RESUMO
BACKGROUND: Being an adolescent mother and cohabiting with the maternal grandmother have been shown to be risk factors for a shorter breastfeeding duration. The objective of this study was to assess whether the positive effects of a pro-breastfeeding intervention aimed at adolescent mothers and maternal grandmothers on the prevalence of breastfeeding observed in the first year of life were maintained at 2 years of age. METHODS: This study is the continuation of a randomized clinical trial initiated in 2006 involving 323 adolescent mothers, their newborns and maternal grandmothers when cohabiting. The intervention consisted of six breastfeeding counseling sessions, the first one held at the maternity ward and the others at the participants' homes at 7, 15, 30, 60, and 120 days postpartum. The present study reports data collected when the children were 4 to 7 years old, concerning the maintenance of breastfeeding at 2 years. Data were analyzed using multivariable Poisson regression model with robust variance, with breastfeeding at 2 years of age as the outcome. RESULTS: Maintenance of breastfeeding for 2 years or more was present in 32.2% of the sample. When the intervention and control groups were compared, the prevalence of breastfeeding at 2 years was similar (29.9 vs. 34.3%, respectively; p = 0.605). Multivariable analysis failed to reveal an association between exposure to the intervention and maintenance of breastfeeding at 2 years in the different models tested. CONCLUSIONS: The positive impact of the intervention on the prevalence of breastfeeding observed in the first year of life was not maintained at 2 years of age. TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov on May 28, 2009 under protocol no. NCT00910377.
Assuntos
Aleitamento Materno/psicologia , Avós/psicologia , Promoção da Saúde/métodos , Relação entre Gerações , Mães/educação , Adolescente , Criança , Pré-Escolar , Aconselhamento/métodos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Mães/psicologia , Período Pós-Parto/psicologia , Gravidez , Gravidez na Adolescência/psicologia , Características de Residência , Fatores de TempoRESUMO
INTRODUCTION: The pattern and duration of breastfeeding (BF) and the age at onset of complementary feeding, as well as its quality, have been associated with the prevalence of overweight in childhood. OBJECTIVE: To assess the effect of a pro-BF and healthy complementary feeding intervention, targeted to adolescent mothers and maternal grandmothers, on growth and prevalence of overweight and obesity in children at preschool age. This intervention had a positive impact on duration of BF and timing of onset of complementary feeding. METHODS: This randomized clinical trial involved 323 adolescent mothers, their infants, and the infants' maternal grandmothers, when they cohabited. Mothers and grandmothers in the intervention group received counseling sessions on BF and healthy complementary feeding at the maternity ward and at home (7, 15, 30, 60, and 120 days after delivery). When children were aged 4 to 7 years, they underwent anthropometric assessment and collection of data on dietary habits. Multivariable Poisson regression with robust estimation was used for analysis. RESULTS: BMI-for-age and height-for-age were similar in the intervention and control groups, as was the prevalence of overweight (39% vs. 31% respectively; p=0.318). There were no significant between-group differences in dietary habits. CONCLUSION: Although the intervention prolonged the duration of exclusive BF and delayed the onset of complementary feeding, it had no impact on growth or prevalence of overweight at age 4 to 7 years. TRIAL REGISTRATION: ClinicalTrials.gov NCT00910377.
Assuntos
Aleitamento Materno , Sobrepeso/prevenção & controle , Adolescente , Criança , Desenvolvimento Infantil , Pré-Escolar , Aconselhamento , Feminino , Avós , Promoção da Saúde , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Idade Materna , Mães , Sobrepeso/epidemiologia , PrevalênciaRESUMO
Introdução: Estudos demonstram o impacto do estado nutricional na qualidade de vida e prognóstico de pacientes pediátricos com câncer. A composição corporal pode afetar a mortalidade e morbidade, porém poucos trabalhos utilizam a bioimpedância nessa população. Objetivo: Comparar o estado nutricional obtido através de antropometria com a bioimpedância em crianças e adolescentes submetidos a tratamento quimioterápico. Materiais e métodos: Foram incluídos pacientes internados no Hospital de Clínicas de Porto Alegre, com idade entre 4 e 18 anos que haviam realizado pelo menos um ciclo de quimioterapia. Foram coletados dados de peso, estatura, circunferência do braço, prega cutânea tricipital e área muscular do braço. Também foi realizada a análise por bioimpedância. Resultados: Foram avaliados um total de 19 pacientes. Segundo os valores de escore-z de índice de massa corporal para idade 10,5% dos pacientes foram classificados como magreza, 52,6% eutrofia e 36,8% excesso de peso. Os valores de percentil de prega cutânea tricipital e área muscular do braço correlacionaram-se com a classificação do estado nutricional segundo o índice de massa corporal para idade, r=0,81 e 0,67 respectivamente. O percentil da prega cutânea tricipital apresentou correlação positiva com o percentual de massa gorda (r= 0,74) e correlação negativa com o percentual de massa magra (r= 0,76). Conclusões: Parâmetros antropométricos apresentaram boa correlação entre si e com valores obtidos por bioimpedância. A bioimpedância parece ser um método acurado para avaliação nutricional e aferição de compartimentos corporais em pacientes pediátricos portadores de neoplasias.
Background: Studies have shown the impact of nutritional status on quality of life and prognostic of pediatric cancer patients. Body composition may affect mortality and morbidity; however, there are few studies using bioelectrical impedance in this population. Aim: To compare the nutritional status based on anthropometric measurements and bioelectrical impedance in children and adolescents submitted to chemotherapy. Methods: Patients admitted to the Hospital de Clínicas de Porto Alegre, aged between 4 and 18 years, who had attended at least one cycle of chemotherapy, participated in the study. We collected data on weight, height, arm circumference, triceps skinfold thickness, and arm muscle area. Bioelectrical impedance analysis was performed. Results: A total of 19 patients were evaluated. According to the z-score values of body mass index for age, 10.5% of patients were considered malnourished, 52.6% had normal weight, and 36.8% were overweight. The percentile values of triceps skinfold and arm muscle area correlated with the nutritional status according to body mass index for age, r=0.81 and 0.67, respectively. The percentile of triceps skinfold thickness correlated positively with the percentage of fat mass (r=0.74) and negatively with the percentage of lean body mass (r=0.76). Conclusions: Anthropometric parameters showed good correlation between them and with values obtained by means of bioelectrical impedance. Bioelectrical impedance seems to be an accurate method for nutritional assessment and measurement of body compartments in pediatric patients with malignancies.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Avaliação Nutricional , Neoplasias/tratamento farmacológico , Composição Corporal , Impedância ElétricaRESUMO
Introdução: O leite materno é o alimento adequado para crianças nos primeiros meses de vida. O padrão de aleitamento materno pode estar relacionado ao estado nutricional de crianças e adolescentes. A escolaridade, a idade materna e a presença de filhos anteriores também podem estar relacionadas com a duração da amamentação. Objetivo: Avaliar a relação entre o tempo de aleitamento materno com o estado nutricional atual de crianças e adolescentes atendidos no Hospital de Clínicas de Porto Alegre (HCPA) - RS. Métodos: Estudo transversal realizado na unidade geral de internação pediátrica e no ambulatório geral de pediatria do HCPA com 106 crianças e adolescentes. Os participantes foram avaliados por meio da caderneta da criança, instrumento formulado para o estudo e avaliação antropométrica. Resultados: Não foram encontradas diferenças estatisticamente significativas em relação ao estado nutricional quando comparado com aleitamento materno, aleitamento materno exclusivo, tempo de amamentação exclusiva e tipo de leite utilizado após a interrupção do aleitamento materno exclusivo. Também não foram encontradas diferenças em relação ao tempo de aleitamento materno exclusivo quando comparado com idade da mãe no nascimento do bebê, escolaridade materna e filhos anteriores. Conclusão: Não foi encontrada associação estatisticamente significativa entre as variáveis analisadas. Entretanto, os dados percentuais sugerem que o aleitamento materno exclusivo pode influenciar positivamente no perfil nutricional das crianças, que mães com maior escolaridade e mães que possuem filhos anteriores amamentam exclusivamente por mais tempo.
Background: Human breast milk is the appropriate food for infants in the first months of life. The pattern of breastfeeding may be related to nutritional status of children and adolescents. Education, maternal age, and the presence of previous children may also be related to duration of breastfeeding. Aim: To evaluate the relationship between duration of breastfeeding and the current nutritional status of children and adolescents treated at the Hospital de Clínicas de Porto Alegre - RS. Methods: Cross-sectional study in a pediatric inpatient unit and an outpatient pediatric clinic with 106 children and adolescents. Participants were assessed by the Child Health Card, an instrument designed to study and anthropometric measurements. Results: There were no statistically significant differences in relation to nutritional status when compared with breastfeeding, exclusive breastfeeding, exclusive breastfeeding duration, and type of milk used after discontinuation of exclusive breastfeeding. We also found no differences in exclusive breastfeeding duration when compared with age of mother at birth, maternal education level, and the presence of previous children. Conclusion: There was no statistically significant association between the variables analyzed. However, the percentage data suggest that exclusive breastfeeding may positively affect the nutritional status of children. Mothers with higher education level or those with previous children are more likely to exclusively breastfeed longer.