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ResumoObjetivo: Determinar a influência da sucção não-nutritiva e da estimulação oral nas taxas de amamentação na alta hospitalar, aos 3 meses e 6 meses de idade corrigida em recém-nascidos pré-termo de muito baixo peso ao nascer. Métodos:Foram randomizados 98 recém-nascidos pré-termo de muito baixo peso ao nascer, e 96 permaneceram no estudo até o 6º mês de idade corrigida. Os recém-nascidos foram randomizados em grupo experimental e grupo controle. O grupo experimental recebeu um programa de estimulação (sucção não-nutritiva associado à estimulação sensório-motora-oral), e o grupo controle, um procedimento simulado a partir do momento em que atingiam alimentação plena até a alimentação oral completa.Resultados: Observou-se que 59 (61,5%) recém-nascidos estavam em amamentação na alta, 31 (32,6%) aos 3 meses e apenas 18 (18,75%) aos 6 meses de idade corrigida. Na alta, 47% dos recém-nascidos do grupo controle e 76% do grupo estimulado estavam em amamentação. Aos 3 meses, 18% do grupo controle e 47% do grupo estimulado continuavam em amamentação, e aos 6 meses, 10% do grupo controle e 27% do grupo estimulado. Houve diferença estatística nos três períodos estudados, favorecendo o grupo estimulado (p < 0,05). Conclusão:O presente estudo demonstra que a sucção não-nutritiva, associada à estimulação oral, pode contribuir para a melhoria das taxas de amamentação em pré-termos de muito baixo peso ao nascer.J Pediatr (Rio J). 2008;84(5):423-427: Recém-nascido prematuro, aleitamento materno, comportamento da sucção. AbstractObjective: To determine the influence of non-nutritive sucking and oral stimulation programs on breastfeeding rates at discharge, at 3 and at 6 months of corrected age in preterm infants with very low birth weight.Methods: Preterm infants were randomized into experimental and control groups. Ninety-eight preterm infants were randomized and 96 remained in the study until reaching the corrected age of 6 months. The experimental group received sensory-motor-oral stimulation and non-nutritive sucking, while infants in the control group received a sham stimulation program. Both were administered from reaching enteral feeding (100 kcal/kg/day) until the beginning of oral feeding.Results: Fifty-nine infants (61.5%) were breastfeeding at the time of hospital discharge, 31 (36.9%) at 3 months, and only 18 (20.5%) at 6 months of corrected age. At discharge, 46.9% of the control group and 76.5% of the experimental group were breastfeeding. There were statistically significant differences between rates of breastfeeding at discharge (47 vs. 76%), 3 months (18 vs. 47%) and 6 months after discharge (10 vs. 27%). The experimental group showed significantly higher rates of breastfeeding (p < 0.05). Conclusion:Non-nutritive sucking, associated with oral stimulation programs, can contribute to the improvement of breastfeeding rates among preterm infants with very low birth weight.J Pediatr (Rio J). 2008;84(5):423-427: Preterm infant, breastfeeding, sucking behavior.

Objective: To determine the influence of non-nutritive sucking and oral stimulation programs on breastfeeding rates at discharge, at 3 and at 6 months of corrected age in preterm infants with very low birth weight.Methods: Preterm infants were randomized into experimental and control groups. Ninety-eight preterm infants were randomized and 96 remained in the study until reaching the corrected age of 6 months. The experimental group received sensory-motor-oral stimulation and non-nutritive sucking, while infants in the control group received a sham stimulation program. Both were administered from reaching enteral feeding (100 kcal/kg/day) until the beginning of oral feeding.Results: Fifty-nine infants (61.5%) were breastfeeding at the time of hospital discharge, 31 (36.9%) at 3 months, and only 18 (20.5%) at 6 months of corrected age. At discharge, 46.9% of the control group and 76.5% of the experimental group were breastfeeding. There were statistically significant differences between rates of breastfeeding at discharge (47 vs. 76%), 3 months (18 vs. 47%) and 6 months after discharge (10 vs. 27%). The experimental group showed significantly higher rates of breastfeeding (p < 0.05). Conclusion:Non-nutritive sucking, associated with oral stimulation programs, can contribute to the improvement of breastfeeding rates among preterm infants with very low birth weight.J Pediatr (Rio J). 2008;84(5):423-427: Preterm infant, breastfeeding, sucking behavior.

Objective: To evaluate and compare the energy content in fresh and processed human milk administered to very low birth weight infants born in the Institute Fernandes Figueira.Methods: Samples of 0.5 ml of fresh and processed human milk were evaluated as for the fat percentile and energy content, which was calculated by mathematical formulas. Four hundred and sixty two human milk samples were analyzed, 401 of processed human milk and 61 of fresh human milk.Results: The median and the standard deviation of the fat percentile checked was 2.9±1.2% in the processed samples and 8.9±4.6% in the fresh samples (p < 0.001). The median and the standard deviation of the energy content calculated was 53.6±7.2 kcal/100 ml in processed samples and 85.9±27.9 kcal/100 ml in fresh samples (p < 0.001). Conclusion:The processed human milk samples had less energy content and less fat than fresh human milk samples suggesting that the complex processes of the human milk manipulation and administration can determine losses in energy content.

Objective: To evaluate and compare the energy content in fresh and processed human milk administered to very low birth weight infants born in the Institute Fernandes Figueira.Methods: Samples of 0.5 ml of fresh and processed human milk were evaluated as for the fat percentile and energy content, which was calculated by mathematical formulas. Four hundred and sixty two human milk samples were analyzed, 401 of processed human milk and 61 of fresh human milk. Results:The median and the standard deviation of the fat percentile checked was 2.9±1.2% in the processed samples and 8.9±4.6% in the fresh samples (p < 0.001). The median and the standard deviation of the energy content calculated was 53.6±7.2 kcal/100 ml in processed samples and 85.9±27.9 kcal/100 ml in fresh samples (p < 0.001). Conclusion:The processed human milk samples had less energy content and less fat than fresh human milk samples suggesting that the complex processes of the human milk manipulation and administration can determine losses in energy content. ResumoObjetivo: Avaliar e comparar o conteúdo energético do leite humano cru e do leite humano processado oferecidos aos recém-nascidos com peso de nascimento menor que 1.500 g no Instituto Fernandes Figueira.Métodos: Foram avaliadas alíquotas com 0,5 ml de leite humano cru e de leite humano processado, determinando-se primeiramente o crematócrito e, posteriormente, por meio da aplicação de fórmulas matemáticas, o teor energético. Foram avaliadas 462 amostras de leite humano, sendo 401 de leite humano processado e 61 de leite humano cru.Resultados: A média do percentual de gordura obtida foi de 3,0±1,2% no leite humano processado e de 8,9±4,6% no leite humano cru (p < 0,001). A média do conteúdo energético calculado foi de 53,6±7,2 kcal/100 ml no leite humano processado e de 85,9±27,9 kcal/100 ml no leite humano cru (p < 0,001).Conclusão: Foram encontrados percentual de gordura e conteúdo energético significativamente menores no leite humano processado em relação ao leite humano cru, sugerindo que o processo de manipulação pode afetar a qualidade do leite humano processado ofertado aos recém-nascidos. J Pediatr (Rio J) IntroduçãoO leite materno é o alimento ideal para qualquer recém-nascido (RN) em função de sua digestibilidade, composição química balanceada e capacidade de gerar imunidade 1 . Seu uso tem sido muito incentivado nas unidades de terapia intensiva (UTI) neonatal, incluindo tanto o leite extraído do seio materno e imediatamente administrado ao RN (leite humano cru LHC) quanto o proveniente de banco de leite (leite humano processado LHP).Nas situações em que a mãe se encontra separada do seu bebê ou quando o bebê não é capaz de sugar o seio, a coleta e a estocagem do leite materno têm sido estimuladas 2 .No entanto, o uso do leite materno exclusivo para alimentar o recém-nascido com muito baixo peso (RNM-BP) tem sido associado a um ganho de peso inadequado e a um déficit nutricional durante a hospitalização 3 . Vários motivos podem contribuir para esta má performance, princip...