Lisiane De Rosa Barbosa

Condições iniciais no aleitamento materno de recém-nascidos prematuros

PURPOSE: To describe the breastfeeding initial conditions for premature infants. METHODS: The sample consisted on 26 mother/baby dyads. The babies had an average of 36.1 weeks corrected gestational age and were hospitalized in a Neonatal Intensive Care Unit in Southern Brazil. Data was collected from medical records, and the observation of the dyads was conducted during feeding, using the Observation and Evaluation of the Breastfeeding Protocol. Favorable and unfavorable behaviors were registered regarding position, responses, suction, affection and anatomy of the breast. After the observation, a questionnaire was applied to the mothers. RESULTS: The best results refer to the position of mother/child and affection and the poorer ones to the infant responses. Statistically significant correlations by the Spearman Correlations Coefficient were observed between some items of the protocol and other study variables. CONCLUSION: Most premature infants from this sample presented a satisfactory initiation on analyzed aspects referring to breastfeeding. Still, we emphasize the need of practices for breastfeeding effectiveness and its encouragement in this population.

Sinais clínicos de disfagia em lactentes com bronquiolite viral aguda

Objective: To determine the occurrence of clinical signs of dysphagia in infants with acute viral bronchiolitis, to compare the respiratory parameters during deglutition, and to ensure the intra- and inter- examiners agreement, as well as to accomplish intra and interexaminators concordance of the clinical evaluation of the deglutition. Methods: This was a cross-sectional study of 42 infants aged 0-12 months. The clinical evaluation was accompanied by measurements of respiratory rate and pulse oximetry. A score of swallowing disorders was designed to establish associations with other studied variables and to ensure the intra- and interrater agreement of clinical feeding assessments. Caregivers also completed a questionnaire about feeding difficulties. Significance was set at p<0.05. Results: Changes in the oral phase (prolonged pauses) and pharyngeal phase (wheezing, coughing and gagging) of swallowing were found. A significant increase in respiratory rate between pre- and post-feeding times was found, and it was determined that almost half of the infants had tachypnea. An association was observed between the swallowing disorder scores and a decrease in oxygen saturation. Infants whose caregivers reported feeding difficulties during hospitalization stated a significantly greater number of changes in the swallowing evaluation. The intra-rater agreement was considered to be very good. Conclusions: Infants with acute viral bronchiolitis displayed swallowing disorders in addition to changes in respiratory rate and measures of oxygen saturation. It is suggested, therefore, that infants displaying these risk factors have a higher probability of dysphagia.Objective:To determine the occurrence of clinical signs of dysphagia in infants with acute viral bronchiolitis, to compare the respiratory parameters during deglutition, and to ensure the intra- and inter- examiners agreement, as well as to accomplish intra and interexaminators concordance of the clinical evaluation of the deglutition.Methods:This was a cross-sectional study of 42 infants aged 0-12 months. The clinical evaluation was accompanied by measurements of respiratory rate and pulse oximetry. A score of swallowing disorders was designed to establish associations with other studied variables and to ensure the intra- and interrater agreement of clinical feeding assessments. Caregivers also completed a questionnaire about feeding difficulties. Significance was set at p<0.05.Results:Changes in the oral phase (prolonged pauses) and pharyngeal phase (wheezing, coughing and gagging) of swallowing were found. A significant increase in respiratory rate between pre- and post-feeding times was found, and it was determined that almost half of the infants had tachypnea. An association was observed between the swallowing disorder scores and a decrease in oxygen saturation. Infants whose caregivers reported feeding difficulties during hospitalization stated a significantly greater number of changes in the swallowing evaluation. The intra-rater agreement was considered to be very good.Conclusions:Infants with acute viral bronchiolitis displayed swallowing disorders in addition to changes in respiratory rate and measures of oxygen saturation. It is suggested, therefore, that infants displaying these risk factors have a higher probability of dysphagia.

Influência do ambiente hospitalar nos aspectos relacionados ao aleitamento materno

PURPOSE: To investigate the influence of hospital environment on aspects related to breastfeeding and communication on the mother/newborn interaction during the breastfeeding process. METHODS: This consisted on a cross-sectional study composed by 34 dyads: 18 in rooming and 16 in intermediate/medium care units of a public hospital. Each dyad was observed at the time of breastfeeding, and data were analyzed considering the aspects standardized by UNICEF for breastfeeding. Verbal and nonverbal communication modes were observed. RESULTS: Comparison of variables showed significant associations between hospital environment and the position of the mother in relation to the newborn and mother stimulation and vocalization to the neonate, with favorable percentage for the dyad that was in rooming. The other variables did not differ. CONCLUSION: Important conditions for the establishment of breastfeeding and communication between mother and newborn are influenced by the location of the dyad, especially the hospital environment.

Speech-language pathology aspects in a pediatric case of head and neck arthrogryposis

Arthrogryposis is a rare, multiple, congenital syndrome of non-progressive nature characterized by a series of genetic malformations, as well as stiffness and joint contractures. This is a clinical case study whose objective is to describe speech-language pathology disorders through the evaluation process in a case of arthrogryposis in Pediatrics. The medical records of a patient were analyzed from birth. A complete clinical evaluation of pediatric dysphagia was performed, establishing a diagnosis of severe oropharyngeal dysphagia evidenced by functional and structural impairments. Hearing loss was detected in association with this condition.