The importance of breast-feeding has been addressed through multi-professional approaches. As healthcare practitioners, dentists are included in this context and - due to the close links between breast-feeding and the development of the stomatognathic system - should be able to advise pregnant women and new mothers on this practice, with countless benefits for mothers and their babies. This paper thus presents up-to-date and enlightened information through a review of the literature that supports the benefits of breast-feeding, urging heightened awareness of its importance and the preparation of policies and actions implemented through Brazil's National Health System (SUS) that rank breast-feeding as a high-priority goal.

/pdf/breast-feeding-as-a-source-of-prevention-in-healthcare-2vbcotflwj.pdf

[Breast-feeding as a source of prevention in healthcare]

Objetivo: Revisar os estudos de prevalencia de anemia no Brasil publicados entre janeiro de 1996 e janeiro de 2007. Fontes de dados: Por meio de revisao sistematica nas bases de dados eletronicas Medline e Lilacs, foram selecionados titulos cientificos publicados no intervalo de onze anos referentes a prevalencia de anemia no Brasil em criancas menores de cinco anos de idade. Foram excluidos artigos de revisao, relatos de caso e trabalhos que relacionaram anemia a outras doencas e ao periodo gestacional. Para a analise comparativa das variaveis categoricas de interesse nos artigos encontrados, realizou-se o teste do qui-quadrado e o teste exato de Fisher, levando-se em conta o nivel de significância estatistica de 5% ( p<0,05). Sintese dos dados: Os dados medianos encontrados para a prevalencia de anemia foram de 53%, confirmando valores estimados pela Organizacao Mundial da Saude e considerados elevados. Nos 53 artigos analisados, a variavel que se associou de forma significante a anemia foi a idade da crianca (p=0,012). Conclusoes: Os estudos mostram alta prevalencia de anemia, principalmente em criancas menores de dois anos. No entanto, os trabalhos foram realizados em creches, visitas domiciliares e Unidades Basicas de Saude, indicando a necessidade de pesquisas com amostras de base populacional.

https://bvsms.saude.gov.br/bvs/is_digital/is_0209/pdfs/IS29(2)033.pdf

Prevalência de anemia ferropriva no Brasil: uma revisão sistemática

OBJECTIVE: The objective of this study was to use statistical modeling to identify risk factors for anemia in children aged 6 to 59 months in the state of Pernambuco, covering socioeconomic and dietary aspects. METHODS: The sample comprised 746 children aged between 6 and 59 months from the state of Pernambuco. Their hemoglobin was assayed and a 24-hour dietary recall performed. Risk of anemia was analyzed with relation to socioeconomic variables and to dietary intakes, using multivariate analysis models. RESULTS: The risk factors for anemia were: a high proportion of calories from cow's milk, low density of nonheme iron, low age and low maternal educational level; age was the most prominent factor, with children under 24 months exhibiting 3.61 times greater risk of being anemic than the older children. CONCLUSIONS: This study confirms the need for a clear picture of the dietary intake of children in Brazil, in order that associations with anemia can be better understood. Our results revealed that the dietary factors which were most responsible for risk of anemia were a greater proportion of calories from cow's milk and lower density of nonheme iron, in addition to age below 24 months and low maternal educational level.

http://www.scielo.br/pdf/jped/v83n1/en_v83n1a08.pdf

Socioeconomic and dietary risk factors for anemia in children aged 6 to 59 months.

The article presents prevalence rates for malnutrition, intestinal parasitic infections, anemia, and iron deficiency in under-five children in a population-based cross-sectional survey performed in the urban area of two counties in the Western Brazilian Amazon, Assis Brasil (n = 200) and Acrelandia (n = 477). Available data included: (a) weight and height measurements, standardized as z-scores using the 1977 NCHS reference population, (b) diagnosis of current intestinal parasitic infection, (c) blood hemoglobin levels, and (d) plasma ferritin and soluble transferrin receptor levels. Overall prevalence rates of low weight-for-height, low weight-for-age, and low height-for-age were 3.7%, 8.7%, and 7.5%, respectively, with similar figures in the two towns. Intestinal parasites were detected in 32.5% children; helminths were uncommon. Anemia and iron deficiency were diagnosed in 30.6% and 43.5% of the children, respectively. Evidence of anemia was found in only 47.6% of the children with depleted iron reserves, indicating that hemoglobin measurement alone would severely underestimate the magnitude of iron deficiency in this population. In both towns, anemia and malnutrition were significantly more prevalent among children in the lowest socioeconomic stratum.

/pdf/child-health-and-nutrition-in-the-western-brazilian-amazon-5d2i9abjef.pdf

Child health and nutrition in the Western Brazilian Amazon: population-based surveys in two counties in Acre State

OBJECTIVE: To identify the feeding practices of children aged 6 to 12 months of age and associated maternal factors. METHODS: This was a cross-sectional study analyzing data from the 2004 Breastfeeding and the Municipalities Project, which was implemented in 136 municipalities in the state of Sao Paulo, Brazil, with 24,448 children. The foods these children ate were profiled according to the number of children who had been given breastmilk and/or other foods during the previous 24 hours, and based on this data the probability of consumption of each food at each age was estimated by means of probit analysis. RESULTS: It was observed that 50% of the sample were being given breastmilk, 77% other types of milk, 63% porridge, 87% fruit, 78% soups, 64% the family meal, 58% meals including beans and 36% soup or meals containing meat. The probability of a 6-month-old child being given soup is elevated (78%), while for the family meal it is low (39%), and the probability of being fed breastmilk is 59%, lower than for other milks (70%) and than for porridge (63%). Associations were observed between milk-based meals and primiparous mothers, mothers employed outside the home and mothers who had spent longer in education. Similar findings were observed for soups, added to maternal age of more than 20 years. The family meal was associated with mothers under 20 years old, mothers who were not employed outside the home, mothers with fewer years' education and multiparous mothers. CONCLUSIONS: Excessive consumption was observed of liquid and semi-solid foods, suggesting that appropriate guidance on complementary feeding is needed, taking into account age, primiparity, education and employed mothers.

http://www.scielo.br/pdf/jped/v83n1/en_v83n1a10.pdf

Feeding habits of children aged 6 to 12 months and associated maternal factors

INTRODUCAO: Resultados de varios estudos permitem levantar a hipotese de que a existencia de anemia no primeiro ano de vida tenha como causa, entre outras, o desmame precoce. O objetivo do presente estudo foi verificar a prevalencia da anemia e sua relacao com o tempo de aleitamento materno, em criancas de ate um ano de idade. MATERIAL E METODO: Estudou-se uma amostra de 317 criancas a partir da demanda de quatro Centros de Saude Escola do Municipio de Sao Paulo, SP, Brasil. As informacoes sobre alimentacao foram obtidas em entrevista com as maes. A presenca de anemia foi verificada pela concentracao de hemoglobina, usando-se o metodo da cianometa-hemoglobina e o criterio recomendado pela Organizacao Mundial de Saude (OMS) para seu diagnostico. Para determinar a duracao do aleitamento materno exclusivo utilizou-se a tecnica da tabua de vida para dados censurados. RESULTADOS: Verificou-se a prevalencia de anemia de 14,5% entre toda a populacao e 22,6% entre as criancas maiores de 180 dias. Nao foi encontrada associacao entre anemia e duracao do aleitamento materno exclusivo, cujo tempo mediano foi o mesmo para anemicos e nao anemicos. COMENTARIOS: O resultado verificado deve-se, provavelmente, as caracteristicas da populacao estudada e nao invalida a importância do aleitamento materno exclusivo na prevencao da anemia.

/pdf/anemia-no-primeiro-ano-de-vida-em-relacao-ao-aleitamento-pfnlzb6393.pdf

Anemia no primeiro ano de vida em relação ao aleitamento materno

O objetivo do estudo foi conhecer a pratica alimentar em criancas de 0 a 12 meses de idade que frequentam quatro Centros de Saude Escola do Municipio de Sao Paulo. Estudou-se uma amostra de 317 criancas a partir da demanda dos Centros. As informacoes sobre alimentacao foram obtidas em entrevista com as maes. Entre as criancas com idades ate 3 meses, 42,2% estavam em aleitamento materno exclusivo, e entre aquelas com idades de 3 a 6 meses a prevalencia do aleitamento materno exclusivo foi de 14,8%. Para as criancas que nao estavam em aleitamento materno exclusivo, verificou-se a introducao de outros tipos de leite, bem como de alimentos nao lacteos no esquema alimentar infantil. Para as que ja consumiam alimentos nao lacteos, levantou-se a frequencia de consumo de alimentos que fornecem, principalmente, ferro e vitamina C, nutrientes encontrados em quantidades insuficientes no leite. Nesse grupo verificou-se que 98,9% das criancas consumiam frutas e 72,4% consumiam carne. O feijao foi referido para 39,6% das criancas. A introducao de outros tipos de leite, bem como de alimentos nao lacteos no esquema alimentar infantil ocorreu precocemente na amostra estudada.

/pdf/pratica-alimentar-no-primeiro-ano-de-vida-em-criancas-2ob1unm78m.pdf

Prática alimentar no primeiro ano de vida, em crianças atendidas em centros de saúde escola do município de São Paulo

Objectives: to determine daily weight and lenghtgain plus anthropometric rates increment with breastfeeding regime in children up to six months of age. Methods: cross-cutting study conducted in theHealthcare Clinics of 12 cities in the five regions ofBrazil using a sample of 3172 children. Variableswere: anthropometric rates (weight for age, weightfor height, height for age), birth weight, birth length,current length, velocity of average daily increment ofweight and length; regimes of exclusive and predomi-nant breast feeding and the use of formulas. Results: it was found a positive association ofvelocity in weight and height gains and of anthropo-metric rates in children fed in an exclusive andpredominant breastfeeding regime in the first monthsof life, adjusted with factors such as age, weight andlength at birth, gender and mother's education level. Conclusions: breast feeding regime, particularlyin the first months has a positive impact in adequategrowth together with factors such as mothers' educa-tion level in the group of children over five years oldand weight at birth.

https://www.scielo.br/pdf/rbsmi/v5n1/a14v05n1.pdf

Crescimento de crianças até seis meses de idade, segundo categorias de aleitamento

Este estudo foi desenvolvido com o objetivo de descrever a evolucao da concentracao de hemoglobina [Hb], considerando os fatores: peso ao nascer; velocidade relativa de crescimento e alimentacao. E um estudo transversal realizado com criancas no primeiro ano de vida, atendidas para acompanhamento do crescimento e do desenvolvimento em servicos publicos de saude, em cidades localizadas nas cinco regioes geograficas brasileiras. Verificou-se que 51,7% das criancas entre 6 e 12 meses de idade eram anemicas. A estimativa da Hb, por meio de uma equacao teorica, sugeriu que o ferro endogeno permite manter os niveis normais de Hb no primeiro trimestre de vida. A prevalencia de baixa Hb foi maior entre as criancas com baixo peso ao nascer. A velocidade relativa de crescimento, avaliada pela diferenca do peso atual e peso ao nascer, em unidades de Z escore, nao foi fator de relevância para a Hb. A importância do aleitamento materno foi evidente nos primeiros meses de vida. Verificou-se, entretanto, que os alimentos complementares nao influenciaram a Hb. A elevada prevalencia de niveis baixos de hemoglobina indica a necessidade de enfatizar programas de intervencao para o controle da anemia ferropriva.

/pdf/concentracao-de-hemoglobina-em-criancas-do-nascimento-ate-um-5ch16hd8qf.pdf

Sonia Buongermino de Souza

Papers

Anemia no primeiro ano de vida em relação ao aleitamento materno

Prática alimentar no primeiro ano de vida, em crianças atendidas em centros de saúde escola do município de São Paulo

Crescimento de crianças até seis meses de idade, segundo categorias de aleitamento

Concentração de hemoglobina em crianças do nascimento até um ano de vida