Claudia Nery Teixeira Palombo

Brazilian Maternal Weight Perception and Satisfaction With Toddler Body Size: A Study in Primary Health Care.

UNLABELLED Maternal perception and satisfaction with childs weight status are important to detect early and to successfully treat the extremes in weight, especially during early childhood, when the child is more dependent on maternal care. OBJECTIVES To assess the inaccuracy of maternal perception of toddler body size and its associated factors and to analyze maternal dissatisfaction with toddler body size. METHODS Cross-sectional study with 135 mother-toddler dyads attending Primary Health Care Facilities, São Paulo, Brazil. Childrens actual weight status was classified using body mass index-for-age. Inaccuracy and dissatisfaction were assessed using an image scale. We used logistic regression to identify the factors associated with inaccuracy of maternal perception of toddler body size. RESULTS Inaccuracy in maternal perception was observed in 34.8% of participants. Mothers of excessive weight children were more likely to have inaccurate perceptions (OR=4.6; 95% CI 2.0-10.7), and mothers of children who attended well-child care were less likely to have inaccurate perceptions (OR=0.3, 95% CI 0.1-0.9). More than half of mothers (52.6%) were dissatisfied with their toddlers size and desired a larger child (75.0% of mothers of underweight children, 25.0% of mothers whose children were at risk for overweight and 23.0% of mothers of overweight children). CONCLUSION The majority of mothers were inaccurate in their perception and was dissatisfied with their toddlers body size. Maternal inaccuracy and dissatisfaction differed by the weight status of the toddler. Attendance at well-child visits was an effective way to decrease maternal inaccuracy, which reinforces the importance of the influence of health professionals.

Uso e preenchimento da caderneta de saúde da criança com foco no crescimento e desenvolvimento

Objetivo Evaluar el uso y llenado de la Libreta de Salud Infantil (LSI), especialmente el crecimiento y el desarrollo. Metodo Estudio transversal con 358 pares de madres e hijos matriculados en 12 Unidades Basicas de Salud (UBS) de una ciudad pequena. Las madres fueron entrevistadas en el UBS desde febrero a abril 2013 mediante un cuestionario. Se utilizo Epi-info y software SPSS. Resultados 53% de las madres estaban llevando LSI durante la entrevista, proporcion similar a las madres que recibieron instrucciones para llevar el LSI a la atencion de la salud. Anotaciones en LSI durante las visitas se registraron en un 49%. Calendario de vacunas fue completa en el 97% de LSI, pero solo el 9% y el 8% de LSI tenido, respectivamente, las curvas de crecimiento y desarrollos debidamente cumplimentados. Conclusion El uso y el relleno satisfactorio de LSI refuerzan la necesidad de inversion en la formacion profesional y el acercamiento a la comunidad para la LSI se convierte efectivamente en un instrumento de promocion de la salud infantil.Objective To evaluate the use and records of the Child Health Handbook (CHH), especially growth and development. Method Cross-sectional study with 358 mother-child pairs registered in 12 Primary Health Centers (PHCs) of a small municipality. Mothers were interviewed at the PHC from February to April 2013 using a questionnaire. Data analysis was done using WHO Anthro software, Epi InfoTM and Stata. Results Fifty-three percent of the mothers were carrying the CHH at the time of the interview, similar to the proportion of mothers who were instructed to bring the CHH to health appointments. Annotations in the CHH during the visits were reported by 49%. The vaccination schedule was completed in 97% of the CHH, but only 9% and 8% of the CHH, respectively, contained growth charts and properly completed developmental milestones. Conclusion Low rates of use and unsatisfactory record-keeping in the CHH reinforce the need for investment in professional training and community awareness for the CHH to become an effective instrument of promotion of child health.

Use and records of child health handbook focused on growth and development

Objetivo Evaluar el uso y llenado de la Libreta de Salud Infantil (LSI), especialmente el crecimiento y el desarrollo. Metodo Estudio transversal con 358 pares de madres e hijos matriculados en 12 Unidades Basicas de Salud (UBS) de una ciudad pequena. Las madres fueron entrevistadas en el UBS desde febrero a abril 2013 mediante un cuestionario. Se utilizo Epi-info y software SPSS. Resultados 53% de las madres estaban llevando LSI durante la entrevista, proporcion similar a las madres que recibieron instrucciones para llevar el LSI a la atencion de la salud. Anotaciones en LSI durante las visitas se registraron en un 49%. Calendario de vacunas fue completa en el 97% de LSI, pero solo el 9% y el 8% de LSI tenido, respectivamente, las curvas de crecimiento y desarrollos debidamente cumplimentados. Conclusion El uso y el relleno satisfactorio de LSI refuerzan la necesidad de inversion en la formacion profesional y el acercamiento a la comunidad para la LSI se convierte efectivamente en un instrumento de promocion de la salud infantil.Objective To evaluate the use and records of the Child Health Handbook (CHH), especially growth and development. Method Cross-sectional study with 358 mother-child pairs registered in 12 Primary Health Centers (PHCs) of a small municipality. Mothers were interviewed at the PHC from February to April 2013 using a questionnaire. Data analysis was done using WHO Anthro software, Epi InfoTM and Stata. Results Fifty-three percent of the mothers were carrying the CHH at the time of the interview, similar to the proportion of mothers who were instructed to bring the CHH to health appointments. Annotations in the CHH during the visits were reported by 49%. The vaccination schedule was completed in 97% of the CHH, but only 9% and 8% of the CHH, respectively, contained growth charts and properly completed developmental milestones. Conclusion Low rates of use and unsatisfactory record-keeping in the CHH reinforce the need for investment in professional training and community awareness for the CHH to become an effective instrument of promotion of child health.

Training in nutritional counseling: knowledge assessment and applicability in child's healthcare

Objetivos: avaliar conhecimento de profissionais da atenção básica antes e após capacitação em aconselhamento nutricional e sua aplicabilidade na saúde da criança. Métodos: estudo de intervenção não controlado, tipo antes e depois, de abordagem quantitativa, desenvolvido no município de Itupeva, São Paulo. Capacitação como intervenção foi implementada para enfermeiros, auxiliares de enfermagem (AE) e agentes comunitários de saúde (ACS), com base na educação crítico-reflexiva. Aplicou-se teste de conhecimento com 16 questões de múltipla escolha antes e após a capacitação. Aplicabilidade da capacitação em aconselhamento nutricional na rotina dos serviços foi avaliada por questão aberta. Utilizou-se estatística descritiva e Teste Exato de Fisher com significância de 5%. Resultados: após capacitação, o conhecimento ‘satisfatório’ aumentou 71% no grupo Enfermeiros e no grupo AE/ACS. Os profissionais apontaram a capacitação como uma oportunidade de qualificação, mas para sua aplicabilidade, falta suporte político e organização dos serviços. Conclusões: a capacitação contribui para ampliação do conhecimento de profissionais da atenção básica, porém a aplicabilidade na rotina depende de esforços da gestão local e organização dos serviços. Palavras-chave Capacitação profissional, Nutrição da criança, Saúde da criança, Enfermagem em saúde pública, Atenção primária à saúde

Aleitamento materno: o que mudou após uma década?

Objective: to analyze the changes in prevalence, median duration and correlates of breastfeeding in a small city in Sao Paulo state, Brazil. Method: analysis of two cross-sectional studies, conducted at intervals of one decade, with 261 and 302 children younger than two years, respectively. We used Kaplan-Meier survival analysis for calculation of the median duration of breastfeeding, and Cox regression for correlates analysis, with significance level of 5%. Results: an increase of 33.4% in the prevalence of exclusive breastfeeding and 20.9% in breastfeeding was identified. Regarding the latter, the median duration increased from 7.2 to 12 months. In the most recent study, the median duration was lower in first-born children who used pacifiers, and it was not associated with breastfeeding incentive actions. Conclusions: advances in the prevalence and duration of breastfeeding were observed during the 10 year-period, however, pacifier use still remains associated to a shorter median duration of breastfeeding. Our findings contribute to highlighting the need for intensification of nursing actions in the promotion of breastfeeding, and discouragement regarding the use of pacifiers.ABSTRACT Objective: to analyze the changes in prevalence, median duration and correlates of breastfeeding in a small city in São Paulo state, Brazil. Method: analysis of two cross-sectional studies, conducted at intervals of one decade, with 261 and 302 children younger than two years, respectively. We used Kaplan-Meier survival analysis for calculation of the median duration of breastfeeding, and Cox regression for correlates analysis, with significance level of 5%. Results: an increase of 33.4% in the prevalence of exclusive breastfeeding and 20.9% in breastfeeding was identified. Regarding the latter, the median duration increased from 7.2 to 12 months. In the most recent study, the median duration was lower in first-born children who used pacifiers, and it was not associated with breastfeeding incentive actions. Conclusions: advances in the prevalence and duration of breastfeeding were observed during the 10 year-period, however, pacifier use still remains associated to a shorter median duration of breastfeeding. Our findings contribute to highlighting the need for intensification of nursing actions in the promotion of breastfeeding, and discouragement regarding the use of pacifiers.

Uso y llenado de la libreta de salud infantil con el foco en el crecimiento y el desarrollo

Objetivo Evaluar el uso y llenado de la Libreta de Salud Infantil (LSI), especialmente el crecimiento y el desarrollo. Metodo Estudio transversal con 358 pares de madres e hijos matriculados en 12 Unidades Basicas de Salud (UBS) de una ciudad pequena. Las madres fueron entrevistadas en el UBS desde febrero a abril 2013 mediante un cuestionario. Se utilizo Epi-info y software SPSS. Resultados 53% de las madres estaban llevando LSI durante la entrevista, proporcion similar a las madres que recibieron instrucciones para llevar el LSI a la atencion de la salud. Anotaciones en LSI durante las visitas se registraron en un 49%. Calendario de vacunas fue completa en el 97% de LSI, pero solo el 9% y el 8% de LSI tenido, respectivamente, las curvas de crecimiento y desarrollos debidamente cumplimentados. Conclusion El uso y el relleno satisfactorio de LSI refuerzan la necesidad de inversion en la formacion profesional y el acercamiento a la comunidad para la LSI se convierte efectivamente en un instrumento de promocion de la salud infantil.Objective To evaluate the use and records of the Child Health Handbook (CHH), especially growth and development. Method Cross-sectional study with 358 mother-child pairs registered in 12 Primary Health Centers (PHCs) of a small municipality. Mothers were interviewed at the PHC from February to April 2013 using a questionnaire. Data analysis was done using WHO Anthro software, Epi InfoTM and Stata. Results Fifty-three percent of the mothers were carrying the CHH at the time of the interview, similar to the proportion of mothers who were instructed to bring the CHH to health appointments. Annotations in the CHH during the visits were reported by 49%. The vaccination schedule was completed in 97% of the CHH, but only 9% and 8% of the CHH, respectively, contained growth charts and properly completed developmental milestones. Conclusion Low rates of use and unsatisfactory record-keeping in the CHH reinforce the need for investment in professional training and community awareness for the CHH to become an effective instrument of promotion of child health.