Acolhimento e características maternas associados à oferta de líquidos a lactentes

Prevalence and factors associated with tea consumption in the first month of life in a birth cohort in the Northeast Region of Brazil

Abstract Objectives: to determine the prevalence and analyze the factors associated with newborns drinking tea in a birth cohort. Methods: A cross-sectional study with nested prospective cohort was conduct with 329 puerperal women and their newborns in Vitória da Conquista, Bahia. Sociodemographic and information about the newborn's diet and mothers/babies was obtained at a maternity and 30 days after birth, at home visits. The prevalence ratios (PR) and its respective confidence intervals (CI95%) were estimated with Poisson regression models according to the hierarchical conceptual model. Results: the prevalence of tea consumption up to 30 days of life was 34.6% (CI95%=29.7; 40.0%). The sociodemographic and maternal characteristics associated with the outcome were not having a partner (PR = 1.39; CI95%=1.03-1.88), more than eight years of schooling (PR=1.38; CI95%=1.03-1.84), lower income (PR=2.21; CI95%=1.31-3.73), primiparous (PR=1.48; CI95%=1.01-2.17) and does not have any experience with breastfeeding before (PR=2.25; CI95%=1.48-3.41). As for the child, there was a higher prevalence of tea consumption than among those who received artificial milk in the first month of life (PR= 2.10; CI95%=1.62-2.73). Conclusions: the offer of tea in the first month of life was high. Tea consumption was positively associated with sociodemographic, maternal and newborn feeding factors.

Impact of Intimate Partner Violence on Primary Health Care Use for Children: Evidences from Rio de Janeiro, Brazil

Objectives To assess whether severe physical intimate partner violence (PIPV) after childbirth affects the number of pediatric visits in Primary Health Care (PHC) units during this period. Methods Cross-sectional study including 927 mothers of infants under 6 months, users of 27 PHC units in Rio de Janeiro, Brazil. PIPV from childbirth to the date of interview was measured using the Revised Conflict Tactics Scales (CTS2). The number of pediatric visits in the first 6 months of life was the outcome measure of interest. Poisson and multinomial regression models were used for data analysis to control for confounders. Results Children of mothers who experienced severe PIPV had a reduced number of pediatric visits than those not reporting it. This finding was identified only among children who had health problems: relative to five or more baseline pediatric visits, the chance of 3-4 and 1-2 visits increased three- and five-fold, respectively, when severe PIPV was present. Conclusions The maternal experience of severe PIPV reduces the number of pediatric visits in PHC services among the most vulnerable children. This is a hindrance to adequate health promotion, prevention and care, required for the healthy growth and development of children. Early violence detection by pediatricians and other health professionals could be a step in the right direction.

Use of a monitoring tool for growth and development in Brazilian children – systematic review

Objective:

To assess the use of a health monitoring tool in Brazilian children, with emphasis on the variables related to growth and development, which are crucial aspects of child health care.

Data source:

A systematic review of the literature was carried out in studies performed in Brazil, using the Cochrane Brazil, Lilacs, SciELO and Medline databases. The descriptors and keywords used were “growth and development”, “child development”, “child health record”, “child health handbook”, “health record and child” and “child handbook”, as well as the equivalent terms in Portuguese. Studies were screened by title and summary and those considered eligible were read in full.

Data synthesis:

Sixty-eight articles were identified and eight articles were included in the review, as they carried out a quantitative analysis of the filling out of information. Five studies assessed the completion of the Child's Health Record and three of the Child's Health Handbook. All articles concluded that the information was not properly recorded. Growth monitoring charts were rarely filled out, reaching 96.3% in the case of weight for age. The use of the BMI chart was not reported, despite the growing rates of childhood obesity. Only two studies reported the completion of development milestones and, in these, the milestones were recorded in approximately 20% of the verified tools.

Conclusions:

The results of the assessed articles disclosed underutilization of the tool and reflect low awareness by health professionals regarding the recording of information in the child's health monitoring document.

Exclusive breastfeeding practices reported by mothers and the introduction of additional liquids

AIM

To assess the concept of exclusive breastfeeding held by nursing women by comparing the period they consider that they perform it and the infants' age at the introduction of additional liquids.

METHOD

Cross-sectional descriptive study conducted with 309 women who delivered babies at a university hospital in the interior of São Paulo, Brazil. The data were subjected to descriptive analysis; the variables of interest were crossed using the non-parametric Kruskal-Wallis test, the chi-square test and Fisher's exact test.

RESULTS

Approximately 30% of the women reported having introduced additional liquids before the infants reached aged six months old, while asserting that they were performing exclusive breastfeeding. The following variables were associated with early introduction of liquids: lack of employment (p = 0.0386), younger maternal age (p = 0.0159) and first pregnancy (p = 0.003).

CONCLUSION

The concept of exclusive breastfeeding might not be fully clear to women, as they seem to believe that it means not to feed the children other types of milk but that giving other liquids is allowed. These results show that promotion of breastfeeding should take beliefs and values into consideration to achieve effective dialogue and understanding with mothers.