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Introduction: The World Health Organization recommends exclusive breastfeeding until six months and complementary feeding until two years or beyond. The longer the breastfeeding lasts, the lower the risk of obesity and infections is. Objective: To describe the exclusive and mixed breastfeeding rate of a population in a health care unit, as well as the facts of weaning; and to compare exclusive breastfeeding and total feeding time among children that were attended by local professionals and medicine students. Methods: Retrospective study reviewing 610 medical records of children born between January 2010 and December 2013, monitored by the unit. Results: The average time of exclusive breastfeeding was 117 days; and of mixed feeding 246 days. The prevalence of exclusive breastfeeding in the first month was 82,3%, higher than in the Brazilian southeast region, with associated facts of early weaning: caesarean birth, low-milk production, and type of professional care. Conclusion: It was observed exclusive and total breastfeeding time beyond the national and international average for this population, especially on the academic care, in which patients have more time of appointment and highest possibility of revaluation during the first month of life. The inclusion of patients with complete records and, therefore, the exclusion of those whose records were inadequate may have caused the oversizing of those rates, because it is unknown if those without adequate records were or were not properly oriented about breastfeeding. [ABSTRACT FROM AUTHOR]

Acute abdominal pain is a major pediatric complain with a wide range of differential diagnoses. Pacient was two years and eight months, female, black, born in Itapeva, São Paulo, Brazil. She referred abdominal pain, diarrhea and cough for 16 days. She was hospitalized with a diagnosis of pneumonia. During hospitalization, she presented coughing, grunting, respiratory distress, vomiting, diarrhea, abdominal distension and fever. The bad evolution and worsening abdominal pain led to an abdominal tomography, which revealed appendix fecal calcifications. She was taken to the reference service, where there was suspicion of acute appendicitis and then surgery was performed. The final diagnosis was acute purulent appendicitis. The patient progressed as expected and was discharged ten days after surgery. Numerous disorders can cause abdominal pain; the most common causes are gastroenteritis and appendicitis. However, other differential diagnosis should be considered, including pneumonia. In the case reported, although the patient was initially tachydyspneic, she had severe abdominal pain and dehydration. A good medical history is essential. Laboratory abnormalities are nonspecific and occur in both cases. In cases in which pneumonia progresses with poor outcome, it is important to think about the possibility of another diagnosis, including appendicitis, if the complains include abdominal pain, due to its high morbidity and mortality. [ABSTRACT FROM AUTHOR]

Infant case report diagnosed with Kawasaki disease, a febrile vasculitis that affects mainly children between 2 and 3 years old. The causative agent is still unknown, but the epidemiology and clinical features suggest infectious character. There may be cardiac involvement and micro aneurysms in the coronary arteries. Differential diagnoses are measles, adenovirus and juvenile rheumatoid arthritis. Treatment is with intravenous immunoglobulin, salicylates and steroids. The patient, who is 13 months old, previously healthy, first presented high fever and runny nose eye congestion, treated with symptomatic medication; three days later she evolved with hyperemia frame in the face, trunk and limbs, again treated with symptomatic and antihistamine. After two days, there was swelling in the face, hands and feet, diffuse hyperemia, oral erythema and fever, and she was referred to a hospital for investigation. She presented all the criteria for Kawasaki disease: high fever, eye congestion, alterations in the mouth, polymorph rash, edema in the extremities and acute cervical lymphadenopathy. She was treated with intravenous immuglobulin and salicylates. After leaving hospital, she coursed with fever, swelling and palmoplantar desquamation. She was hospitalized and intravenous immunoglobulin, salicylates and corticosteroids were reintroduced; she progressed well and was discharged in two days. During her hospitalization, the echocardiogram ruled out heart problems. [ABSTRACT FROM AUTHOR]