RESUMO
Introdução: O aleitamento materno exclusivo é preconizado até os seis meses de vida, mas algumas situações exigem o uso de utensílios para oferta do leite. O objetivo deste estudo é comparar o desempenho dos neonatos com bico ortodôntico e bico convencional de mamadeira, e com o copo. Metodologia: Foram incluídos 63 neonatos que ainda não tinham prescrição de alimentação por via oral. Os neonatos foram avaliados através da aplicação do protocolo Avaliação da habilidade para alimentação oral (Lau e Smith, 2011) com os três utensílios, em momentos diferentes. Os resultados foram analisados através do Teste Equações de Estimações Generalizadas e Teste de Friedman. Resultados: A maioria dos neonatos eram pretermos (n = 58; 92,06%), do sexo masculino (n = 36; 57,14%) e baixo peso ao nascer (n = 25; 39,68%). Foi identificado maior número de episódios de náusea com o bico convencional (p=0,049), e escape extraoral de leite (p=0,000) e aumento no peso da compressa após a oferta com o copo (p=0,000). A proficiência e a taxa de transferência foram maiores com o bico convencional (p=0,022 e p=0,016, respectivamente). Conclusão: Eventos adversos durante a alimentação por via oral ocorrem mais com o copo e com o bico convencional. Os neonatos ingerem maior volume em menos tempo com o bico convencional, mas não presentam melhor desempenho. (AU)
Assuntos
Humanos , Recém-Nascido , Sistema Único de Saúde , Alimentação com Mamadeira , Aleitamento Materno , Saúde Pública , Alimentação com Mamadeira/métodos , Alimentação com Mamadeira/psicologiaRESUMO
PURPOSE: To evaluate the oxygen saturation, heart rate, length of hospital stay and weight preterm infants or preterm newborns (PTNBs) (in the Neonatal Intensive Care Unit in the diet supply by cup and finger feeding techniques, simultaneously with breastfeeding. METHODS: Simultaneous randomized clinical trial. Twenty-five preterm infants admitted to the Neonatal Intensive Care Unit of the Public Hospital from October 2011 to February 2012 were selected. The sample was divided into two groups: Eight preterm infants who received the diet in the cup probe group (CPG) who were born on the same day, and 17 by finger probe group (FPG) who were born on the odd day. In the diet offer, the minimum and maximum values of oxygen saturation (O2 Sat) and heart rate (HR) were recorded: before offering the diet, during and after the offer. RESULTS: Regarding the variables O2 Sat and HR, no statistically significant differences were observed between the groups, but in the group vs time factor, the groups showed differences, not continuous in the O2 Sat variable. Regarding weight, a statistically significant gain was observed for both groups, and in CPG the highest weight gain was due to the longer hospitalization time. It was verified that FPG presented shorter hospitalization time. CONCLUSION: There were no differences regarding O2 Sat and HR. However, when analyzing the time factor, the groups presented some differences, not continuous, indicating the need for other studies for a better understanding of the effect. The FPG presented shorter hospitalization time and the CPG infants had greater weight gain due to longer hospitalization time.
OBJETIVO: Avaliar a saturação de oxigênio (SatO2), a frequência cardíaca (FC), o tempo de internação e o peso dos recém-nascidos pré-termos (RNPTs) em Unidade de Terapia Intensiva Neonatal, na oferta de dieta pelas técnicas de alimentação via copo e sonda-dedo, simultaneamente ao aleitamento materno. MÉTODO: Ensaio clínico randomizado simultâneo. Foram selecionados 25 prematuros internados na Unidade de Terapia Intensiva Neonatal de hospital público, no período de outubro de 2011 a fevereiro de 2012. A amostra foi dividida em dois grupos: 8 prematuros nascidos em dia par, que receberam a dieta no copo (GCP) e 17 prematuros, nascidos em dia ímpar, que receberam a dieta pela sonda-dedo (GSD). Na oferta da dieta foram anotados os valores mínimos e máximos da SatO2 e FC, antes de oferecer a dieta, durante e após a oferta. RESULTADOS: Quanto às variáveis SatO2 e FC, não foram observadas diferenças estatisticamente significativas entre os grupos, mas, no fator grupo versus tempo, os grupos apresentaram diferenças, não contínuas na variável SatO2. Em relação ao peso, foi constatado ganho estatisticamente significativo para ambos os grupos, sendo que, no GCP, o maior ganho de peso foi por causa do maior tempo de internação. Foi verificado que o GSD apresentou menor tempo de internação. CONCLUSÃO: Não houve diferenças quanto à SatO2 e FC. Contudo, ao se analisar o fator tempo, os grupos apresentaram algumas diferenças, não contínuas, o que indica a necessidade de outros estudos para melhor compreensão do efeito. O GSD apresentou menos tempo de internação e os RNPTs do GCP tiveram maior ganho de peso em razão do maior tempo de internação.
Assuntos
Métodos de Alimentação , Frequência Cardíaca/fisiologia , Consumo de Oxigênio/fisiologia , Alimentação com Mamadeira/métodos , Aleitamento Materno , Feminino , Humanos , Recém-Nascido Prematuro , Tempo de Internação , Masculino , Fatores de Tempo , Aumento de PesoRESUMO
BACKGROUND: Breastfeeding plays an important role in child health. However, there are doubts about its influence on malocclusions. Systematic reviews have yielded contradictory results. Research aim: This study aimed to investigate whether the type and duration of breastfeeding are associated with malocclusions in primary teething. METHODS: The review strategy included several electronic databases, lists of references, reviews, dissertation and thesis websites, experts, and other relevant documents. Published and unpublished observational studies ( N = 42) were reviewed using the Participants (children), Interventions (breastfeeding), Comparisons (bottle feeding), Outcomes (malocclusion), and Study design (observational) strategy, without restrictions on language or locale. Information about the authors, publication year, country of study, setting, study design, sample size, age, type and duration of exclusive and mixed breastfeeding, and malocclusions was recorded by two blinded evaluators. Quantitative meta-analysis ( N = 30) of the studies with available data was performed. RESULTS: Breastfeeding was a protective factor against malocclusions. The odds of association increased with breastfeeding duration. Irrespective of duration, breastfeeding had a protective association with open bite. For those who were breastfed for up to 6 months, breastfeeding protected against overjet, open bite, posterior crossbite, and crowding. Breastfeeding for 12 months or longer was associated with lower odds of overjet, open bite, and posterior crossbite. Breastfeeding exclusively for 6 months was also a protective factor against malocclusions. However, studies on this subject presented low quality, statistical heterogeneity, and only unadjusted measures of association in most of the cases. CONCLUSION: Breastfeeding beneficially affects primary occlusion when practiced for at least 6 months.
Assuntos
Alimentação com Mamadeira/métodos , Alimentação com Mamadeira/tendências , Aleitamento Materno/métodos , Aleitamento Materno/tendências , Má Oclusão/complicações , Criança , Pré-Escolar , Feminino , Humanos , Lactente , MasculinoRESUMO
INTRODUCCIÓN: el abandono precoz de la lactancia materna exclusiva trae complicaciones a corto y largo plazo. OBJETIVO: determinar el estado nutricional y las alteraciones lipídicas en pacientes pediátricos según la duración de la lactancia materna exclusiva. MÉTODOS: estudio descriptivo de corte transversal en 50 pacientes, de edades comprendidas entre 1 y 18 años, con diferente tiempo de duración de la lactancia materna exclusiva, pertenecientes al consultorio médico 25, del área de salud del policlínico "Carlos Manuel Portuondo", en el período comprendido desde noviembre de 2012 a noviembre de 2013. Se estudiaron las variables edad, sexo, estado nutricional, tiempo de lactancia materna exclusiva, colesterol y triglicéridos. Los datos fueron incluidos en una base de datos automatizada con la hoja de cálculo electrónica Excel 2003, y resumidos y representados en tablas estadísticas y expresados textualmente. Se utilizó la estadística descriptiva. RESULTADOS: de los 42 pacientes que abandonaron precozmente la lactancia materna exclusiva, el 81 % presentó malnutrición, y el 74 % hipertrigliceridemia. CONCLUSIONES: resulta insuficiente la promoción de la lactancia materna exclusiva, expresada por la sustitución artificial de esta a medida que el niño transcurre por los primeros 6 meses de vida.
INTRODUCTION: the early cessation of exclusive breastfeeding brings short- and long term complications. OBJECTIVE: to determine the nutritional status and lipid alterations in pediatric patients according to the duration of exclusive breastfeeding. METHODS: descriptive and cross-sectional study of 50 patients aged one to 18 years and with varied lengths of time of exclusive breastfeeding, who were seen at the doctor's office no. 25 of "Carlos Manuel Portuondo" polyclinics in the period of November 2012 through November 2013. The study variables were age, sex, nutritional status, duration of exclusive breastfeeding, and cholesterol and triglyceride levels. The collected data were introduced into a database with electronic Excel 2003 spreadsheet and summarized and shown in statistical tables and textually expressed. Summary statistics were used. RESULTS: out of 42 patients who were early weaned, 81% presented with malnutrition and 74% with hypertriglyceridemia. CONCLUSIONS: promotion of the use of exclusive breastfeeding is poor since the mother's milk is replaced in the course of the first 6 months of life of the child.
Assuntos
Humanos , Lactente , Pré-Escolar , Alimentação com Mamadeira/efeitos adversos , Alimentação com Mamadeira/métodos , Epidemiologia Descritiva , Estudos TransversaisRESUMO
OBJECTIVE: to determine the prevalence of mouth breathing and to associate the history of breastfeeding with breathing patterns in children. METHODS: this was an observational study with 252 children of both genders, aged 30 to 48 months, who participated in a dental care program for mothers and newborns. As an instrument of data collection, a semi-structured questionnaire was administered to the children's mothers assessing the form and duration of breastfeeding and the oral habits of non-nutritive sucking. To determine the breathing patterns that the children had developed, medical history and clinical examination were used. Statistical analysis was conducted to examine the effects of exposure on the primary outcome (mouth breathing), and the prevalence ratio was calculated with a 95% confidence interval. RESULTS: of the total sample, 43.1% of the children were mouth breathers, 48.4% had been breastfed exclusively until six months of age or more, and 27.4% had non-nutritive sucking habits. Statistically significant associations were found for bottle-feeding (p < 0.001) and oral habits of non-nutritive sucking (p = 0.009), with an increased likelihood of children exhibiting a predominantly oral breathing pattern. A statistically significant association was also observed between a longer duration of exclusive breastfeeding and a nasal breathing pattern presented by children. CONCLUSION: an increased duration of exclusive breastfeeding lowers the chances of children exhibiting a predominantly oral breathing pattern. .
OBJETIVO: determinar a prevalência da respiração bucal e associar o histórico de amamentação com os padrões de respiração em crianças. MÉTODOS: este foi um estudo observacional com 252 crianças de ambos os sexos, com idades entre 30-48 meses, que participaram de um programa de assistência odontológica para mães e recém-nascidos. Como um instrumento de coleta de dados, foi entregue um questionário semiestruturado para as mães das crianças com perguntas sobre a forma e a duração da amamentação e os hábitos bucais de sucção não nutritiva. Para determinar os padrões de respiração desenvolvidos nas crianças, foram utilizados o histórico médico e o exame clínico. Foi realizada uma análise estatística para determinar os efeitos de exposição no principal resultado (respiração bucal), e o índice de prevalência foi calculado com um intervalo de confiança de 95%. RESULTADOS: do total da amostra, 43,1% das crianças apresentaram respiração bucal, 48,4% foram amamentados exclusivamente até os seis meses de idade ou mais e 27,4% apresentaram hábitos de sucção não nutritiva. Foram encontradas associações estatisticamente significativas para uso de mamadeira (p < 0,001) e hábitos bucais de sucção não nutritiva (p = 0,009), com um aumento da probabilidade de as crianças apresentarem um padrão de respiração predominantemente bucal. Também foi observada uma associação estatisticamente significativa entre uma maior duração do aleitamento materno exclusivo e um padrão de respiração bucal apresentado pelas crianças. CONCLUSÃO: uma maior duração do aleitamento materno exclusivo diminui ...
Assuntos
Pré-Escolar , Feminino , Humanos , Masculino , Aleitamento Materno/métodos , Respiração , Comportamento de Sucção/fisiologia , Alimentação com Mamadeira/métodos , Estudos Transversais , Respiração Bucal/fisiopatologia , Prevalência , Inquéritos e Questionários , Fatores de TempoRESUMO
PURPOSE: To compare the swallowing performance of premature infants using a cup and a bottle during the first offer of food by mouth. METHODS: This study was carried out with preterm newborns who presented low weight at birth and no neurological illnesses, genetic syndromes or congenital malformations. The newborns were assessed by videofluoroscopy while using a cup and a bottle, when they reached a post-conceptual age of ≥34 weeks, weight ≥ 1,500 g and showed signs of readiness for oral feeding. All children were fed exclusively by gavage during the period prior to the study. RESULTS: This study included 20 preterm newborns, with average birth weight of 1,356 g and gestational age of 31.3 weeks. The majority of the bottle-fed newborns (68%) presented strong and rhythmic suction and 63% showed good sucking/swallowing/breathing coordination. The same percentage of newborns fed by cup (68%) could not perform the sipping movement and only 32% could suck a minimal amount of liquid contrast. There were no signs of laryngeal penetration and tracheal aspiration in both procedures. CONCLUSION: At the first oral feeding, preterm newborns showed better swallowing performance with a bottle in comparison to using a cup.
Assuntos
Alimentação com Mamadeira/métodos , Deglutição/fisiologia , Recém-Nascido Prematuro/fisiologia , Comportamento de Sucção/fisiologia , Aleitamento Materno , Estudos Transversais , Humanos , Recém-Nascido , RespiraçãoRESUMO
OBJECTIVE: to determine the prevalence of mouth breathing and to associate the history of breastfeeding with breathing patterns in children. METHODS: this was an observational study with 252 children of both genders, aged 30 to 48 months, who participated in a dental care program for mothers and newborns. As an instrument of data collection, a semi-structured questionnaire was administered to the children's mothers assessing the form and duration of breastfeeding and the oral habits of non-nutritive sucking. To determine the breathing patterns that the children had developed, medical history and clinical examination were used. Statistical analysis was conducted to examine the effects of exposure on the primary outcome (mouth breathing), and the prevalence ratio was calculated with a 95% confidence interval. RESULTS: of the total sample, 43.1% of the children were mouth breathers, 48.4% had been breastfed exclusively until six months of age or more, and 27.4% had non-nutritive sucking habits. Statistically significant associations were found for bottle-feeding (p<0.001) and oral habits of non-nutritive sucking (p=0.009), with an increased likelihood of children exhibiting a predominantly oral breathing pattern. A statistically significant association was also observed between a longer duration of exclusive breastfeeding and a nasal breathing pattern presented by children. CONCLUSION: an increased duration of exclusive breastfeeding lowers the chances of children exhibiting a predominantly oral breathing pattern.
Assuntos
Aleitamento Materno/métodos , Respiração , Comportamento de Sucção/fisiologia , Alimentação com Mamadeira/métodos , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Respiração Bucal/fisiopatologia , Prevalência , Inquéritos e Questionários , Fatores de TempoRESUMO
OBJECTIVE: To evaluate in-hospital formula supplementation among first-time mothers who intended to exclusively breastfeed and determined if in-hospital formula supplementation shortens breastfeeding duration after adjusting for breastfeeding intention. STUDY DESIGN: We assessed strength of breastfeeding intentions prenatally in a diverse cohort of expectant primiparae and followed infant feeding practices through day 60. Among mothers planning to exclusively breastfeed their healthy term infants for ≥1 week, we determined predictors, reasons, and characteristics of in-hospital formula supplementation, and calculated the intention-adjusted relative risk (ARR) of not fully breastfeeding days 30-60 and breastfeeding cessation by day 60 with in-hospital formula supplementation (n = 393). RESULTS: Two hundred ten (53%) infants were exclusively breastfed during the maternity stay and 183 (47%) received in-hospital formula supplementation. The most prevalent reasons mothers cited for in-hospital formula supplementation were: perceived insufficient milk supply (18%), signs of inadequate intake (16%), and poor latch or breastfeeding (14%). Prevalence of not fully breastfeeding days 30-60 was 67.8% vs. 36.7%, ARR 1.8 (95% CI, 1.4-2.3), in-hospital formula supplementation vs exclusively breastfed groups, respectively, and breastfeeding cessation by day 60 was 32.8% vs. 10.5%, ARR 2.7 (95% CI, 1.7-4.5). Odds of both adverse outcomes increased with more in-hospital formula supplementation feeds (not fully breastfeeding days 30-60, P = .003 and breastfeeding cessation, P = .011). CONCLUSIONS: Among women intending to exclusively breastfeed, in-hospital formula supplementation was associated with a nearly 2-fold greater risk of not fully breastfeeding days 30-60 and a nearly 3-fold risk of breastfeeding cessation by day 60, even after adjusting for strength of breastfeeding intentions. Strategies should be sought to avoid unnecessary in-hospital formula supplementation and to support breastfeeding when in-hospital formula supplementation is unavoidable.
Assuntos
Alimentação com Mamadeira/psicologia , Aleitamento Materno/psicologia , Cuidado do Lactente/métodos , Pacientes Internados/estatística & dados numéricos , Paridade , Adulto , Fatores Etários , Alimentação com Mamadeira/métodos , Aleitamento Materno/métodos , Estudos de Coortes , Intervalos de Confiança , Comportamento Alimentar , Feminino , Seguimentos , Humanos , Lactente , Fórmulas Infantis , Recém-Nascido , Intenção , Estudos Longitudinais , Masculino , Comportamento Materno , Razão de Chances , Cuidado Pós-Natal/métodos , Medição de Risco , Fatores de Tempo , Suspensão de TratamentoRESUMO
Purpose: To compare the swallowing performance of premature infants using a cup and a bottle during the first offer of food by mouth. Methods: This study was carried out with preterm newborns who presented low weight at birth and no neurological illnesses, genetic syndromes or congenital malformations. The newborns were assessed by videofluoroscopy while using a cup and a bottle, when they reached a post-conceptual age of ≥34 weeks, weight ≥ 1,500 g and showed signs of readiness for oral feeding. All children were fed exclusively by gavage during the period prior to the study. Results: This study included 20 preterm newborns, with average birth weight of 1,356 g and gestational age of 31.3 weeks. The majority of the bottle-fed newborns (68%) presented strong and rhythmic suction and 63% showed good sucking/swallowing/breathing coordination. The same percentage of newborns fed by cup (68%) could not perform the sipping movement and only 32% could suck a minimal amount of liquid contrast. There were no signs of laryngeal penetration and tracheal aspiration in both procedures. Conclusion: At the first oral feeding, preterm newborns showed better swallowing performance with a bottle in comparison to using a cup. .
Objetivo: Comparar o desempenho da deglutição com uso de copo e mamadeira em prematuros, na primeira oferta do alimento por via oral. Métodos: Estudo em prematuros de muito baixo peso ao nascer, sem comprometimento neurológico, síndromes genéticas ou malformações congênitas. Os recém-nascidos foram avaliados por meio da videofluoroscopia, com uso de copo e mamadeira, quando atingiram idade corrigida ≥34 semanas, peso ≥1.500 g e apresentavam indicação de iniciar alimentação por via oral. Todos receberam alimentação exclusivamente por gavagem no período prévio ao estudo. Resultados: Foram avaliados 20 prematuros, com peso médio de 1.356 g e idade gestacional ao nascimento de 31,3 semanas. Grande parte dos recém-nascidos alimentados por mamadeira (68%) apresentou sucção forte e com ritmo e 63% mostraram boa coordenação das funções sucção/deglutição/respiração. A mesma porcentagem de recém-nascidos alimentados pelo copo (68%) não realizou o movimento de sorver e apenas 32% sorveram quantidades mínimas de contraste líquido. Não foram observados sinais de penetração laríngea e aspiração traqueal em ambos os procedimentos. Conclusão: Na primeira oferta de alimento por via oral, recém-nascidos prematuros apresentaram melhor desempenho na deglutição com o uso da mamadeira em relação ao copo. .
Assuntos
Humanos , Recém-Nascido , Alimentação com Mamadeira/métodos , Deglutição/fisiologia , Recém-Nascido Prematuro/fisiologia , Comportamento de Sucção/fisiologia , Aleitamento Materno , Estudos Transversais , RespiraçãoRESUMO
OBJECTIVE: To evaluate 3 research questions: (1) Does a Women, Infants, and Children (WIC)-based counseling intervention reduce (milk) bottle use?; (2) Does this intervention reduce energy intake from bottles?; and (3) Does this intervention reduce the risk of a child being >85th percentile weight-for-length? STUDY DESIGN: Parents of n = 300 12-month-olds consuming >2 bottles/d were randomized to a bottle-weaning intervention or control group. Nutritionists at WIC Supplemental Feeding Program sites delivered the intervention. Researchers assessed dietary intake and beverage container use via computer-guided 24-hour recalls, and anthropometrics at 15, 18, 21, and 24 months old. Intent-to-treat analyses controlled for baseline measures of outcomes and months post-baseline. RESULTS: At 1 year follow-up, the intervention group had reduced use of any bottles (OR = 0.23, 95% CI = 0.08-0.61), calories from milk bottles (OR = 0.36, 95% CI = 0.18-0.74), and total calories (ß = -1.15, P = .043), but did not differ from controls in risk of overweight status (ie, >85th percentile weight-for-length (OR = 1.02, 95% CI = 0.5-2.0). The intervention group's decreased bottle usage at 15 and 18 months was paralleled by increased "sippy cup" usage. CONCLUSION: A brief intervention, during WIC routine care, reduced early childhood risk factors for overweight-bottle use and energy intake--but not risk of overweight. The intervention group's increased use of sippy cups may have attenuated an intervention effect upon risk of overweight. Toddlers consume a high proportion of their calories as liquid. Parents should be counseled about excess intake from bottles and sippy cups. WIC is an ideal setting for such interventions.
Assuntos
Alimentação com Mamadeira/efeitos adversos , Sobrepeso/etiologia , Aumento de Peso , Alimentação com Mamadeira/métodos , Feminino , Seguimentos , Humanos , Incidência , Lactente , Masculino , Sobrepeso/epidemiologia , Sobrepeso/prevenção & controle , Prognóstico , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Estados Unidos/epidemiologia , DesmameRESUMO
O crescimento facial é mais acentuado nos primeiros anos de vida, mas pode sofrer alterações extrínsecas de forma e/ou tamanho durante seu crescimento e desenvolvimento, que vão até a puberdade. O método alimentar utilizado nos primeiros anos de vida mostra-se um fator influenciador do crescimento e desenvolvimento das estruturas orofaciais, atuando por meio do exercício muscular como um direcionador do crescimento dos ossos anexos e também de funções como a respiração e deglutição. O mecanismo de sucção, realizado por músculos que podem interferir no processo de crescimento e desenvolvimento da face e nas funções de respiração e deglutição, difere em cada método de alimentação. Neste artigo são apresentados os efeitos musculares nas estruturas da face, considerando três métodos diferentes de alimentação infantil: aleitamento materno, copinho e mamadeira. As informações e dados sobre esses três métodos de alimentação dos recém-nascidos foram separados em tópicos para facilitar a comparação e compreensão de seus efeitos: reflexos, vedamento, postura da língua, movimento muscular, respiração e alterações anatômicas. (AU)
Facial growth is more pronounced in the first years of life, but there may be extrinsic alterations in form and /or size during growth and development up to puberty. The feeding method used in the first years of life proves to be an influencing factor in the orofacial structures growth and development, by means of the muscular exercises as a directing factor of the annex bones growth and also of functions such as breathing and swallowing. The suction mechanism carried out by muscles that may interfere in the growth process and development of the face and in the breathing and swallowing functions is different in each feeding method. This article shows the muscular effects in the face structures, taking into consideration three different methods of baby feeding: breastfeeding, cup and bottle. The information and data concerning these three feeding methods in newborn babies were divided into topics in order to make easier the comparison and understanding of their effects: reflection, occlusion, tongue posture, muscle movement, breathing and anatomical changes. (AU)
Assuntos
Humanos , Recém-Nascido , Lactente , Alimentação com Mamadeira/métodos , Aleitamento Materno , Desenvolvimento Maxilofacial/fisiologia , Deglutição , Dentição , Ossos Faciais/anormalidades , Má Oclusão , Mastigação , Leite Humano , Respiração Bucal , Mamadeiras , Ortodontia Corretiva , Fonação , ReflexoAssuntos
Anemia Ferropriva/etiologia , Americanos Mexicanos , Leite/efeitos adversos , Sangue Oculto , Anemia Ferropriva/etnologia , Animais , Alimentação com Mamadeira/efeitos adversos , Alimentação com Mamadeira/métodos , Feminino , Humanos , Incidência , Lactente , Masculino , Medição de Risco , Sensibilidade e Especificidade , Fatores de TempoRESUMO
OBJECTIVE: To determine the effectiveness of feeding-facilitating techniques in children with Robin sequence. SETTING: Hospital de Reabilitação de Anomalias Craniofaciais, University of São Paulo, Bauru, São Paulo, Brazil. PATIENTS: Twenty-six children less than 2 months of age with Robin sequence, whose only cause of respiratory obstruction was glossoptosis. Thirteen infants were treated by being placed in the prone position (Group 1), and 13 were treated by nasopharyngeal intubation (Group 2). INTERVENTIONS: During hospitalization, the following feeding-facilitating techniques were applied daily to all children: pacifier, massage to relax and anteriorize the tongue, long and soft bottle nipple with original or enlarged hole, global symmetric position, rhythmic movement of the nipple during suction, and insertion of the nipple on the tongue. RESULTS: During the first evaluation, Group 1 patients accepted 36.15 +/- 33.05 mL milk orally within a period of 44.62 +/- 42.94 minutes, whereas Group 2 ingested 20.00 +/- 20.51 mL milk within 30.38 +/- 25.77 minutes. A significant increase (p < .01) in the volume of ingested milk was observed for the two groups at hospital discharge after a mean treatment period of 10.7 days (Group 1: 63.46 +/- 22.58 mL and Group 2: 55.00 +/- 13.07 mL). The mean duration of feeding decreased in the two groups, with a value of 21.54 +/- 7.18 minutes for Group 1 and of 20.28 +/- 8.53 minutes for Group 2. CONCLUSION: The results showed that feeding-facilitating techniques can foster oral feeding in infants with Robin sequence.
Assuntos
Alimentação com Mamadeira/métodos , Síndrome de Pierre Robin/reabilitação , Obstrução das Vias Respiratórias/prevenção & controle , Alimentação com Mamadeira/instrumentação , Deglutição/fisiologia , Desenho de Equipamento , Humanos , Lactente , Comportamento do Lactente/fisiologia , Alimentos Infantis , Intubação Intratraqueal , Mandíbula/anatomia & histologia , Massagem , Chupetas , Decúbito Ventral , Comportamento de Sucção/fisiologia , Língua/anatomia & histologia , Hábitos LinguaisRESUMO
The impact of cup-feeding or bottle-feeding on weight gain, oxygen saturation, and breastfeeding rates of preterm infants was studied in 34 bottle-fed and 44 cup-fed preterm infants. At initiation of oral feeding, postconceptional age and weight were 37.2 +/- 2.2 weeks and 1676 +/- 83 g for the bottle-fed group (BF) and 37.0 +/- 1.6 weeks and 1637 +/- 40 g for the cup-fed (CF) group, respectively. No significant differences between groups were found with regard to time spent feeding, feeding problems, weight gain, or breastfeeding prevalence at discharge or at 3-month follow-up. Possible beneficial effects of cup-feeding were lower incidence of desaturation episodes (13.6% vs 35.3%, CF vs BF, P = .024) and a higher prevalence of breastfeeding at 3 months among those still breastfeeding at the first follow-up visit (68.4% vs 33.3%, CF vs BF, P = .04).
Assuntos
Aleitamento Materno , Métodos de Alimentação , Recém-Nascido Prematuro/metabolismo , Oxigênio/sangue , Alimentação com Mamadeira/métodos , Utensílios de Alimentação e Culinária , Comportamento Alimentar , Feminino , Humanos , Lactente , Alimentos Infantis , Recém-Nascido , Recém-Nascido Prematuro/crescimento & desenvolvimento , Masculino , Aumento de PesoRESUMO
OBJECTIVES: Although introducing freely flowing formula into the infant's mouth is a common feeding practice, its effect on feeding behavior is largely unknown. We evaluated the effects of free flow of formula from the nipple on infant feeding activity (sucking, swallowing, ingestion rate) and documented potential adverse behaviors such as cough, restless behavior, drooling, apnea, and bradycardia. METHODS: We studied 13 preterm and 7 term infants. During a feeding, bottle pressure was adjusted every 2 to 3 minutes to increase or decrease free flow from the nipple. RESULTS: Increase in free flow of formula from the nipple caused rapid increases in suck and swallow frequency in term and preterm infants and increased ingestion rate. The response was reversed by decreasing flow and was repeatable throughout the feeding. Peak suck and swallow rates were highest in term infants. Although drooling increased with increased milk flow, no effect of flow on coughing, restless behavior, or apnea was observed. CONCLUSIONS: Free-flow formula is a potent stimulus for feeding activity in both preterm and term infants and is not associated with increased apnea or other adverse behaviors. The ability of the infant to divert excess formula flow by drooling is an efficient airway protective behavior. Reduced maximum suck and swallow frequency may be a primary basis for slow feeding in preterm infants.
Assuntos
Alimentação com Mamadeira/métodos , Recém-Nascido/psicologia , Recém-Nascido Prematuro/psicologia , Comportamento de Sucção , Deglutição , Comportamento Alimentar , Humanos , Comportamento do Lactente , PressãoRESUMO
The authors present five cases of large palatine ulcers of a traumatic nature in infants, with duration from two weeks to four months. Causal diagnosis was difficult at first until the possibility of trauma caused by non-orthodontic nipples (all cases) and dummies (4)--Bednar's aphthae--was considered. Other problems related to sucking were observed: a horizontal position for nursing (all) and very narrow nipple hole (4). The infants' mothers were advised to enlarge the orifice in the nipple and correct the position for nursing (3 cases) and, in addition, to suspend use of a dummy (1 case) and discontinue use of a bottle and dummy (1 case). All of the ulcers healed within a period from one to four weeks. Small scars remained in two of the children.
Assuntos
Alimentação com Mamadeira/efeitos adversos , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/etiologia , Alimentação com Mamadeira/métodos , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Palato , Prognóstico , Estomatite Aftosa/terapia , Ferimentos e LesõesRESUMO
OBJECTIVE: To determine whether bottle feeding with the infant in the supine position is related to entry of milk into the middle ear, thereby predisposing the infant to otitis media. STUDY DESIGN: Ninety children, aged 7 to 24 months, who were free of respiratory infection and had normal tympanograms initially, were bottle fed in either the supine or the semiupright position, and tympanography was repeated immediately afterward. RESULTS: Thirty-four (59.6%) of the 57 infants fed in the supine position had abnormal postfeeding tympanographic results compared with only five (15%) of the 33 infants fed in the semiupright position (p < 0.005). In addition, when the infants with abnormal tympanograms were placed in semiupright or prone positions for 15 minutes after feeding, the majority of tympanograms returned to normal. CONCLUSION: These data suggest that supine bottle feeding has a significant effect on middle-ear pressure dynamics, probably caused by the aspiration of milk into the ear. The results also suggest that repositioning infants after feeding may mitigate the effects of supine feeding, at least in healthy children. Although this study did not demonstrate that tympanographic abnormality definitely predisposes to otitis media, it provides more evidence to encourage the practice of feeding infants in a semiupright position.
Assuntos
Testes de Impedância Acústica , Alimentação com Mamadeira/métodos , Postura/fisiologia , Alimentação com Mamadeira/efeitos adversos , Pré-Escolar , Humanos , Lactente , Otite Média/etiologiaRESUMO
The species-specific advantages and significant nutritional and health benefits of breast-feeding are widely acknowledged. Less recognized are the advantages of the process of breast-feeding itself. Adherence to the natural mechanics of breast-feeding will preclude many of the problems associated with improper bottle feeding. For example, the semiupright position of the infant during breast-feeding helps eliminate the entry of milk into the middle ear and reduces choking and regurgitation. The action of suckling during breast-feeding minimizes the intake of air. In addition, the direct eye contact that is natural to breast-feeding fosters bonding, and the close body contact promotes a sense of security in the child. These advantages, so natural to breast-feeding, are likely to be absent from bottle feeding unless some of the natural techniques associated with breast-feeding are adopted. This article describes various aspects of the breast-feeding process with the goal of urging practitioners to instruct patients to transfer these techniques to bottle feeding. In so doing, clinicians may help their patients avoid the hazards of improper bottle feeding.
Assuntos
Alimentação com Mamadeira/métodos , Aleitamento Materno , Pediatria , Papel do Médico , Feminino , Humanos , Lactente , Recém-Nascido , Mães/educação , Apego ao Objeto , Postura/fisiologia , Reflexo/fisiologia , Comportamento de Sucção/fisiologiaRESUMO
OBJECTIVE: To determine whether an angled-bottle feeding system is more effective than a straight-bottle feeding system in facilitating the medically recommended semiupright infant posture and to determine whether an angled bottle promotes improved ergonomic alignment and comfort for the feeder. STUDY DESIGN: On two consecutive days, 23 pairs of parent-infant teams, seated in an ergonomic chair, were videotaped at the same time of day, during which infants were fed by their parents with either an angled or a straight bottle (presented in balanced order) fitted with the infants' regular nipple. Infants were given their regular type and amount of formula. RESULTS: The angled bottle provided a higher level of satisfaction compared with the straight bottle. Less gastric discomfort occurred with the angled bottle versus the straight bottle when each was compared with the bottle used at home. In addition, feeders assumed ergonomically sound positions. CONCLUSION: This study indicates that an angled bottle is preferable to a straight bottle because it encourages more physiologic positioning of the infant, improves the comfort level of the feeder, improves ergonomic feeding performance, and decreases the need for burping.