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Gastrointestinal epithelial cells respond to milk-born molecules throughout breastfeeding, influencing growth, and development. The rapid renewal of the small intestine depends on the proliferation in the crypt that drives cell fates. We used early weaning model to investigate immediate and late effects of breastfeeding on proliferation, differentiation of jejunal epithelial cells. Wistar rats were either allowed to suckle (S) until 21 postnatal days or submitted to early weaning (EW) at 15 days. By comparing ages (18, 60, and 120 days), we found that EW decreased Ki67 indices and villi height at 18 and 60 days (p < 0.05), and at 120 days they were similar between diets. Proliferative reduction and augmented expression of Cdkn1b (p27 gene) were parallel. In the stem cell niche, EW increased the number and activity (Defa24) of Paneth cells at 18 and 60 days (p < 0.05), and Lgr5 and Ascl2 genes showed inverted responses between ages. Among target cells, EW decreased goblet cell number at 18 and 60 days (p < 0.05) and increased it at 120 days (p < 0.05), whereas enteroendocrine marker genes were differentially altered. EW reduced enterocytes density at 18 days (p < 0.05), and at 120 days this population was decreased (vs. 60 days). Among cell fate crypt-controlling genes, Notch and Atoh1 were the main targets of EW. Metabolically, intraperitoneal glucose tolerance was immediately reduced (18 days), being reverted until 120 days (p < 0.05). Currently, we showed that breastfeeding has a lifespan influence on intestinal mucosa and on its stem cell compartment. We suggest that, although jejunum absorptive function is granted after early weaning, the long lasting changes in gene expression might prime the mucosa with a different sensitivity to gut disorders that still have to be further explored.

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Introducción: La leche materna es considerada la vacuna perfecta de todos los tiempos y la mejor fuente de nutrición para los niños. Objetivo: Determinar el nivel de conocimientos de madres y padres sobre lactancia materna exclusiva. Métodos: Se realizó un estudio descriptivo y transversal de 27 madres y 27 padres de lactantes con destete precoz, pertenecientes al área de salud del Policlínico Docente Camilo Torres Restrepo de Santiago de Cuba, desde enero hasta diciembre del 2021, para lo cual el instrumento empleado fue la encuesta. Resultados: Se halló que los conocimientos sobre lactancia materna fueron considerados altos en 13 madres (48,1 %) y medios en 11 padres (40,7 %). Todos los integrantes de la serie recibieron información sobre el tema y las vías fundamentales para ello fueron los medios de difusión masiva (85,0 %), seguidos de los familiares y amigos (55,0 %). Conclusiones: El conocimiento acerca de la lactancia materna exclusiva en los padres resultó insuficiente y, en las madres, fue necesario ampliar dichos conocimientos sobre las técnicas para amamantar.

Introduction: Breast milk is considered the perfect vaccine of all times and the best nutrition source for children. Objective: To determine the knowledge level of mothers and fathers on exclusive breast feeding. Methods: A descriptive and cross-sectional study was carried out of 27 mothers and 27 fathers of early weaning infants. They were from the health area of Camilo Torres Restrepo Teaching Polyclinic in Santiago de Cuba, from January to December, 2021, for which the survey was used. Results: It was found that knowledge on breast feeding was considered high in 13 mothers (48.1 %) and medium in 11 fathers (40.7 %). All members of the series received information on the topic and the fundamental ways were mass media (85.0 %), followed by relatives and friends (55.0 %). Conclusions: The knowledge about exclusive breast feeding in fathers was insufficient and, in mothers, it was necessary to increase this knowledge on the techniques to breastfeed.

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Objetivo: avaliar a experiência de mães residentes em município paraibano sobre aleitamento materno. Método: nota prévia de um projeto guarda-chuva, de corte transversal, realizado com 252 mães, através de questionário virtual, por meio do Google Forms. Resultados: a principal motivação para continuidade do aleitamento materno exclusivo foi vínculo entre mãe e filho (23,4%) e a principal barreira foi o retorno ao trabalho (16,8%). Os três principais recursos de ingestão que provocaram a percepção do aumento do aleitamento materno foram sucos cítricos (21,2%), água (19,5%) e frutas diversas (7%). A maioria ingeriu até dois litros de água (46,4%), a substância mais eliciada para favorecer o volume de leite foi a tintura de algodoeiro (12,3%) e o método mais referido para aumento da produção foi a ordenha manual (63,6%), sendo problemas emocionais (40,5%) o maior motivo para a redução do leite. Sobre a ingestão de alimentos que porventura poderiam provocar gases, foram chocolate (27,6%), refrigerante (17,6%) e café (15%) os mais eliciados. Conclusão: acredita-se que este estudo traz contribuições a área materno-neonatal, bem como aos profissionais de saúde, pois incita o debate acerca dessa temática, de maneira que possibilita a ampliação do conhecimento e permita uma reflexão sobre as ações de promoção e apoio a amamentação, em busca da intersetorialidade e interdisciplinaridade, visando a redução nas taxas de desmame precoce.

Objective: to evaluate the experience of mothers living in a municipality in Paraíba regarding breastfeeding. Method: previous note of an umbrella project, cross- sectional, carried out with 252 mothers, through a virtual questionnaire, using Google Forms. Results: the main motivation for continuing exclusive breastfeeding was the bond between mother and child (23.4%) and the main barrier was returning to work (16.8%). The three main intake resources that caused the perception of increased breastfeeding were citrus juices (21.2%), water (19.5%) and various fruits (7%). The majority ingested up to two liters of water (46.4%), the most elicited substance to favor milk volume was cotton dye (12.3%) and the most mentioned method for increasing production was manual milking ( 63.6%), with emotional problems (40.5%) being the main reason for reducing milk. Regarding the intake of foods that could possibly cause gas, chocolate (27.6%), soda (17.6%) and coffee (15%) were the most elicited. Conclusion: it is believed that this study brings contributions to the maternal-neonatal area, as well as to health professionals, as it encourages the debate on this theme, in a way that allows the expansion of knowledge and allows a reflection on the promotion and support actions breastfeeding, in search of intersectoriality and interdisciplinarity, aiming at reducing early weaning rates.

Objetivo: evaluar la experiencia de las madres residentes en un municipio de Paraíba sobre la lactancia materna. Método: nota previa de un proyecto paraguas, transversal, realizado con 252 madres, a través de un cuestionario virtual, utilizando Google Forms. Resultados: la principal motivación para continuar con la lactancia materna exclusiva fue el vínculo madre-hijo (23,4%) y la principal barrera fue la reincorporación al trabajo (16,8%). Los tres principales recursos de ingesta que provocaron la percepción de aumento de la lactancia materna fueron los jugos de cítricos (21,2%), el agua (19,5%) y las frutas diversas (7%). La mayoría ingirió hasta dos litros de agua (46,4%), la sustancia más elicitada para favorecer el volumen de leche fue el tinte de algodón (12,3%) y el método más mencionado para aumentar la producción fue el ordeño manual (63,6%), con problemas emocionales (40,5%). %) siendo la principal razón para reducir la leche. En cuanto a la ingesta de alimentos que posiblemente puedan causar gases, el chocolate (27,6%), las gaseosas (17,6%) y el café (15%) fueron los más elicitados. Conclusión: se cree que este estudio trae contribuciones para el área materno- neonatal, así como para los profesionales de la salud, una vez que incentiva el debate sobre este tema, de manera que permite la ampliación del conocimiento y posibilita una reflexión sobre la promoción y acciones de apoyo a la lactancia materna, en busca de la intersectorialidad y la interdisciplinariedad, con el objetivo de reducir las tasas de destete precoz.

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Early weaning (EW) is associated with obesity later in life. Here, using an EW model in rats, we investigated changes in feeding behavior and the dopaminergic and endocannabinoid systems (ECS) in the adult offspring. Lactating Wistar rats were divided into two groups: EW, dams were wrapped with a bandage to interrupt suckling during the last 3 days of breastfeeding; CONT; dams fed the pups throughout the period without hindrances. EW animals were compared with CONT animals of the same sex. At PN175, male and female offspring of both groups could freely self-select between high-fat and high-sugar diets (food challenge test). EW males preferred the high-fat diet at 30 min and more of the high-sugar diet after 12 h compared to CONT males. EW females did not show differences in their preference for the palatable diets compared to CONT females. Total intake of standard diet from PN30-PN180 was higher in both male and female EW animals, indicating hyperphagia. At PN180, EW males showed lower type 2 dopamine receptor (D2r) in the nucleus accumbens (NAc) and dorsal striatum, while EW females had lower tyrosine hydroxylase in the ventral tegmental area and NAc, D1r in the NAc, and D2r in the prefrontal cortex. In the lateral hypothalamus, EW males had lower fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase, whereas EW females showed lower N-arachidonoyl-phosphatidylethanolamine phospholipase-D and increased FAAH. Early weaning altered both the dopaminergic and ECS parameters at adulthood, contributing to the eating behavior changes of the progeny in a sex-dependent manner.

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Objetivo: O objetivo do presente trabalho é descrever, por meio de revisão da literatura, as causas do desmame precoce em lactentes no Brasil. Métodos: Foram incluídos na revisão artigos publicados entre o período de 2016 e 2020. As informações foram coletadas nas bases de dados BVMS, Google Acadêmico, NCBI PubMed e Portal de Periódicos Capes e nos sites da Sociedade Brasileira de Pediatria, da OMS, da Unicef e da Opas, usando-se os termos indexadores: desmame precoce, dificuldade no aleitamento materno e prevalência do aleitamento materno. Resultados: Os artigos coletados para a pesquisa demonstraram que as maiores dificuldades encontradas pelas mães foram ocasionadas por: uso de mamadeira e chupeta, problemas nas mamas, falta de informação, parto cirúrgico e falta do contato pele a pele. Conclusão: Para reduzir o desmame precoce, é necessário que as mães recebam orientação e incentivo desde a gestação. Também é importante haver divulgação sobre as possíveis dificuldades e intercorrências que podem surgir durante o aleitamento materno, bem como orientações sobre a gestação e os procedimentos a serem adotados quando ocorrerem problemas nas mamas, como mastite e fissuras, que estão associadas com a pega incorreta. O apoio precisa ser multiprofissional. Deixa-se como sugestão a Iniciativa Hospital Amigo da Criança como possível estratégia para combater o desmame precoce.(AU)

Objective: The aim of this study is to describe, through a literature review, the causes of early weaning in infants in Brazil. Methods: Articles published between the period 2016 to 2020 were included in the review. The information collected was from the Virtual Health Library database of the Ministry of Health, Google Scholar, NCBI PubMed, Portal de Periódicos Capes and on the website of the Brazilian Society of Pediatrics, on the website of WHO and on the website of Unicef and on the PAHO website using the indexing terms: early weaning, difficulty in breastfeeding and prevalence of breastfeeding. Results: The articles collected for the research show me the greatest difficulties encountered by mothers were bottle use, pacifier, breast problems, lack of information, surgical delivery, and lack of skin-to-skin contact. Conclusion: To reduce early weaning, mothers need to receive guidance and encouragement from pregnancy. Disclosure about the possible difficulties and complications that may arise during the breastfeeding. Guidance since pregnancy what procedures to take, when breast problems occur such as mastitis, fissures, which are associated with incorrect handle. Support needs to be multiprofessional. The Iniciativa Hospital Amigo da Criança is suggested as a possible strategy to combat early weaning.(AU)

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RESUMEN Introducción: La leche materna es el producto fisiológico fundamental para promover la salud nutricional del niño y su interrupción precoz es un factor de riesgo para el desarrollo de enfermedades. Objetivo: Caracterizar la morbilidad en lactantes con destete precoz. Metódos: Estudio observacional, correlacional, de corte transversal realizado en 720 lactantes entre 29 días y 6 meses de edad, ingresados en el Hospital Pediátrico Docente de San Miguel del Padrón entre enero y diciembre del año 2014, que constituyeron el universo y muestra del estudio. Se analizaron variables como edad y tipo de destete, ingresos anteriores y causas de ingresos. La recolección de información se realizó a través de las historias clínicas y un cuestionario aplicado a las madres. Resultados: Solo el 27,7 % estaba con lactancia materna exclusiva, el resto fueron destetados en cualquier edad, incluso antes del mes de nacido. Al aumentar la edad del destete, disminuyeron la cantidad de ingresos y la morbilidad. Los destetados presentaron mayor frecuencia de infecciones respiratorias y digestivas. Conclusiones: En los lactantes estudiados, mientras más temprano ocurre el destete, mayor es el riesgo de morbilidad y de necesidad de ingresos en servicios hospitalarios, por tanto, menor protección para la salud del pequeño.

ABSTRACT Introduction: Breast milk is the fundamental physiological product to promote the nutritional health of the child and its early interruption is a risk factor for the development of diseases. Objective: Characterize morbidity in infants with early weaning. Methods: Observational, correlational, cross-sectional study conducted in 720 infants between 29 days and 6 months of age, admitted to the Pediatric Teaching Hospital of San Miguel del Padrón from January to December 2014, whom represented the universe and the sample of the study. Variables such as age and type of weaning, previous hospitalizations and their causes were analyzed. The collection of information was carried out through medical records and a questionnaire applied to the mothers. Results: Only 27.7% of the children were exclusively breastfed, the rest were weaned at any age, even before one month of birth. As the age of weaning increased, the amount of hospitalizations and morbidity decreased. Those weaned had a higher frequency of respiratory and digestive infections. Conclusions: In the infants studied, the earlier the weaning occurs, the greater the risk of morbidity and the need for admission to hospital services was; therefore, it represented less protection for the child's health.

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The gastric mucosa is disturbed when breastfeeding is interrupted, and such early weaning (EW) condition permanently affects the differentiation of zymogenic cells. The aim of the study was to evaluate the immediate and long-term effects of EW on gastric cell proliferation, considering the molecular markers for cell cycle, inflammation, and metaplasia. Overall, we investigated the lifelong adaptation of gastric growth. Wistar rats were divided into suckling-control (S) and EW groups, and gastric samples were collected at 18, 30, and 60 days for morphology, RNA, and protein isolation. Inflammation and metaplasia were not identified, but we observed that EW promptly increased Ki-67-proliferative index (PI) and mucosa thickness (18 days). From 18 to 30 days, PI increased in S rats, whereas it was stable in EW animals, and such developmental change in S made its PI higher than in EW. At 60 days, the PI decreased in S, making the indices similar between groups. Spatially, during development, proliferative cells spread along the gland, whereas, in adults, they concentrate at the isthmus-neck area. EW pushed dividing cells to this compartment (18 days), increased PI at the gland base (60 days), but it did not interfere in expression of cell cycle molecules. At 18 days, EW reduced Tgfß2, Tgfß3, and Tgfbr2 and TßRII and p27 levels, which might regulate the proliferative increase at this age. We demonstrated that gastric cell proliferation is immediately upregulated by EW, corroborating previous results, but for the first time, we showed that such increased PI is stable during growth and aging. We suggest that suckling and early weaning might use TGFßs and p27 to trigger different proliferative profiles during life course.

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Background: Women who are obese have lower rates of breastfeeding initiation and duration and are less likely to breastfeed exclusively compared with women who are not obese. To develop programs to improve breastfeeding practices among this group of women, we investigated the association between maternal obesity and breastfeeding practices and problems in the first days postpartum. Methods: We analyzed medical records from postpartum women at a rooming-in maternity ward in State of São Paulo, Brazil, between 2016 and 2018. We included those who had intended to exclusively breastfeed, had given birth to a singleton and were admitted to rooming-in. We analyzed exclusive breastfeeding and nonexclusive breastfeeding each day of hospitalization and the presence of breastfeeding problems, comparing women in the obese category (body mass index [BMI] ≥30 kg/m2) to normal and overweight women (≥18.6 to ≤29.9 kg/m2). Results: Two hundred and twenty-four postpartum women participated, including 86 women in the obese category. More than 50% of women with obesity reported a breastfeeding problem in the first and second postpartum days (p = 0.026 and p = 0.017, respectively) compared with the 41% and 38% nonobese group. Children of obese women were 2.8 times more likely to have poor latch during breastfeeding (95% confidence interval [CI]: 1.29-6.10) compared with the nonobese group on the third day. Conclusion: Maternal obesity increased the probability of breastfeeding difficulties and nonexclusive breastfeeding at discharge. Professionals need to support breastfeeding techniques in the days immediate after delivery to improve breastfeeding outcomes for mothers with obesity.

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Objetivo: comparar o crescimento pondo-estatural dos lactentes aos seis meses de vida em aleitamento materno exclusivo e aleitamento complementar ou misto. Método: estudo transversal, com 38 mães e lactentes entre o quinto e o sexto mês de vida, cuja coleta de dados ocorreu em unidades de saúde de um município no Oeste do estado do Paraná, Brasil. Os dados foram analisados por estatística descritiva. Resultados: a prevalência do aleitamento materno exclusivo foi de 21% (n=8) da amostra. As variáveis antropométricas (peso, altura e perímetro cefálico - PC) dos lactentes em aleitamento materno exclusivo apresentaram médias inferiores àqueles em aleitamento materno predominante e/ou com uso de fórmula. Conclusão: o crescimento pondo-estatural dos lactentes aos seis meses de vida em aleitamento materno exclusivo e em aleitamento complementar ou misto estava dentro do esperado para a idade. Contudo, evidenciou-se baixa prevalência de aleitamento materno exclusivo. Palavras-chave: Aleitamento materno; Alimentação artificial; Desmame precoce; Crescimento; Lactente.

Objective: compare the weight-height growth of the infants at six months of life in exclusive breastfeeding and complementary or mixed breastfeeding. Method: transversal study, with 38 mothers and infants between the fifth and the sixty months of life, whose data collect occurred in primary health care units of a city in the West of the state of Paraná, Brazil. The data was analyzed by descriptive statistics. Results: the prevalence of exclusive breastfeeding was of 21% (n=8) of the sample. The anthropometrics variables (weight, height and head circumference - HC) of the infants in exclusive breastfeeding show lower averages to those in predominant breastfeeding and/or with use of formula. Conclusion: the weight-height growth of the infants at six months of life in exclusive breastfeeding and in complementary or mixed breastfeeding was inside of the expected for age. However, was evidenced low prevalence of exclusive breastfeeding.

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Adverse experiences that occur during the early stages of life can have permanent repercussions in adulthood. Among these experiences, early weaning is one that can alter the molecular, cellular, and behavior patterns in later life. Centered on this fact, the objective of the current study was to evaluate the effect of early weaning at 15 days of life of Wistar rats on their feeding behavior and if the opioidergic system blockade would cause a reversal of these outcomes. Experimental groups were formed based on the weaning period of each litter. On postnatal day 15, the group D15 was weaned and, on postnatal day 30 (natural weaning), the group D30 was weaned. The rats weaned on postnatal day 15, and administered subcutaneous Naltrexone (3 mg/kg) were from group D15 + NTX. Those weaned at 15 days of age exhibited higher depressive-like behavior, lesser reactivity time to sucrose, and higher intake of palatable food than the control group. The Naltrexone administration was observed to reverse some outcomes, such as increasing the reactivity time to sucrose and decreasing the quantity of palatable food consumed, to levels similar to those of the control group. Together, the findings of the present study are indicative of the vital role played by the opioidergic system in inducing the changes noted in the eating behavior patterns during adulthood, post early weaning.

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Early weaning can lead to changes in the morphology of organs in adulthood, and the consumption of functional foods during lactation and postnatal life is believed to prevent these changes. However, it is not known if early weaning affects testicular morphology and if the use of cocoa can prevent that. We studied the effects of maternal and postnatal supplementation of cocoa powder on the testicular morphology of early weaned adult rats. The animals were divided into four groups (n = 6 each), control group, cocoa control group, early weaning (EW) group, and cocoa early weaning (EWCa) group, and were analyzed for 90 d, after which they were euthanized. The animals from the EW group showed a reduction in the tubular diameter and height of the seminiferous epithelium, a decrease in epithelial surface density (Sv), and an increase in the lumen and proper tunic. However, the animals from the EWCa group showed an increase in the diameter and height of the epithelium, an increase in the epithelium Sv, and a decrease in the lumen and the proper tunic. The early weaning promotes morphological changes in the testicles; however, supplementation with cocoa powder can preserve the testicular histoarchitecture.

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Introducción: La lactancia materna exclusiva aporta macro y micronutrientes que son suficientes para un correcto desarrollo y crecimiento del lactante. La promoción de la lactancia materna exclusiva debe ser óptima, puesto que en la actualidad el destete precoz ha aumentado en gran magnitud. Objetivo: Determinar qué factores influyen en el destete precoz en madres con lactantes de 0 a 11 meses en el Centro de Salud Augusto Egas, de la ciudad de Santo Domingo, Ecuador. Método: Se utilizó un estudio correlacional, descriptivo, con enfoque cuantitativo, durante el periodo de julio hasta inicios de agosto de 2021, en una población de 252 madres que asistieron dicha unidad de salud. Se realizó un muestreo por conveniencia donde se obtuvo una muestra de 153 madres. Las variables medidas, fueron: dificultades a inicio de la lactancia materna, alimentos con los que complementaron la lactancia materna exclusiva, abandono precoz, mitos que influyeron en el abandono parcial o completo de la lactancia materna exclusiva y madres que recibieron información después del parto. Resultados: El 85 por ciento de las madres refirió dificultades en la cantidad suficiente de leche. Las madres no abandonaron la lactancia por decisión propia, el 64,7 por ciento expresó no creer en los mitos. Hubo mayoría de acuerdo en haber recibido una correcta información después del parto por parte del personal de salud (64,7 por ciento). Conclusión: La insuficiente cantidad de leche en las madres es el factor que más influye en esta unidad de salud, por lo que optan por una alimentación mixta(AU).

Introduction: Exclusive breastfeeding provides macro and micronutrients that are sufficient for the correct development and growth of the infant. The promotion of exclusive breastfeeding should be optimal, since early weaning has greatly increased nowadays. Objective: To determine what factors influence early weaning in mothers with infants from 0 to 11 months at the Augusto Egas Health Center, in the city of Santo Domingo, Ecuador. Method: A descriptive correlational study was undertaken, with a quantitative approach, during the period from July to the beginning of August 2021, in a population of 252 mothers who attended this health unit. A convenience sampling was carried out, and a sample of 153 mothers was obtained. The variables measured were: difficulties at the beginning of breastfeeding, foods that supplemented exclusive breastfeeding, early abandonment, myths that influenced the partial or complete abandonment of exclusive breastfeeding, and mothers who received information after delivery. Results: 85 percent of the mothers reported difficulties in the sufficient quantity of milk. Mothers did not abandon breastfeeding by their own decision, 64.7 percent expressed not believing in the myths. There was a majority of agreement in having received correct information after delivery from health personnel (64.7 percent). Conclusion: The insufficient amount of milk in mothers is the factor that influences the most in this health unit, so they opted for a mixed diet(AU).

Introdução: O aleitamento materno exclusivo fornece macro e micronutrientes suficientes para o correto desenvolvimento e crescimento da criança. A promoção do aleitamento materno exclusivo deve ser ótima, pois hoje o desmame precoce aumentou muito. Objetivo: determinar quais fatores influenciam o desmame precoce de mães com bebês de 0 a 11 meses no Centro de Saúde Augusto Egas, na cidade de Santo Domingo, Equador. Método: Foi utilizado um estudo descritivo correlacional, com abordagem quantitativa, no período de julho a início de agosto de 2021, em uma população de 252 mães atendidas nesta unidade de saúde. Realizou-se uma amostragem por conveniência, obtendo-se uma amostra de 153 mães. As variáveis mensuradas foram: dificuldades no início da amamentação, alimentos que complementavam a amamentação exclusiva, abandono precoce, mitos que influenciaram no abandono parcial ou total do aleitamento materno exclusivo e mães que receberam informações após o parto. Resultados: 85 porcento das mães relataram dificuldade na quantidade suficiente de leite. As mães não abandonaram a amamentação por decisão própria, 64,7 porcento expressaram não acreditar nos mitos. Houve maior concordância em ter recebido informações corretas do pessoal de saúde após o parto (64,7 porcento). Conclusão: A quantidade insuficiente de leite das mães é o fator que mais influencia esta unidade de saúde, por isso optam por uma alimentação mista(AU).

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RESUMO Objetivo: avaliar o desempenho de nutrizes e recém-nascidos, durante a mamada, no período neonatal e identificar as dificuldades para a prática do aleitamento materno/amamentação. Método: estudo longitudinal, comparativo, realizado em hospital regional, no Piauí, Brasil. Participaram 49 nutrizes, abordadas no primeiro e 28° dia de vida dos recém-nascidos. A coleta aconteceu entre setembro de 2018 e fevereiro de 2019, com questionário de caracterização e aplicação do instrumento LATCH - Scoring System (Latch, Audible swallowing, Type of nipple, Comfort, Hold). Para análise, utilizou-se estatística descritiva e testes de associações múltiplas. Resultados: verificou-se que, na primeira avaliação, 32,7% das nutrizes e recém-nascidos necessitaram de suporte para adequação do processo de amamentação, enquanto na segunda, apenas 2%. Conclusão: evidenciou-se que intervenções precoces voltadas para promoção e manutenção do aleitamento materno devem ser implementadas por enfermeiros, com início no pré-natal e indispensáveis na primeira semana puerperal, especialmente relacionadas à técnica de amamentação.

RESUMEN Objetivo: evaluar la actuación de las madres lactantes y de los recién nacidos, durante la lactancia materna, en el período neonatal e identificar las dificultades para la práctica de la lactancia materna/amamantamiento. Material y método: estudio longitudinal, comparativo, realizado en un hospital regional, en Piauí, Brasil. Participaron 49 madres lactantes, abordadas el primer y el 28º día de vida de los recién nacidos. La recolección se realizó entre septiembre de 2018 y febrero de 2019, con un cuestionario de caracterización y la aplicación del instrumento LATCH - Scoring System (Latch, Audible swallowing, Type of nipple, Comfort, Hold). Para el análisis se utilizaron estadísticas descriptivas y pruebas de asociación múltiple. Resultados: se verificó que, en la primera evaluación, el 32,7% de las madres y los recién nacidos necesitan apoyo para la adecuación del proceso de amamantamiento, mientras que, en la segunda, sólo el 2%. Conclusión: se evidenció que las intervenciones precoces dirigidas a la promoción y mantenimiento de la lactancia materna deben ser implementadas por los enfermeros, con inicio en el prenatal e indispensables en la primera semana de puerperio, especialmente relacionadas con la técnica de amamantamiento.

ABSTRACT Objective: to evaluate the performance of nursing mothers and newborns, during breastfeeding, in the neonatal period and to identify the difficulties for the practice of breastfeeding/breastfeeding. Method: longitudinal, comparative study, carried out in a regional hospital, in Piauí, Brazil. Forty-nine nursing mothers participated, approached on the first and 28th day of life of their newborns. The collection took place between September 2018 and February 2019, with a characterization questionnaire and application of the LATCH - Scoring System instrument (Latch, Audible swallowing, Type of nipple, Comfort, Hold). For analysis, descriptive statistics and multiple association tests were used. Results: It was found that in the first assessment, 32.7% of the nursing mothers and newborns needed support for adequacy of the breastfeeding process, while in the second, only 2%. Conclusion: It was evidenced that early interventions aimed at promoting and maintaining breastfeeding should be implemented by nurses, beginning in the prenatal period and indispensable in the first puerperal week, especially those related to breastfeeding technique.

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Introducción: El abandono progresivo de la lactancia materna es una nueva situación de salud en la que influyen diversos aspectos. Objetivo: Caracterizar factores clínicos y sociodemográficos referentes al destete precoz en lactantes y su relación con aspectos sociodemográficos de sus madres. Métodos: Estudio observacional, correlacional, de corte transversal, realizado en el Hospital Pediátrico Docente de San Miguel del Padrón. Se conformó una muestra con 520 infantes con edades entre 29 días y 6 meses, destetados precozmente e ingresados en el 2014. La información se tomó de las historias clínicas y de un cuestionario aplicado a las madres. Resultados: Entre 3 y 5 meses de edad se encontraron 56,5 por ciento de los lactantes con predominio masculino (59,0 por ciento) y solo 51,3 por ciento de los casos presentó adecuado estado nutricional. Prevaleció la lactancia mixta (52,9 por ciento). El destete prevaleció entre 4 y 5 meses de edad (53,7 por ciento) y por causas comerciales (43,1 por ciento). Las madres entre 20-34 años fueron las que más destetaron (65,7 por ciento), trabajadoras (53,4 por ciento), de escolaridad media (51,6 por ciento) y en unión consensual (50,6 por ciento). Conclusiones: Los factores clínicos como tipo de destete y valoración nutricional se relacionan con factores sociodemográficos como la edad cronológica del niño y la edad del destete. La edad materna no tiene que ver con el destete precoz ni con sus causas. El abandono precoz de la lactancia materna exclusiva es común e independiente de la ocupación laboral y nivel de escolaridad materna, lo que favorece la malnutrición en los infantes(AU)

ntroduction: The progressive dropping of maternal breastfeeding is a new health situation in which different factors have influences. Objective: To characterize the clinical and socio-demographic factors related to early weaning in newborns and their relation with socio-demographic aspects of their mothers. Methods: Observational, correlational, cross-sectional study in the Pediatric Teaching Hospital of San Miguel del Padrón. It was formed a sample of 520 newborns in ages from 29 days and six months old, whom were early weaned and admitted in the hospital in 2014. The correlation of information was made through the clinical records and a questionnaire applied to the mothers. Results: 56.5 percent of the newborns were between 3 and 5 months old predominating the male sex (59.0 percent), and just 51.3 percent of the cases presented an adequate nutritional state. There was a predominance of mixed lactation (52.9 percent), and the weaning prevailed in the 4 to 5 month of life (53.7 percent), and it was due to commercial causes in the 43.1 percent. Mothers in the ages from 20 to 34 years (65.7percent), mothers who work (53.4 percent), mothers of medium education level (51.6 percent) and in consensual union (50.6 percent) were the ones that practiced weaning the most. Conclusions: There clinical factors as the type of weaning and the nutritional value that were associated with socio-demographic factors as the chronological age of the child and the age of weaning. The maternal ages were not related with early weaning or its causes. Regardless of the job or the educational level of the mother is common the early dropping of exclusive breastfeeding, which favours malnutrition in the newborns(AU)

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Este estudo se propôs a averiguar a existência de associação entre o uso de chupeta e a interrupção precoce do aleitamento materno exclusivo (AME) ao longo dos quatro primeiros meses de vida da criança. Para isso, utilizaram-se dados de uma coorte composta por 1.037 mães e crianças. Para estimar a associação entre a variável desfecho e aquelas de exposição ao longo do tempo, foi utilizada a técnica de Equação de Estimação Generalizada (GEE). Foi averiguado que a interrupção precoce do AME e o uso de chupeta aumentaram gradativamente conforme a idade da criança; no quarto mês, mais da metade das crianças já estava desmamada e fazia uso de chupeta. Os resultados da estimativa obtida por meio da GEE mostraram que permaneceu significativo apenas o uso de chupeta associado à baixa escolaridade materna como risco de interrupção precoce do AME, quando ajustado para as demais covariáveis. Os resultados reforçam a interferência negativa do uso da chupeta na duração do AME e a necessidade de informar às mães sobre as desvantagens do uso de chupetas.

This study investigates the possible association between pacifier use and early termination of exclusive breastfeeding for four months following birth. Data was collected from a cohort comprising1037 mothers and children. The association between the outcome variable and the exposure variables over time was estimated using the Generalized Estimation Equation (GEE). Early weaning and pacifier use increased gradually with the child's age; by the fourth month, more than half of the children were already weaned and using a pacifier. GEE estimations showed that only pacifier use associated with low maternal schooling level remained significant as a risk of early weaning, when adjusted for the other covariates. The results reinforce the negative interference of pacifier use on EB duration and the need to inform mothers about the disadvantages of pacifier use.

Este estudio tuvo como objetivo investigar la existencia de una asociación entre el uso de chupete y la interrupción temprana de la lactancia materna exclusiva (LME) durante los primeros cuatro meses de vida del niño. Se utilizaron datos de una cohorte, compuesta por 1.037 madres y niños. Para estimar la asociación entre la variable resultado y las de exposición en el tiempo, se utilizó la técnica de Ecuación de Estimación Generalizada (GEI). La interrupción temprana de la LME y el uso de un chupete aumentaron gradualmente conforme a la edad del niño; en el cuarto mes, más de la mitad de los niños ya habían sido destetados y usaban chupete. Los resultados de la estimación obtenida a través de GEI mostraron que solo el uso de chupetes asociado a bajos niveles de educación materna permaneció significativo como riesgo de interrupción temprana de la LME, cuando se ajustó con las otras covariables. Los resultados apuntan la interferencia negativa del uso de chupete en la duración de la LME y la necesidad de informar a las madres sobre las desventajas del uso de chupete.

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Exposure to environmental factors can program the metabolism, conferring resistance or increasing the risk to chronic disease development in childhood and adulthood. In this sense, lactation is an important period in this window of development. Herein, we investigated the effect of early weaning on neurochemical and behavioral changes in offspring at weaning and adulthood. Female and male pups were divided into four groups: (1) Control weaning (weaning on the PND21, pups were kept with the biological mother); (2) Early Weaning Bromocriptine group (EWB) (pharmacological weaning on PND16); (3) Early Weaning Cross-Fostering group (EWCF) (pups housed with a foster mother on PND16 up to PND21); (4) Early Weaning Without Care group (EWWC) (weaning on PND16, maternal separation). Weight control of pups was recorded from postnatal Day 16 to 59. On the 21st day, part of the pups was euthanized and the hippocampus and hypothalamus were removed for biochemical evaluation. The remaining pups were submitted to behavioral tests on the 60th postnatal day. Early weaning reduced the pups' body weight, in a sex-dependent way. At 60 days of age, male pups of EWCF and EWWC groups have lower body weight compared to control male, and female body weight was lower than male pups. In relation to biochemical changes in the brain, weaning altered the levels of oxidants, increased the enzymatic activity of superoxide dismutase (SOD), and glutathione peroxidase (GPx), as well as induced lipid peroxidation. Weaning was also able to alter long-term memory and induce anxious behavior in pups. Our results demonstrate that the different types of early weaning changed the parameters of redox status in the hippocampus and hypothalamus of pups (21 days old), suggesting a prooxidative profile, in addition, to alter learning/memory and inducing an anxious behavior in male offspring (60 days old).

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Early life stress (ELS) has been associated with developmental impairments. Early weaning (EW) is a postnatal stress model consisting of interruption of lactation and maternal care. The 5HT-system has been associated with neurobehavioral modulations promoted by ELS. Thus, the present work aims to investigate the effects of early weaning on feeding behavior and serotonergic system of juvenile male rats. For this, rats were submitted to early (PND15) or natural (PND30) weaning and had the body weight, food intake in circadian phases, and food intake in response to fenfluramine assessed. mRNA expression of serotoninergic receptors (5HT1A and 5HT2C) and transporter (SERT) was assessed in the hypothalamus and brainstem, as well as NPY and POMC mRNA expression in hypothalamus. The results show that early weaning promoted changes in the percentage of weight gain during lactation period and increase in body weight at PND40. It was also observed that EW promoted increase and decrease in food intake in light and dark phase, respectively, and leads to a decreased action of fenfluramine on inhibition of food intake. In addition, early weaning promoted increased NPY and SERT mRNA expression in the hypothalamus and 5HT2C in the brainstem. Together, the data indicate that the stress caused by early weaning impairs the eating behavior of juvenile male rats through hypofunction of the 5HT-system.

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PURPOSE: Early weaning (EW) is a stressful condition that programmes a child to be overweight in adult life. Fat mass depends on glucocorticoids (GC) to regulate adipogenesis and lipogenesis. We hypothesised that the increased adiposity in models of EW was due to a disturbed HPA axis and/or disrupted GC function. METHODS: We used two experimental models, pharmacological early weaning (PEW, dams were bromocriptine-treated) and non-pharmacological early weaning (NPEW, dams' teats were wrapped with a bandage), which were initiated during the last 3 days of lactation. Offspring from both genders was analysed on postnatal day 180. RESULTS: Offspring in both models were overweight with increased visceral fat mass, but plasma corticosterone was increased in both genders in the PEW group but not the NPEW group. NPEW males had increased GRα expression in visceral adipose tissue (VAT), and GRα expression decreased in PEW males in subcutaneous adipose tissue (SAT). Females in both EW groups had increased 11ßHSD1 expression in SAT. PEW males had increased C/EBPß expression in SAT. PEW females had lower PPARy and FAS expression in VAT than the NPEW females. We detected a sex dimorphism in VAT and SAT in the EW groups regarding 11ßHSD1, GRα and C/EBPß expression. CONCLUSIONS: The accumulated adiposity induced by EW exhibited distinct mechanisms depending on gender, specific fat deposition and GC metabolism and action. The higher proportion of VAT/SAT in both sets of EW males may be related to the action of GC in these tissues, and the higher conversion of GC in SAT in females may explain the differences in the fat distribution.

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PURPOSE: Early weaning (EW) is a risk factor for obesity development. Brown adipose tissue (BAT) hypofunction is related to obesity onset. Here, we evaluated whether sympathetic nervous system (SNS) activity in BAT and the thermogenic function of BAT are decreased in adulthood in obese rats from two EW models. METHODS: At the time of birth, lactating Wistar rats and their pups (three males and three females) were separated into three groups: the control group, in which pups consumed milk throughout lactation; the non-pharmacological EW (NPEW) group, in which suckling was interrupted with a bandage during the last 3 days of lactation; and the pharmacological EW (PEW) group, in which dams were treated with bromocriptine (0.5 mg/twice a day) 3 days before weaning. The offspring were sacrificed on PN180. RESULTS: Adult male rats from both EW models exhibited lower BAT SNS activity. Female rats from the PEW group showed a decrease in BAT SNS activity. The protein levels of UCP1 were lower in the NPEW males, while PGC1α levels were lower in both PEW and NPEW males. Both groups of EW females showed reductions in the levels of ß3-AR, TRß1, and PGC1α. The UCP1 protein level was reduced only in the NPEW females. The EW groups of both sexes had lower AMPK protein levels in BAT. In the hypothalamus, only the PEW females showed an increase in AMPK protein levels. In both groups of EW males, adrenal catecholamine was increased and tyrosine hydroxylase was decreased, while in EW females, adrenal catecholamine was decreased. CONCLUSIONS: Early weaning alters the thermogenic capacity of BAT, which partially contributes to obesity in adulthood, and there are sex-related differences in these alterations.

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Convergent evidence in literature shows that rapid disruption of maternal care and breastfeeding due to an early weaning protocol changes the development of several neurobehavioral patterns in rodents, including the circadian pattern of feeding. The serotoninergic system has been associated with the control of feeding patterns. Therefore, we aim to evaluate the patterns of feeding, the mRNA expression of 5 H T-1b, 5 H T-2c, and SERT on the hypothalamus, brainstem, and the body weight of female juvenile Wistar rats, submitted to early (PND15) or regular (PND30) weaning. The results demonstrate that early weaning promotes an increase in food intake in a 24 -h period, in the dark phase of the circadian cycle and in the four-hour time intervals at the beginning of the dark and light phases. Also, early weaning decreases the mRNA expression of 5 H T-1b, 5 H T-2c, and SERT on the hypothalamus, but increases it on the brainstem. Additionally, early weaning promotes an increase in body weight. Therefore, the present data demonstrate that early weaning changes the patterns of feeding in juvenile female rats and suggests that this behavioral modification is due to the modulations promoted in the 5 H T-system.

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