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Copyright of Revista Paulista de Pediatria is the property of Assocoacao de Pediatria de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: There is a gap in knowledge on the growth of children exclusively breastfed during the fifth and sixth months of life. This study aimed to assess the growth of infants who were exclusively breastfed for the first 6 months of life and compare the distributions of anthropometric measures based on the National Center for Health Statistics (NCHS, 1977) and World Health Organization (WHO, 2006) curves. Methods: Cross-sectional study that measured the weight and length of 360 healthy and exclusively breastfed infants who were enrolled in a primary care program in Belem, Brazil from October 2006 to December 2008. The children were evenly grouped into age groups from 1 to 6 months of age. Results: The mean weights were higher than the NCHS, 1977 mean weight for all of the studied groups regardless of gender and showed greater similarity to the WHO, 2006 mean weight, especially when standard deviations were considered. Regarding length, although the average length at birth was smaller, females had higher averages in the second and sixth months compared with the reference curves (p < 0.05). Conclusions: Exclusive breastfeeding in the first 6 months of life provides adequate physical growth, resulting in height and weight gain curves that are similar to or greater than the NCHS, 1977 and WHO, 2006 curves. The greater mean weight at the fifth and sixth months of life suggests that the second-quarter growth curves of children who are exclusively breastfed are greater than those of children who receive other types of food. [ABSTRACT FROM AUTHOR]

Copyright of Revista Paulista de Pediatria is the property of Assocoacao de Pediatria de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ObjectiveTo test the impact of training for educators on the health of children enrolled in public and philanthropic day-care nurseries.DesignA randomised, institutional, non-blind clinical trial was conducted. An educational intervention was performed in four day-care centres and the control group consisted of four other day-care centres. Interviews with the mothers, collection of blood from the children by digital puncture and anthropometry were performed. The chosen indicator for the improvement of health was anaemia (Hb <11 g/dl). An unconditional logistic regression model was set for the risk factors for anaemia, considering associations with P ≤ 0·05 as statistically significant.SettingEight day-care centres in the city of Sao Paulo, Brazil.SubjectsTwo hundred and fifty-two children from day-care nurseries.ResultsThe children from the day-care centres that were not subject to intervention presented a 2·11 times greater risk (95% CI 1·04, 4·30; P = 0·40) of having anaemia at the end of the study independent of the control variables (sex, age, time in the day-care centre, anaemia at the beginning of the study, maternal age, use of oral iron supplements, number of siblings, per capita family income, use of antibiotics and the necessity of avoidable hospitalisations) used in the construction of the final logistical model.ConclusionsThe assessed educational intervention promoted significant changes in the health status of the children, reinforcing the importance of training for professionals who care for young children in day-care centres in developing countries in order to promote child health. [ABSTRACT FROM AUTHOR]

Objective: To estimate the temporal trend of the incidence rates of accidents with venomous animals in children and adolescents in Brazil., Methods: An ecological time-series study was carried out between 2007 and 2019. Data were obtained from the Brazilian Information System on Diseases of Compulsory Declaration (Sistema de Informação de Agravos de Notificação - SINAN). The time series of incidence rates of accidents with venomous animals were stratified by age group (children aged 0 to 9 years and adolescents aged 10 to 19 years), Brazilian macro-regions (North, Northeast, Midwest, Southeast, and South), and type of accident (snake, scorpion, spider, and caterpillar). For trend analysis, the Prais-Winsten model and the Annual Percent Change (APC) were used., Results: The time series of the incidence rate of accidents with venomous animals in children and adolescents from the North, Northeast, Midwest, and Southeast macro-regions and in children from the South region showed an upward trend. The average annual incidence rates were higher in the age group of 10 to 19 years, except for the South macro-region. Accidents with scorpions, snakes, and spiders, in this order, were the most frequent; the trends in the time series stratified by type of animal varied according to the geographic macro-region., Conclusions: There was an upward trend in the incidence rate of accidents with venomous animals in children and adolescents in Brazil, except for adolescents in the South macro-region of the country.

Objective: To identify the prevalence and factors associated with the consumption of ultra-processed foods by Brazilian adolescents., Methods: The sample was representative of adolescents and participants in the cross-sectional population-based study National Survey of School Health, 2015 edition (PeNSE-2015). A self-administered questionnaire was used for data collection. The variable weekly consumption of ultra-processed foods was considered, and consumption more than seven times a week was considered excessive. Descriptive and inferential analyses of demographic, socioeconomic, behavioral and environmental characteristics potentially associated with the outcome were performed. Poisson's multiple regression model was adjusted to control for confounding factors., Results: The prevalence of excessive consumption of ultra-processed foods among 16,324 adolescents in Brazil was 75.4%. Nine factors independently associated with this outcome were identified: age under 15 years (RR 1.08; p<0.001), daily sitting time greater than four hours (RR 1.13; p<0.001), eating while watching TV or studying more than four days a week (RR 1.09; p<0.001), daily TV time greater than three hours (RR 1.08; p<0.001), breakfast frequency less than four days a week (RR 1,03; p=0.001), having a cell phone (RR 1.12; p<0.001), absent maternal education (RR 0.88; p<0.001), being enrolled in a private school (RR 1.05; p=0.002) located in the urban area (RR 1.13; p=0.002)., Conclusions: The results express the multifactorial characteristic of excessive consumption of ultra-processed foods and suggest the need for the development and implementation of health policies to guide the consumption of these foods and the importance of adopting healthy behaviors for this population group in both school and home environments.

The scope of this article is to evaluate to what extent social support for families with children with congenital disease impacts their quality of life. It involved a cross-sectional study with 254 parents of children with congenital heart disease. A semi-structured interview was conducted with the parents, using the Ecomap and the quality of life (World Health Organization Quality of Life Bref) and social support (Medical Outcomes Study) scales. Receiving social support was positively correlated with quality of life (r=0.535; p<0.001). A 10-point increase in the social support scale led to a 3-point increase in the total score of the quality of life scale (β=0.30; CI95%: 0.23; 0.37). Socioeconomic conditions were associated with quality of life (β=0.27; CI95%: 0.11; 0.43) and caregivers who reported not having leisure activity (β=-3.27; CI95% -5.55; -1.12) and who were undergoing health treatment (β=-2.86; CI95%: -5.55; -0.17) had a lower perception of quality of life. Negative consequences to the quality of life of caregivers taking care of a child with congenital heart disease can be intensified by a lack of leisure activity and having health problems. Adequate social support and socioeconomic resources positively influence the quality of life of these caregivers.

Objective: To identify the prevalence and factors associated with inadequate milk consumption among adolescents., Methods: This was a cross-sectional study based on secondary data from the National School Health Survey (2012), a Brazilian survey carried out using a self-administered questionnaire in a representative sample of 9th-grade students from public and private schools. The frequency of milk intake and its association with socio-demographic characteristics, food consumption and physical activity were estimated. A descriptive and inferential analysis of factors associated with inadequate milk consumption (no consumption at least one of the seven days of the week) was performed. A multiple logistic model was adjusted to control confounders., Results: The sample included 108,828 adolescents and inadequate milk consumption ocurred in 58.9%. The final model included nine variables independently associated with inadequate milk intake: breakfast frequency less than 4 days per week (odds ratio [OR]=2.40; p<0.001), unprocessed or minimally processed foods intake less than 5 days per week (OR=1.93; p<0.001), living in the northeast region (OR=1.39; p<0.001), less maternal schooling (OR=1.35; p<0.001), physical inactivity (OR=1.33; p<0.001), attending public school (OR=1.26; p<0.001), not being white (OR=1.14; p<0.001), being older than 14 years old (OR=1.13; p<0.001) and having a habit of eating meals while watching TV or studying (OR=1.04; p=0.036)., Conclusions: Inadequate milk consumption is prevalent among Brazilian adolescents. The identification of associated factors suggests the need to develop nutritional guidance strategies for the prevention of diseases that result from low calcium intake.

Objective: To describe the socioeconomic and nutritional characteristics of children and adolescents with sickle cell anemia., Data Sources: The present study is a systematic literature review based on published scientific articles. The searches were carried out using the electronic database of the National Library of Medicine, National Institutes of Health- PubMed. Two searches of articles published in the last 20years and without limitation of language were carried out. Thefirst one started from the Medical Subject Headings term "Anemia, Sickle Cell" associated with "Socioeconomic Factors"; and the second started from the term "Anemia, Sickle Cell" associated with "Anthropometry". Thesearches were directed to research conducted on humans in the age group from 0 to 18years., Data Synthesis: The final selection was composed by 11 articles on socioeconomic characteristics and 21articles on nutritional characteristics. Allstudies included children and adolescents with sickle cells disease (age range 0-18years), both genders, and most of them of black ethnicity. Families of children and adolescents with sickle cell anemia were of predominantly low socioeconomic status. Parents had lower educational levels when compared to parents of healthy children and adolescents. Body measurements (weight and height) and anthropometric indicators of children with sickle cell anemia were often lower when compared to healthy groups or reference populations., Conclusions: Children and adolescents with sickle cell anemia have socioeconomic limitations and worse nutritional conditions, when compared to reference populations. These limitations may lead to worse growth and greater occurrence of possible complications that can impair their quality of life.

Objective: To evaluate the prevalence, and identify factors associated with rapid weight gain in preschool children., Methods: A cross sectional study was carried out with 136 children between 24 and 35 months of age attending public daycare centers in Mogi das Cruzes between February and December 2014. Interviews were conducted with the mothers for clinical, sociodemographic and anthropometric characterizations of the children. It was considered to be rapid weight gain when the children presented a difference greater than 0.67 between the weight for age Z score from birth to evaluation. A logistic regression model was adjusted for factors associated with rapid weight gain., Results: Fifty children (36.8%) presented rapid weight gain and 36 (26.5%) were overweight. Of these, 22 children were in the rapid weight gain group. The logistic model showed that longest total breastfeeding time (OR 0.94, 95%CI 0.88-0.99; p=0.031) was a protection factor, and low socioeconomic level (OR 4.18, 95%CI 1.04-18.60; p=0.044) was a risk factor for rapid weight gain., Conclusions: There was a high prevalence of rapid weight gain and being overweight among three year old preschoolers attending public day care centers in Brazil. Encouraging the practice of breastfeeding children in the first years of life, in addition to giving guidance about appropriate foods, especially for families with a low socioeconomic status, can potentially contribute to reduce rapid weight gain and, consequently, future metabolic complications of being overweight.

This article stresses the importance of the qualification of professionals involved in the feeding of children in daycare centers, such that they offer adequate food and programs are developed in order to foster healthy food habits in infants from birth. Thus, the scope of this paper was to evaluate the impact of a training program for these daycare teachers in their perceptions and practices in infant feeding. A qualitative approach was used to evaluate the impact of training, with the application of the focus group technique. Sixteen groups were created, eight of which were daycare centers with training and eight without training, the average number of participants being 6 to 11 per institution aged between 19 and 66. The discourse of the teachers who took part in the training program is replete with signs of small changes, or at least with the recognition that it is indeed necessary and possible to promote change. The importance of organizing and conducting training programs for the nutritional education of teachers in day care centers is emphasized, with the continuous supervision of the effects of the qualification as a strategy for infant health.