Susana Elena Delgado

A ocorrência de ceceio em crianças de oito a 11 anos em escolas municipais

PURPOSE: To verify the occurrence of lisp in eight- to 11-year-old children from public schools in Itaqui/RS (Brazil), according to gender and age group, and to associate the lisp with possible risk factors, such as sucking habits (pacifier, finger and bottle) up to six years of age, malocclusion, oral breathing and tongue praxis. METHODS: An observational, exploratory, contemporary, prospective, group study was conducted using a questionnaire applied to caregivers and a speech-language evaluation that included examination of oral structures, tongue praxis, signs suggestive of oral breathing, and speech sounds articulation. Non-parametric statistics (Chi-square) was used in order to verify the association between variables. RESULTS: Two hundred children with ages ranging from eight to 11 years took part in the study (50% male and 50% female). The occurrence rate of lisp was 19%, higher for female subjects. It was observed that anterior lisp decreases with age, but the same did not occur for lateral lisp. Suggestive signs of oral breathing (p=0.037), prolonged use of bottle (p=0.027), tongue praxis alterations (p=0.002), and malocclusion (p=0.0001) were the risk factors that showed statistical association. CONCLUSION: The occurrence of lisp was high, and affected more female subjects. Most of the risk factors were significantly associated.

Caracterização do desenvolvimento da alimentação de crianças nascidas pré-termo entre três e 12 meses

Purpose: characterizing the feeding development of preterm infants between three and 12 months, those were born in Canoas/RS, checking the breastfeeding type, the timing of introduction of complementary feeding, the deleterious oral habits, the guidance received, the feeding difficulties and the sociodemographic profile. Methods: this study was evaluated and approved by the ethics committee of ULBRA under no. CEP-2011-480h ULBRA. This is a descriptive, quantitative and transversal study. Interviews with those responsible and evaluation of 32 children born preterm who attended follow-up appointments at a hospital in Canoas took place. Results: we found that only 37,5% (N=12) of the children received exclusive breastfeeding and the duration period was 31 days. Liquids were offered early; pasty food introduction was adequate time and the offer of solid food was performed early, considering the chronological age of the children. Parents reported that in 53,1% (N=17) of the babies had feeding difficulties. It was a significant association (p=0,004) between food refusal, extreme prematurity and very low birth weight. Furthermore, we observed significant association (p=0,047) between lips’, tongue’ and cheeks’ sagging and extreme prematurity. Conclusion: exclusive breastfeeding was uncommonly practiced while complementary breastfeeding also showed low prevalence and low rates of duration. Just over half of the population complained of feeding difficulty and a significant association between extreme prematurity, extreme low birth weight and food refusal was found. Furthermore, an association was found between lips’, tongue’ and cheeks’ sagging and extreme prematurity. It is evident the need of further extensive research in this area.

Non-nutritive sucking evaluation in preterm newborns and the start of oral feeding: a multicenter study

OBJECTIVES: The assessment of early sucking by preterm infants provides information on the ability of these infants to efficiently and safely receive nutrients via an oral route (oral feeding). To analyze the application and reliability of an instrument in assessing non-nutritive sucking that indicates a capacity for oral feeding in the routine care of different neonatal units. METHODS: A multicenter, prospective cohort study was conducted in seven neonatal units. A non-nutritive sucking assessment with a formulary validated by Neiva et al (2008) (variables evaluated: rooting reaction; easy initiation of sucking; labial sealing; tongue central groove; peristaltic tongue movements; jaw raising and lowering movements; labial, tongue and jaw coordination; sucking strength; sucking rhythm; bites; excessive jaw excursion; stress signals) was applied to 199 pre-term newborns, who had a chronological age ≥ 2 days and were clinically stable. These infants were divided into two groups based on their corrected gestational age at the first assessment, as follows: Group I-infants with a gestational age ≤ 33 weeks and Group II-infants with a gestational age between 34 and 36 6/7 weeks. RESULTS: The mean gestational age was 31.66±2 weeks, and the mean birth weight was 1494 ± 373 g. The mean scores on the non-nutritive sucking assessment were 46 ± 25 in Group I and 49 ± 24 in Group II. The beginning of oral feeding was successful in 43 (67.2%) infants in Group I and 64 (81%) infants in Group II (p = 0.089). CONCLUSION: The method identified preterm infants who were able to feed orally based on 33 points in the non-nutritive sucking assessment and a corrected gestational age of 32 weeks or more. The corrected gestational age was the most important factor in predicting the success of oral feeding.

Atuação fonoaudiológica na Unidade De Terapia Intensiva em bebê com síndrome de pterígeo poplíteo

The aim of this study was to describe the speech-language intervention for the adequacy of the alimentary function through assessment and treatment of the stomatognathic system and its functions. The study was carried out based on the case report of a newborn with popliteal pterygium syndrome, fed by tube while taken care of at the Neonatal Intensive Care Unit (NICU). The speech-language assessment presented the following results: retracted jaw with little opening, hypertrofic inferior and superior gums, incomplete cleft palate, present and adequate oral reflexes (search, sucking, swallowing), anterior trigger of the gag reflex and overactive bite reflex. The oral sensitiveness was impaired. The non-nutritive sucking resulted in a ratio of 3:1 sucks per burst, with rhythm, but weak. In the nutritive sucking with a bottle, the newborn presented a 5:1 sucks per burst ratio, with long pauses. Signs of stress were observed, with breathing alteration, mild inspiratory stridor, a choking episode, and anterior and overactive gag reflex, demonstrating oral hypersensitivity in response to the use of a conventional bottle teat. Five weekly sessions of speech-language therapy were carried out, with orientations to the mother and the nursing team regarding position, oral stimulation and use of orthodontic bottle teats. The newborn was discharged with full oral feeding and good weight gain.

Alterações das funções de mastigação e deglutição no processo de alimentação de idosos institucionalizados

OBJETIVO: Analisar o processo de alimentacao de idosos institucionalizados e, mais especificamente, descrever o perfil sociodemografico dos idosos, verificar as possiveis alteracoes estruturais do sistema estomatognatico, das funcoes de mastigacao e degluticao e constatar as dificuldades alimentares autorreferidas. METODO: Estudo do tipo quantitativo, descritivo, observacional, transversal e prospectivo. A amostra foi constituida por 27 individuos do genero feminino e tres do genero masculino, com idades entre 65 e 93 anos, residentes em uma instituicao de longa permanencia para idosos de Canoas-RS, no periodo de julho a agosto de 2012. Utilizando-se de dois protocolos, foi realizada uma entrevista, uma avaliacao das estruturas do sistema estomatognatico e a observacao de uma refeicao em ambiente habitual de alimentacao do idoso. RESULTADOS: Quanto aos aspectos alimentares, a dificuldade de mastigar algum tipo de alimento e a preferencia por alimentos macios foram frequentemente citadas. As principais modificacoes nas estruturas estomatognaticas e em suas funcoes foram as alteracoes de mobilidade e tonicidade e a adaptacao da mastigacao e da degluticao, por meio da participacao exagerada da musculatura perioral e do ritmo mastigatorio lentificado. CONCLUSAO: O processo de alimentacao dos idosos institucionalizados sofre modificacoes ao longo dos anos, e a habituacao das dificuldades encontradas, por meio da realizacao de compensacoes, e frequente entre eles. Os resultados evidenciam a necessidade da atuacao fonoaudiologica interdisciplinar nas instituicoes de longa permanencia para idosos, a fim de minimizar o impacto dos efeitos do envelhecimento nas funcoes estomatognaticas, proporcionando qualidade de vida ao idoso institucionalizado.

Caracterização do desenvolvimento da alimentação em crianças de 6 aos 24 meses de idade do município de Canoas/RS

PURPOSE: to characterize the feeding in children aged from 6 to 24-month old; and specifically, to characterize the time of introduction, types of foods and textures offered according to childs age, to check oral habits and to verify who guided the parents about feeding. METHODS: the sample was composed by 100 children of 6 to 24 months, which attended two Basic Health Care Units, in Canoas, RS. Interviews were accomplished with the sponsors. RESULTS: it was verified that 98 (98%) of the children were exclusively breastfeed, however with medium duration of 2 months and 8 days. The offer of liquids presented a precocious introduction of tea at the beginning with median of 60 days; 92 (92%) of the children used bottle-feeding and in 47 (47%) of them increased the hole. The pacifier was used by 60 (60%) of the sample and had an association with the time of breast feeding. The beginning of offering fruits and soups presented a median of 150 days and meat in 210 days. There was a statistical association between the age and increase of consistence. It was still verified, that foods are being presented in appropriate consistence for the age. CONCLUSION: it was concluded that there was an exclusive practice of maternal breastfeeding with period shorter than it is recommended. Foods were introduced before the proper time; however, the consistence is being adapted in the current feeding. It can also be verified the great frequency for employing bottle-feeding and pacifier as a deleterious oral habits. Most of the time, orientation about feeding was made by lay people.

Conhecimento de puérperas sobre amamentação e introdução alimentar

Objective: To assess mothers’ knowledge about breastfeeding and introduction of other foods and identify the difficulties in breastfeeding in the rooming-in ward of a university hospital. Methods: Quantitative observational cross-sectional study carried out in 2016 in Canoas, Rio Grande do Sul, with a sample of 40 mother-baby binomials admitted to the rooming-in ward of a university hospital. A protocol adapted from the United Nations Children’s Fund was used to assess favorable and unfavorable behaviors during breastfeeding through interviews addressing: sociodemographic information, type of delivery, gestational age, weight of the baby, knowledge about exclusive breastfeeding and its benefits, age at the time of introduction of other foods, and the types of foods introduced. Descriptive statistics was used and associations between variables were assessed. Results: The frequency of difficulties in breastfeeding ranged from 5% to 45% according to the aspect assessed. Breast tissue excoriations were associated with baby’s difficulty in maintaining the latch, fast sucking with clicking noises and bottom lip turned inwards (p<0.05). With regard to knowledge, 65% (n=26) of the participants did not know how they benefited from breastfeeding. Additionally, 88% (n=35) reported growth and 75% (30) reported immunity and bonding as the main benefits to the baby. In all, 45% (n=18) of the mothers could not define exclusive breastfeeding and 95% (n=18) said that complementary feeding should be started after 6 months of life. Conclusion: The mothers interviewed have poor knowledge about breastfeeding and do not know the benefits to women’s health. However, they reported the benefits to the baby. Unfavorable aspects were evident during breastfeeding.

Caracterização do desenvolvimento da alimentação em crianças de 6 a 24 meses

PURPOSE:to characterize the feeding of children between six and 24 months old of a Rio Grande do Sulmunicipality.METHODS:it is a transverse and descriptive method. The sample consisted of 88 children who were enrolled in the municipal health department. Data collection was carried out duringJuly-September 2012 interview with those responsible were conducted.RESULTS: it was found that 86% of infants were exclusively breastfed with an average duration of three and a half months. There was early introduction of liquids with four months of age, and on average, there was a positive correlation with shorter breastfeeding. The offer of pasty food was early, with a median of introduction in the fifth month; the consistency was adequate in the currentage. Soft drinks and snacks were consumed by 80.7% and 76.1% of the children, respectively. The bottle was used by 93.2% and the use was correlated with shorter breastfeeding. The pacifier was used by 64% of them. From the responsible, about 47,7% had received informations of the introduction of foodby pediatricians (47.7%).CONCLUSION:it was found that both the practice of exclusive breastfeeding and the complemented feeding occur in a shorter period than recommended. Theearly introduction of liquids and pastes was predominant. There was high use of bottles and pacifiers. Even though the pediatrician was the most cited source of information about feeding, we also identified lay advice.