Claudia Choma Bettega Almeida

Fatores associados ao aleitamento materno exclusivo em Guarapuava, Paraná

OBJECTIVE: This research investigated the prevalence of exclusive breastfeeding at the age of six months and its association with socioeconomic, demographic, environmental, biological and morbidity characteristics. METHODS: A cross-sectional study was done with a sample of 426 children from Guarapuava, PR, aged 0 to 23.9 months seen by the Family Health Program. Pre-coded questionnaires were administered during home interviews to investigate breastfeeding-associated factors. RESULTS: The median of exclusive breastfeeding at six months was 60 days and the prevalence was 12.9%. Exclusive breastfeeding at six months was significantly associated (p<0.05) with the mothers employment status and with breastfeeding continuing until the occasion of the interview. CONCLUSION: The results indicate low prevalences of exclusive breastfeeding and the need of more effective actions to support working mothers, since it is harder for them to continue exclusive breastfeeding once they go back to work.

Segurança alimentar e nutricional de crianças menores de dois anos de famílias de trabalhadores rurais Sem Terra

To date little is known of health, nutrition and food safety conditions of children living in rural camps and settlements. The present cross-sectional descriptive study seeks to present and discuss such conditions for children under two years of age in families of landless rural workers in the Central Western region of the State of Parana. The study was conducted with a total of 337 children under two years of age in families living in two rural settlements and two rural camps. The main variables related with protein-energy malnutrition were assessed. Results indicated that the prevalence of protein-energy malnutrition was 4.7% in settlements and 10% in camps. Home location, home type and the possibility of producing food for private consumption were the distal variables that influenced most the nutritional status of the pediatric population analyzed. This study established that the search for nutritional and food safety must consider the right of accessing resources and proper means to produce safe and healthy foods in order to enable adequate feeding compatible with the habits and practices of the region.

Bolsa Família: insegurança alimentar e nutricional de crianças menores de cinco anos

This is a descriptive cross-sectional study of the population base conducted in the town of Colombo in the state of Parana. The objectives were to identify the prevalence of food insecurity in families that are beneficiaries of the Bolsa Familia Program and the factors related to this condition, and describe the nutritional status of children under five years of age. Analyses of association were performed using Fishers exact test. The sample included 442 families, of which 168 have children under five years of age. The Brazilian Food Insecurity Scale was applied to evaluate food insecurity and the nutritional status of the 199 children evaluated was determined by the height-for-age, weight-for-age and body mass-for-age indices in accordance with the WHO reference values for 2006. The prevalence of food insecurity was 81.6%. Overweight and stunting among children coexisted. Food insecurity was found to be associated with the height-for-age index among children under two years of age. The per capita income and food deficits influenced the situation of food insecurity significantly.

Prevalence and risk factors of anemia in children

OBJECTIVE To identify the prevalence and factors associated with anemia in children attending Municipal Early Childhood Education Day Care Center (Centros Municipais de Educação Infantil [CMEI]) nurseries in Colombo-PR. METHODS Analytical, cross-sectional study with a representative sample of 334 children obtained by stratified cluster sampling, with random selection of 26 nurseries. Data collection was conducted through interviews with parents, assessment of iron intake by direct food weighing, and hemoglobin measurement using the finger-stick test. Bivariate association tests were performed followed by multiple logistic regression adjustment. RESULTS The prevalence of anemia was 34.7%. Factors associated with anemia were: maternal age younger than 28 years old (p=0.03), male children (p=0.02), children younger than 24 months (p=0.01), and children who did not consume iron food sources (meat+beans+dark green leafy vegetables) (p=0.02). There was no association between anemia and iron food intake in CMEI. However, iron intake was well below the recommended levels according to the National Education Development Fund resolution, higher prevalence of anemia was observed in children whose intake of iron, heme iron, and nonheme iron was below the median. CONCLUSIONS In terms of public health, the prevalence of anemia is characterized as a moderate problem in the studied population and demonstrates the need for coordination of interdisciplinary actions for its reduction in CMEI nurseries.

Consumo alimentar de crianças de 12 a 30 meses que frequentam Centros Municipais de Educação Infantil no município de Colombo, Sul do Brasil

Objetivo:Analisar o consumo alimentar de criancas de 12 a 30 meses que frequentam Centros Municipais de Educacao Infantil.Metodos:Estudo transversal realizado com 86 criancas dos Centros Municipais de Educacao Infantil do municipio de Colombo, Parana. O consumo alimentar nas creches foi avaliado pelo metodo da pesagem direta individual dos alimentos em dois dias nao consecutivos e, no domicilio, utilizando-se o recordatorio alimentar de 24 horas. Foram analisadas as medianas e o risco de inadequacao de energia e de nutrientes de acordo com as Ingestoes Dieteticas de Referencia e as recomendacoes do Programa Nacional de Alimentacao Escolar.Resultados:A maioria dos nutrientes apresentou ingestao mediana diaria acima dos valores recomendados pelas Ingestoes Dieteticas de Referencia; o calcio apresentou o maior risco de inadequacao entre os nutrientes; 43% das criancas mostraram elevada ingestao energetica e o lipideo apresentou valor abaixo do aceitavel. O consumo nas creches foi inferior as recomendacoes do Programa Nacional de Alimentacao Escolar para energia, carboidrato, lipideo, calcio, ferro e fibras. A contribuicao da ingestao de energia e lipideo no domicilio foi superior a 50% em relacao a ingestao diaria.Conclusao:Os valores medianos dos nutrientes, geralmente acima das recomendacoes, associados aos riscos de inadequacao de alguns micronutrientes e ao elevado consumo energetico, evidenciam a importância de adequar o consumo alimentar e promover habitos alimentares saudaveis nas criancas.

Maternidade e amamentação: identidade, corpo e gênero

Resumo A amamentacao e um fenomeno multifacetado que envolve a complexidade do mundo social, os papeis assumidos pela mulher, seus atributos e expectativas sociais. Este ensaio teorico propoe uma reflexao em torno da maternidade, problematizando a experiencia da amamentacao e a construcao de identidade se aproximando de conceitos sociologicos do interacionismo de Anselm Levi Strauss. Procurou-se fazer associacoes entre o corpo, a identidade e os processos de socializacao na vida adulta gerados pelas novas demandas sociais na realizacao de papeis de mulher e mae, concentrando-se na experiencia da amamentacao. Problematiza-se a forma como a maternidade e concebida na sociedade contemporânea e a inscricao da amamentacao como fenomeno da natureza, de tal forma que se confere a mulher uma vocacao a maternidade e ao aleitamento, produzindo-se uma expectativa social de habilidade nata para o desempenho dos mesmos.Breastfeeding is a multifaceted phenomenon involving the complexity of the social world, the roles assumed by women, their attributes and social expectations. This theoretical essay proposes a reflection on motherhood, problematizing the experience of breastfeeding and the construction of social identity in line with Anselm Levi Strausss sociological concepts of interactionism. This article sought to make associations between body, identity, and socialization processes in adulthood, generated by new social demands in fulfilling the roles of woman and mother, focusing on the breastfeeding experience. The way motherhood is conceived in contemporary society and the register of breastfeeding as a phenomenon of nature are problematized to give the woman a vocation to motherhood and breastfeeding, producing a social expectation of the innate ability to perform them.

Professional practice of dietitians in the Brazilian School Feeding Program: A multiple case study

Objetivo: Verificar a adequacao dos parâmetros numericos de nutricionistas na alimentacao escolar e discutir limites e possibilidades da atuacao profissional no Programa de Alimentacao Escolar em municipios do Vale do Ivai, Norte do Parana. Metodos: Estudo de casos multiplos realizado por meio de entrevista semiestruturada com nutricionistas da alimentacao escolar de nove municipios do Vale do Ivai. A Resolucao no 465/2010, do Conselho Federal de Nutricionistas, foi utilizada como base para calculo da adequacao da carga horaria do nutricionista. A legislacao do Programa Nacional de Alimentacao Escolar foi utilizada para discussao da atuacao profissional. Resultados: Os municipios contavam com nutricionista responsavel tecnico pelo Programa de Alimentacao Escolar, porem, o percentual de adequacao da carga horaria variou de 20 a 66%. Foram evidenciadas atividades de gestao, licitacao e contabilidade, alem das atribuicoes do nutricionista previstas para o Programa. A maioria dos nutri-cionistas tambem atendia a outras areas dos municipios, como saude, social e eventos, o que sugere um comprometimento das atribuicoes do profissional e, consequentemente, da execucao do Programa. Conclusao: O numero de nutricionistas no Programa Nacional de Alimentacao Escolar nos municipios investigados e insuficiente em relacao ao numero de alunos. A carga horaria insuficiente e a demanda excessiva de atividades podem impedir que o desenvolvimento de atividades privativas do nutricionista. A contratacao de tecnicos em nutricao e dietetica e auxiliares administrativos para tarefas burocraticas deve ser incitada.

Consumption of processed foods among children under two years of age: Foods’ pattern analysis

Objective: To evaluate the consumption of processed foods and their association with socioeconomic, demographic and environmental characteristics. Design: Cross-sectional study. Setting: Through home interviews a pre-coded questionnaire was applied, containing data relating to food consumption and socioeconomic, demographic and environmental characteristics. Subjects: Children (n=376) between six months and two years old assisted by the Family Health Program in Guarapuava, Paraná Brazil. Results: Of the 15 industrialized foods eaten more often, 8 were correlated together: artificial juice powder, soda, candy, lollipop, potato chips, margarine, refined sugar and bologna. It was found that this group of food is consumed, on average, 10 days per month. The factors that were significantly associated with increased consumption of these foods were: maternal age under 25 years, maternal education less than eight years, more than 4 people in the household, presence of other children in the household and household income per capita between 0.5 and 1 minimum wage. Conclusions: It is evident that the early introduction of processed foods among young children is influenced by socio-economic, demographic and environmental factors.