , Feminino , Humanos , Fórmulas Infantis/estatística & dados numéricos , Recém-Nascido , Estudos Prospectivos , Adulto Jovem
5.
Birth ; 46(1): 137-145, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30051498

RESUMO

BACKGROUND: In-hospital feeding practices have been shown negatively to affect breastfeeding exclusivity and duration. The purpose of this study was to report the prevalence and determinants of delayed breastfeeding, provision of traditional prelacteal foods, and use of infant formula in hospital. METHODS: Between June 2014 and March 2015, 700 women were recruited from three public and two private maternity hospitals in Shiraz, Iran. Data were collected at recruitment via face-to-face interviews and extracted from medical records. Multivariable logistic regression was used to explore the association of feeding practices with a variety of maternal characteristics and hospital practices. RESULTS: Only 32.2% of infants were breastfed within 1 hour of birth, with 40.8% receiving a traditional prelacteal food, and 34.9% given formula during their hospital stay. Compared with infants delivered vaginally, those delivered by cesarean were more likely to have experienced delayed breastfeeding and received formula, but less likely to have received traditional prelacteal foods. Infants who did not experience skin-to-skin contact were more likely to have experienced delayed breastfeeding and received traditional prelacteal foods and formula in hospital. CONCLUSIONS: Although four out of the five hospitals were designated as Baby-Friendly, several of the 10 Steps to Successful Breastfeeding were not adhered to. The high rate of cesarean delivery was a barrier to the early initiation of breastfeeding and the majority of infants did not experience early skin-to-skin contact. Maternity care practices should be reviewed and include a clear breastfeeding care plan for women who undergo a cesarean delivery.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Cesárea/psicologia , Comportamento Alimentar/psicologia , Fórmulas Infantis/estatística & dados numéricos , Adulto , Aleitamento Materno/psicologia , Cesárea/estatística & dados numéricos , Feminino , Hospitais , Humanos , Lactente , Recém-Nascido , Irã (Geográfico) , Modelos Logísticos , Análise Multivariada , Estudos Prospectivos , Fatores de Tempo , Adulto Jovem
6.
Pediatr Allergy Immunol ; 30(1): 47-54, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30194887

RESUMO

BACKGROUND: In very preterm-born children, alveolar maturation is challenged and lung function is often compromised during childhood. So far, very few studies have focused on type of early nutrition and lung function in children born preterm. METHODS: This study is a 6 years follow-up of 281 very preterm-born infants (VPI) with a gestational age (GA) <32 + 0 weeks. Infants breastfed at discharge from hospital were randomized to unfortified (UHM) or fortified (FHM) mother's (human) milk, whereas those not breastfed received a preterm formula (PF). The intervention lasted until 4 months corrected age. At 6 years of age fractional exhaled nitric oxide (FeNO), airway resistance and occlusion measurements with reversibility were performed. Data on predisposition to asthma and allergy as well as possible allergic symptoms of the child were obtained with questionnaires. RESULTS: Outcome data was fully or partially available on 160 (66.9%) of 239 children. This included 49 (30.6%) children fed UHM, 58 (36.3%) fed FHM and 53 (33.1%) fed PF. Successful FeNO measurements were obtained in 119 (74.4%) children and airway resistance measurements in 160. FeNO results were not significantly different between feeding groups. Children fed a protein-enriched diet (FMH/PF) had the lowest, for example, best, airway resistance; FHM-fed had lower values than UHM-fed (P = 0.042) before, and PF-fed had significantly lower values than UHM-fed after beta-2-agonist inhalation (P = 0.050). The tendency of lower airway resistance when protein enriched were the same in gender-specific analyses. In SGA children, the same tendency was found between PF- and UHM-fed (P = 0.007 before and P = 0.046 after beta-2-agonist inhalation). All values were within reference limits. CONCLUSIONS: Lung function in very preterm-born children may improve when fed a protein-enriched nutrition post-discharge.


Assuntos
Proteínas na Dieta/administração & dosagem , Fórmulas Infantis/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Lactente Extremamente Prematuro/fisiologia , Pulmão/fisiologia , Criança , Pré-Escolar , Dinamarca , Feminino , Seguimentos , Alimentos Fortificados/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Leite Humano/fisiologia , Estudos Prospectivos , Testes de Função Respiratória/métodos
7.
J Natl Med Assoc ; 111(2): 153-157, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30177281

RESUMO

OBJECTIVE: Infant feeding practices have been shown to differ between immigrants and non-immigrants in the United States. Our study characterizes feeding practices of infants of immigrant versus American-born mothers followed in an inner city Pediatric continuity clinic serving predominantly low socioeconomic status families. METHODS: A survey was given to 102 parents of infants ranging from 12 to 15 months of age who attended the clinic. Parents were asked about their country of origin, ethnic background and time since immigration to the US. They were also asked about their breastfeeding and early infant feeding practices. Statistical significance was estimated using chi-squared tests. RESULTS: Not only were breastfeeding rates higher among immigrant mothers compared to American-born mothers (88% vs. 63%, p-value 0.008) but they introduced commercially available baby food less frequently (37% vs. 52%, p-value 0.03) and rarely fed their infants fast food (22% vs. 50%, p-value<0.001). Moreover, breast feeding rates decreased with duration of residence in the United States. 53% of immigrant mothers who have been in the United States for less than 5 years breastfed for over 6 months versus 22% of immigrant mothers who resided more than 5 years in the United States (p-value 0.02). The vast majority of immigrant mothers who switched to formula did so because they felt their milk production was insufficient (93%) whereas the vast majority of American-born mothers stopped breastfeeding because they perceived it to be painful (64%, p value 0.001). CONCLUSIONS: Infant feeding practices differ between immigrant and American-born mothers and the differences diminish the longer the mothers reside in the United States. These differences stem from differences in cultural perceptions of breastfeeding. Therefore, in educating mothers about infant feeding, physicians should strongly consider cultural and ethnic factors.


Assuntos
Aleitamento Materno/etnologia , Aleitamento Materno/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Fórmulas Infantis/estatística & dados numéricos , Mães/estatística & dados numéricos , População Urbana/estatística & dados numéricos , África/etnologia , Região do Caribe/etnologia , América Central/etnologia , Cultura , Emigração e Imigração , Feminino , Humanos , Lactente , Áreas de Pobreza , América do Sul/etnologia , Inquéritos e Questionários , Fatores de Tempo , Estados Unidos
8.
Matern Child Nutr ; 15(2): e12726, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30338632

RESUMO

Despite efforts to support breastfeeding for HIV-positive mothers in South Africa, being HIV-positive remains a barrier to initiating and sustaining breastfeeding. The aim was to explore decision-making about infant feeding practices among HIV-positive mothers in a rural and urban settings in KwaZulu-Natal, South Africa. HIV-positive pregnant women were purposively sampled from one antenatal clinic in each setting. A qualitative longitudinal cohort design was employed, with monthly in-depth interviews conducted over 6 months postdelivery. Data were analysed using framework analysis. We report findings from 11 HIV-positive women within a larger cohort. Participants were aged between 15 and 41 years and were all on antiretroviral therapy. Before delivery, nine mothers intended to exclusively breastfeed (EBF) for 6 months, and two intended to exclusively formula feed (EFF). Three mothers successfully EBF for 6 months, whereas four had stopped breastfeeding, and two were mixed breastfeeding by 6 months. Mothers reported receiving strong advice from health workers (HWs) to EBF and made decisions based primarily on HWs advice, resisting contrary pressure from family or friends. The main motivation for EBF was to protect the child from HIV acquisition, but sometimes fear of mixed feeding led to mothers stopping breastfeeding entirely. Infant feeding messages from HWs advice were frequently inadequate and out of date, and failed to address mothers' challenges. Minimal support was provided for EFF. In conclusion, HWs play a pivotal role in providing infant feeding support to HIV infected mothers, but need regular updates to ensure if advice is correct and appropriate.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Tomada de Decisões , Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Alimentos Infantis/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Lactente , Fórmulas Infantis/estatística & dados numéricos , Recém-Nascido , Estudos Longitudinais , Estudos Prospectivos , Pesquisa Qualitativa , População Rural , África do Sul/epidemiologia , População Urbana , Adulto Jovem
9.
Asia Pac J Clin Nutr ; 27(6): 1294-1301, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30485929

RESUMO

BACKGROUND AND OBJECTIVES: To explore advantages and challenges for exclusive breastfeeding (EBF), compared to non-exclusive breastfeeding (nEBF). METHODS AND STUDY DESIGN: Mothers from 7 cities in China were visited at 3, 10, 60, 120, and 180 days postpartum. Data about feeding practices, infant growth, and the macronutrient contents of human milk (HM) were collected. RESULTS: 130 lactating mothers attended 5 visits. 59 mothers (45.4%) exclusively breastfed infants for 0-4 month. Frequencies of breastfeeding per day were higher in the EBF group than the nEBF group at day 3, 10, 120 and 180, and were less than 8 times per day in the nEBF group. For Weight-for-age z scores, there were no differences between the two groups. Length-for-age z score was greater in the nEBF group at day 180 (0.74±1.05 vs 0.33±1.28). Weight-for-length z scores were greater in the EBF group at day 120 and 180 (day 120: 0.88±1.08 vs 0.36±1.1, day 180: 1.1±0.94 vs 0.54±1.07). The average protein and lactose contents of HM in the nEBF group were higher than in the EBF group at day 10. CONCLUSIONS: For nEBF infants, intake of formula replaced intake of breastmilk, due to lack of breastfeeding frequency, which did not bring weight gain for nEBF infants. During the introduction of complementary foods, EBF infants needed complementary nutrients to support growth. Therefore, lactating mothers may need to provide appropriate complementary feeding and maternal leave extension to attend to their infant's nutritional requirements. The criteria for linear growth may also need to be more commensurate with breastfeeding and relevant to later health outcomes.


Assuntos
Aleitamento Materno/métodos , Aleitamento Materno/estatística & dados numéricos , Fórmulas Infantis/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Ganho de Peso , China , Feminino , Humanos , Lactente , Recém-Nascido , Lactose/análise , Estudos Longitudinais , Proteínas do Leite/análise , Leite Humano/química , Necessidades Nutricionais , Fatores de Tempo
10.
Brasília; CONITEC; nov. 2018. tab.
Não convencional em Português | BRISA/RedTESA | ID: biblio-997733

RESUMO

CONTEXTO: A APLV é o tipo de alergia alimentar mais comum nas crianças até vinte e quatro meses e é caracterizada pela reação do sistema imunológico às proteínas do leite. Dados internacionais mostram prevalência de crianças com APLV que variam de 0,3% a 7,5% até os dois anos de idade. Não há pesquisas ou inquéritos nacionais sobre a prevalência da APLV no Brasil. No entanto, em agosto de 2012, o MS realizou um levantamento nos municípios brasileiros, nos quais foi identificada média de acompanhamento de 0,4% (0,2% a 0,7%) de crianças com APLV em serviços/programas de atenção nutricional estruturados nesses municípios pelo SUS. A conduta na APLV baseia-se na exclusão da proteína alergênica da dieta; prescrição de dieta substitutiva que proporcione todos os nutrientes necessários em crianças até 6 meses; prescrição de alimentação complementar (de 6 a 24 meses). As fórmulas infantis para necessidades dietoterápicas específicas são indicadas para crianças de até vinte e quatro meses de idade. TECNOLOGIA: As fórmulas nutricionais utilizadas na APLV são as fórmulas à base de soja (FS), à base de proteína extensamente hidrolisada (FEH) com ou sem lactose e à base de aminoácidos (FAA). As FEH são indicadas como primeira opção para todas as crianças até vinte e quatro meses com APLV não mediada por IgE e são toleradas em 90% dos casos de crianças menores de seis meses e em 95% das crianças acima de seis meses. Para crianças de seis a vinte e quatro meses com formas de APLV mediadas por IgE, a primeira opção deve ser a prescrição de FS. Somente 10% das crianças menores de seis meses e 5% das crianças acima de seis meses não toleram FEH, sendo necessário o uso de FAA. AVALIAÇÃO DE IMPACTO ORÇAMENTÁRIO: Com os preços de compra das fórmulas nutricionais praticados pelas Secretarias Estaduais de Saúde que responderam ao levantamento feito pelo CONASS, o impacto orçamentário seria de R$ 79.631.103,17 no primeiro ano de incorporação e de R$ 659.212.776,41 em cinco anos de incorporação. RECOMENDAÇÃO PRELIMINAR DA CONITEC: os membros da CONITEC recomendaram que o tema fosse submetido à consulta pública com recomendação preliminar favorável à incorporação no SUS das fórmulas nutricionais para tratamento de crianças de 0 a 24 meses de idade com alergia à proteína do leite de vaca. CONSULTA PÚBLICA: Foram recebidas 69 contribuições técnico-científicas e 252 contribuições de experiência ou opinião. A maioria das contribuições se referiu a aspectos relacionados ao Protocolo Clínico e Diretrizes Terapêuticas de APLV e estas não foram consideradas na avaliação da incorporação das fórmulas nutricionais. As contribuições que questionaram aspectos da incorporação das fórmulas relataram a inadequação da utilização da fórmula à base de proteína de soja, mas não apresentaram embasamento científico robusto, ou sugeriram a inclusão da fórmula à base de arroz, para a qual ainda existem questionamentos sobre eficácia e segurança. DELIBERAÇÃO FINAL: Os membros da CONITEC deliberaram por recomendar a incorporação das fórmulas nutricionais à base de soja, à base de proteína extensamente hidrolisada com ou sem lactose e à base de aminoácidos para crianças de 0 a 24 meses com alergia à proteína do leite de vaca (APLV). DECISÃO: Incorporar as fórmulas nutricionais à base de soja, à base de proteína extensamente hidrolisada com ou sem lactose e à base de aminoácidos para crianças de 0 a 24 meses com alergia à proteína do leite de vaca (APLV), no âmbito do Sistema Único de Saúde - SUS. Dada pela Portaria nº 67, publicada no DOU nº 226, seção 1, página 57, em 26 de novembro de 2018.


Assuntos
Humanos , Hidrolisados de Proteína/administração & dosagem , Hipersensibilidade a Leite , Proteínas de Soja/administração & dosagem , Fórmulas Infantis/estatística & dados numéricos , Aminoácidos/administração & dosagem , Avaliação da Tecnologia Biomédica , Avaliação em Saúde/economia , Sistema Único de Saúde , Brasil , Análise Custo-Benefício/economia
11.
AMA J Ethics ; 20(10): E924-931, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30346920

RESUMO

Eliminating formula giveaways ("banning the bag") has been embraced as a way to reduce the influence of formula marketing in hospitals and to increase breastfeeding rates among new mothers, but the policy raises ethical concerns in the mind of some, notably because it denies a useful benefit to mothers who have trouble affording formula. Hospital policies to promote breastfeeding, including banning the bag, should be sensitive to the economic and other costs associated with breastfeeding and should be consciously designed to make breastfeeding easier and not just to make formula feeding more difficult. We recommend that hospitals evaluate the negative impacts of banning the bag on their patient population in order to ensure that families are not being negatively affected.


Assuntos
Aleitamento Materno/ética , Fórmulas Infantis/estatística & dados numéricos , Marketing/métodos , Feminino , Promoção da Saúde/ética , Humanos , Lactente , Alimentos Infantis/estatística & dados numéricos , Recém-Nascido , Rotulagem de Produtos/ética , Fatores Socioeconômicos
12.
Am J Public Health ; 108(12): 1659-1665, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30359102

RESUMO

OBJECTIVES: To examine the relationship of parental sugar-sweetened beverage (SSB) attitudes with SSB consumption during the first 1000 days of life-gestation to age 2 years. METHODS: We studied 394 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-enrolled families during the first 1000 days of life in northern Manhattan, New York, in 2017. In regression models, we assessed cross-sectional relationships of parental SSB attitude scores with habitual daily parent SSB calories and infant SSB consumption, adjusting for demographic and socioeconomic characteristics. RESULTS: Each point higher parental SSB attitude score was associated with lower parental SSB consumption (-14.5 median kcals; 95% confidence interval [CI] = -22.6, -6.4). For infants, higher parental SSB attitude score was linked with lower odds of infant SSB consumption (adjusted odds ratio [AOR] = 0.84; 95% CI = 0.71, 0.99), and adjustment for socioeconomic factors slightly attenuated results (AOR = 0.85; 95% CI = 0.71, 1.02). CONCLUSIONS: During the first 1000 days of life, greater negativity in parental attitudes toward SSB consumption was associated with fewer parental calories consumed from SSBs and lower likelihood of infant SSB consumption. Public Health Implications. Parental attitudes toward SSBs should be targeted in future childhood obesity interventions during pregnancy and infancy.


Assuntos
Bebidas/estatística & dados numéricos , Assistência Alimentar/estatística & dados numéricos , Pais/psicologia , Açúcares/administração & dosagem , Animais , Aleitamento Materno/estatística & dados numéricos , Bebidas Gaseificadas , Grupos de Populações Continentais , Estudos Transversais , Ingestão de Energia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Fórmulas Infantis/estatística & dados numéricos , Recém-Nascido , Masculino , Leite/estatística & dados numéricos , Cidade de Nova Iorque , Gravidez , Saúde Pública , Análise de Regressão , Fatores Socioeconômicos
13.
Chin J Dent Res ; 21(3): 167-179, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30255168

RESUMO

OBJECTIVE: To investigate the prevalence and severity of dental caries among pre-school children in China as part of the 4th National Oral Health Survey. METHODS: The sampling process was conducted with a multistage stratified cluster method. A total of 40,360 children aged between 3 and 5 years were recruited for this study. Each participant was clinically assessed according to the 5th edition of the oral health survey's basic methods recommended by the World Health Organization (WHO) and their parents or grandparents completed a questionnaire at a face-to-face interview. The status of dental caries was shown in the form of the mean dmft and the prevalence of dental caries. The logistic regression analysis was performed to study the relationships between the prevalence of dental caries and the selected variables. RESULTS: The prevalence of dental caries was 50.8%, 63.6% and 71.9% for 3-, 4- and 5-year-olds, respectively. The mean dmft was 2.28, 3.40 and 4.24, respectively. Logistic regression analysis showed that children who were mixed-fed had a higher chance of staying free of dental caries; children who had dessert before going to bed were associated with a higher probability of caries. CONCLUSION: The status of dental caries among preschool children in China is on the increase. The preschoolers' dental caries status related to their breastfeeding conditions within the first 6 months of life and their snacking habits.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Cárie Dentária/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Fórmulas Infantis/estatística & dados numéricos , Pais , Pré-Escolar , China/epidemiologia , Estudos Transversais , Índice CPO , Inquéritos de Saúde Bucal , Escolaridade , Feminino , Humanos , Renda/estatística & dados numéricos , Modelos Logísticos , Masculino , Refeições , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricos , Índice de Gravidade de Doença , Escovação Dentária/estatística & dados numéricos , População Urbana/estatística & dados numéricos
14.
Pediatr Allergy Immunol ; 29(8): 857-862, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30192414

RESUMO

BACKGROUND: Cows 'milk protein allergy (CMPA) is the most common food allergy in infants in the United Kingdom. Infants with CMPA who are not exclusively breastfed require a substitute hypoallergenic formula, which are perceived as having a poor palatability. This study compares the palatability of different extensively hydrolysed formulas (EHFs) and explores healthcare professional (HCP) expectations of how palatability impacts infants and their families. METHODS: Healthcare professional with experience of CMPA were recruited to take part in a home palatability test of four EHFs [Aptamil Pepti 1, Nutricia Ltd. (EHF W1); Althera, Nestle Health Science (EHF W2); Similac Alimentum, Abbott (EHF C1); Nutramigen LGG 1, Mead Johnson (EHF C2)] using a blind taste procedure. A randomised, complete block design was used to minimise order and carry-over biases. Participants completed a questionnaire about the impact of formula palatability on infants and their families. RESULTS: A total of 100 HCPs took part (51 dietitians and 49 general practitioners). Overall, whey-based lactose-containing EHFs were ranked the most palatable: EHF W1 by 77% of participants and EHF W2 by 20%. EHF W1 was liked significantly more (P < 0.0001) than the other formulas. The vast majority of participants agreed that better palatability would result in an increased chance of non-rejection (96%), more content families (92%) and decreased healthcare costs (90%). CONCLUSION: Amongst HCPs who manage infants with CMPA, whey-based lactose-containing EHFs were ranked the most palatable. HCPs expected that good palatability would result in better acceptance, more content infants and families, alongside decreased wastage and healthcare costs.


Assuntos
Fórmulas Infantis/estatística & dados numéricos , Hipersensibilidade a Leite/terapia , Leite/imunologia , Satisfação do Paciente/estatística & dados numéricos , Adulto , Animais , Atitude do Pessoal de Saúde , Bovinos , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Lactente , Masculino , Inquéritos e Questionários , Paladar
15.
Artigo em Inglês | MEDLINE | ID: mdl-30087304

RESUMO

In southwestern Sydney the timing of introduction of formula and solids may be associated with risk of childhood overweight or obesity, and this may vary by age at breastfeeding cessation during first year. We included 346 infants from southwestern Sydney using the longitudinal study for Australian children (LSAC), who at baseline were singleton, full term, and normal weight births. The outcome risk of overweight or obesity was measured at every two-year interval of children aged 0 or 1 year at baseline until they reached age 10 or 11, defined by body mass index (BMI) ≥ 85th percentile, using the Centre for Disease Control and Prevention growth charts. Age at introduction to formula or solids was dichotomized at four months. We used mixed effects logistic regression for performing all analyses with and without adjusting for mother's BMI, age during pregnancy, and social disadvantage index. Missing data were estimated using multivariate normal imputation having 25 imputations. The odds of overweight or obesity were significantly higher among infants introduced to formula or solids at ≤4 months compared to those introduced at >4 months in both unadjusted (odds ratio = 2.3262, p = 0.023) and adjusted (odds ratio = 1.9543, p = 0.0475) analyses. The odds of overweight or obesity when age at formula or solids introduction was held fixed at ≤4 months, increased significantly (odds ratio = 2.0856, p = 0.0215) for children stopping breastfeeding at age ≤4 months compared to >4 months. Thus, increasing the prevalence of breast-feeding without any formula or solids to 4⁻6 months in southwest Sydney should be a worthwhile public health measure.


Assuntos
Fórmulas Infantis/estatística & dados numéricos , Obesidade Pediátrica/epidemiologia , Populações Vulneráveis/estatística & dados numéricos , Aleitamento Materno/estatística & dados numéricos , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Estudos Longitudinais , Masculino , New South Wales/epidemiologia , Obesidade Pediátrica/etiologia , Prevalência , Risco
16.
Pediatr Surg Int ; 34(11): 1201-1207, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30128701

RESUMO

PURPOSE: This study aims to understand the clinical characteristics of preterm neonatal necrotizing enterocolitis (NEC) to improve the medical management level. METHODS: The clinical characteristics of preterm NEC infants with low birth weight (LBW, ≥ 1500 g) and very low birth weight (VLBW, < 1500 g) were compared. Then, clinical information, including demographics, surgical interventions and morbidity, were collected. RESULTS: A total of 149 preterm NEC infants (60 with VLBW and 89 with LBW) were enrolled. Their median birth weight and gestational age were 1600 g and 31 weeks, respectively. Respiratory support and surfactant therapy were more frequent in VLBW infants (90% vs. 38% and 75% vs. 21.3%) than in LBW infants. In addition, 70.5% of these infants were fed by formula before the NEC occurred. Prematurity-associated morbidities were significantly higher in VLBW infants. Furthermore, 12.8% of all NEC infants died at discharge, and mortality was more prevalent in VLBW infants (21.7% vs. 6.7%). The most frequently received surgeries were enterostomy (n = 58), primary anastomosis (n = 42), and peritoneal drainage (n = 2). Multifocal, localized and pan-intestinal disease occurred in 77.5%, 19.6% and three infants, respectively. Furthermore, postoperative complications occurred more frequently in VLBW infants. CONCLUSION: The overall mortality was 12.8% for infants who had a larger mean gestational age and birth weight, when compared to that in developed countries. Higher rate of formula feeding might be an important risk factor for NEC development. Furthermore, mortality and morbidities, especially nutrition-associated complications, were more frequent in VLBW infants.


Assuntos
Enterocolite Necrosante/mortalidade , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Recém-Nascido de muito Baixo Peso , Anastomose Cirúrgica/estatística & dados numéricos , China/epidemiologia , Drenagem/estatística & dados numéricos , Enterocolite Necrosante/terapia , Enterostomia/estatística & dados numéricos , Feminino , Idade Gestacional , Humanos , Lactente , Fórmulas Infantis/estatística & dados numéricos , Recém-Nascido , Masculino , Oxigenoterapia/estatística & dados numéricos , Complicações Pós-Operatórias , Surfactantes Pulmonares/uso terapêutico , Estudos Retrospectivos
17.
Cien Saude Colet ; 23(7): 2403-2412, 2018 Jul.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30020392

RESUMO

This paper aims to evaluate the prevalence of breastfeeding among premature infants following hospital discharge. Cohort (< 33 gestation weeks) followed up to 12 months (adjusted age). VARIABLES: breastfeeding, anthropometric measurements, social and family information. The proportion of breastfeeding during follow-up was calculated. Survival analysis was conducted to estimate breastfeeding duration. In total, 242 of the 258 infants (93.7%) returned to follow-up; 170 (69.9%) at 6 months and 139 (57.2%) at 12 months (adjusted age). A history of miscarriages (27.5%), stillbirths (11.7%), neonatal deaths (9.5%) and preterm births (21.1%) was noted in 65.5% of women. At hospital discharge: 5.5% received exclusive breastfeeding, 65.8% breastfeeding and formula, 28.6% formula. At month 1, 81.3% received breastfeeding, decreasing to 68.5% at month 2, 62.4% at month 3, 48.1% at month 4 and 22.4% at month 6 (adjusted age). The median of breastfeeding duration was 4 months. Breastfeeding occurred up to four months adjusted age in almost half of the population. Despite the need to improve these rates, the results could reflect the profile of the Child-Friendly Hospital Initiative Unit. Maintaining breastfeeding amongst preterm infants following hospital discharge is still a challenge, for both mothers and health professionals.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Comportamento Alimentar , Fórmulas Infantis/estatística & dados numéricos , Recém-Nascido Prematuro , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Mães/estatística & dados numéricos , Prevalência , Fatores de Tempo , Adulto Jovem
18.
J Pediatr ; 201: 27-33.e4, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30007772

RESUMO

OBJECTIVE: To examine whether feeding patterns from birth to age 6 months modify the association between birth weight and weight at 7-12 months of age. STUDY DESIGN: Longitudinal mixed models were used to examine feeding trajectories across categories of birth weight and weight at 7-12 months of age in 1799 mother-infant dyads enrolled in the Infant Feeding Practices Study II. The percentage of breast milk received and the average daily formula consumption were calculated from birth to 6 months of age. Birth weights were classified as high (≥4000 g) and normal (≥2500 g and <4000 g). Weights at 7-12 months of age were categorized as high (z score >1) or normal (z score ≤1). A secondary analysis was performed using categories defined by birth weight adjusted for gestational age percentiles (>90% and 10th-90th percentile). RESULTS: High birth weight (HBW) infants with high weights at 7-12 months of age demonstrated a rapid decline in the percentage of breast milk feedings compared with HBW infants with normal weights at 7-12 months of age. Normal birth weight infants with high weights at 7-12 months of age received a lower percentage of breast milk and had greater absolute intakes of formula than those with normal weights at 7-12 months of age; these associations did not vary over time. Results were similar when infants were categorized by birth weight percentiles. CONCLUSIONS: A lower proportion of breast milk feedings was associated with excess weight at 7-12 months of age in HBW infants. These findings suggest an initial target for obesity prevention programs focusing on the first 6 months after birth.


Assuntos
Peso ao Nascer , Aleitamento Materno/estatística & dados numéricos , Ganho de Peso , Adulto , Feminino , Humanos , Lactente , Fórmulas Infantis/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Modelos Lineares , Estudos Longitudinais , Masculino , Obesidade Pediátrica/prevenção & controle , Inquéritos e Questionários
19.
AIDS Behav ; 22(Suppl 1): 114-120, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29959720

RESUMO

As part of the Mother-Infant Health Study, we describe infant feeding practices among HIV-infected and HIV-uninfected mothers over a 12-month period when the Western Cape Province prevention of mother-to-child transmission (PMTCT) program was transitioning from a policy of exclusive formula feeding to one of exclusive breastfeeding. Two hundred pairs of mother and HIV-uninfected infant were included in the analysis, among whom 81 women were HIV uninfected and breastfeeding. Of the 119 HIV-infected mothers, 50 (42%) were breastfeeding and 69 (58%) were formula feeding. HIV-infected mothers predominantly breastfed for 8.14 (7.71-15.86) weeks; HIV-uninfected mothers predominantly breastfed for 8.29 (8.0-16.0) weeks; and HIV-infected mothers predominantly formula fed for 50.29 (36.43-51.43) weeks. A woman's HIV status had no influence on the time to stopping predominant breastfeeding (P = 0.20). Our findings suggest suboptimal duration of breastfeeding among both HIV-infected and HIV-uninfected mothers. Providing support for all mothers postdelivery, regardless of their HIV status, may improve breastfeeding practices.


Assuntos
Alimentação Artificial/estatística & dados numéricos , Aleitamento Materno/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Adulto , Feminino , Guias como Assunto , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Fórmulas Infantis/estatística & dados numéricos , Recém-Nascido , Estudos Longitudinais , Comportamento Materno , Mães , África do Sul/epidemiologia , Organização Mundial da Saúde
20.
Health Qual Life Outcomes ; 16(1): 121, 2018 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-29884187

RESUMO

BACKGROUND: The rising prevalence of childhood obesity in Asia has led to interest in potential risk factors such as infant health-related quality of life (HRQoL), temperament and eating behaviors. This pilot study evaluated the utility of administering parent-reported outcome measures (PROMs) to explore these factors in Filipino infants and examined the relationships between these factors and infant sex, formula intake and weight, over time. METHODS: Forty healthy, 4-week-old, formula-fed infants (n = 20 males) were enrolled in this 6-week, prospective, uncontrolled study during which infants were exclusively fed a standard term infant formula enriched with alpha-lactalbumin. On Day-1 and 42, anthropometrics were measured and mothers completed a 97-item measure of HRQoL [Infant Toddler Quality of Life Questionnaire (ITQOL)] covering 6 infant-focused and 3 parent-focused concepts and a 24-item measure of infant temperament [Infant Characteristics Questionnaire (ICQ)]. At Day-42, mothers also completed an 18-item measure of infant appetite [Baby Eating Behaviour Questionnaire (BEBQ)]. A 3-day formula intake diary was completed before Day-42. Nonparametric statistics were used to evaluate correlations among outcomes and compare outcomes by visit and sex. RESULTS: Thirty-nine infants completed the study; similar results were observed in males and females. Completion of PROMs was 100% with no missing responses, but Cronbach's α was low for many concept scales scores. ITQOL scores [range 0 (worst)-100 (best)] were generally high (median ≥ 80) except for Day-1 and Day-42 Temperament and Mood and Day-1 General Health Perceptions scores. ITQOL but not ICQ temperament scores improved significantly between Day-1 and Day-42 (P < 0.01). Mean ± standard deviation BEBQ scores (range 1-5) were high for Enjoyment of Food (4.59 ± 0.60) and Food Responsiveness (3.53 ± 0.81), and low for Satiety Responsiveness (2.50 ± 0.73) and Slowness in Eating (1.71 ± 0.60). Better HRQoL scores were significantly (P < 0.05) associated with high General Appetite scores (3 ITQOL concepts, r = 0.32 to 0.54), greater Enjoyment of Food (4 ITQOL concepts, r = 0.35 to 0.42) and low levels of Slowness in Eating (7 ITQOL concepts, r = - 0.32 to - 0.47). CONCLUSION: Findings demonstrated the utility of the ITQOL, ICQ and BEBQ for measuring HRQoL, temperament and eating behavior, and the need for further adaptations for use in Filipino infants. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT02431377; Registered May 1, 2015.


Assuntos
Comportamento Alimentar , Fórmulas Infantis/estatística & dados numéricos , Qualidade de Vida , Temperamento/classificação , Adulto , Peso Corporal , Feminino , Humanos , Lactente , Masculino , Mães , Filipinas , Projetos Piloto , Estudos Prospectivos , Estatísticas não Paramétricas , Inquéritos e Questionários , Traduções
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