Os autores analisaram diferentes fatores que podem influenciar na decisão das mães de amamentar, na duração da amamentação e as principais razões do desmame. Foram selecionados artigos publicados entre 1990 e 2004 das bases de dados Lilacs, Medline, Scielo, Bireme, utilizando as palavras-chave: desmame e fatores de risco, bem como suas versões em inglês. Alguns fatores, como maternidade precoce, baixo nível educacional e socioeconômico maternos, paridade, atenção do profissional de saúde nas consultas de pré-natal, necessidade de trabalhar fora do lar, são freqüentemente considerados como determinantes do desmame precoce. Contudo, outros, como o apoio familiar, condições adequadas no local de trabalho e uma experiência prévia positiva, parecem ser parâmetros favoráveis à decisão materna pela amamentação. Apesar da relevância dos fatores mencionados acima, os aspectos culturais e a história de vida da mãe foram os mais importantes na decisão materna pelo aleitamento e pelo momento do desmame. Termos de indexação: aleitamento materno; desmame; fatores de risco. A B S T R A C T The authors analyzed different factors than can influence the mother's decision to breastfeed, the duration of breastfeeding and the main weaning reasons. Articles published from 1990 to 2004 in the databases

The CHQ-PF50 was considered adequate for demonstrating compromised quality of life in children with functional defecation disorders, as has been reported for other diseases, being a useful tool for making treatment decisions and for patient follow-up.

This study was designed to correlate entertainment of clown-doctors (CD) activities on hospitalized children and aphysiological bio-marker. For this purpose we collected saliva samples and verified children satisfaction with these activities by using a visual analog scale (VAS). Children from 6 to 7 years-old, with diagnosis of any acute pathology, interned in the Pediatric Ward of the Botucatu Medical School Hospital (São Paulo, Brazil) were interviewed. Two groups were taken into consideration: lunchCD and dinnerCD. The following protocol was applied in each group (lunch and dinner): collection of the first saliva sample and presentation of VAS prior to CD activities, followed by collection of a second saliva sample and another VAS assessment after CD activities. The salivary cortisol was reduced in both groups comparing the first saliva sample. The satisfaction of the intervention was evident for lunchCD. The CD intervention is effective in decreasing an important physiological biomarker of stress factor, cortisol, in hospitalized children, been effective for the healing process.

Objective: To evaluate the health-related quality of life in children with functional defecation disorders. Methods:One hundred children seen consecutively were enrolled and subdivided into three subsets according to the Roma II classification criteria: functional constipation (n = 57), functional fecal retention (n = 29) and nonretentive functional soiling (n = 14). The generic instrument Child Health Questionnaire -Parent Form 50 (CHQ-PF50 ® ), was used to measure quality of life and to assess the impact of these disorders from the point of view of parents. The instrument measures physical and psychosocial wellbeing in 15 health domains, each of which is graded on a scale from 0 to 100, with higher values indicating better health and greater wellbeing. Ten of these are then used to obtain two aggregated and summary scores: the physical and psychosocial scores.Results: No statistically significant differences were detected between subsets in terms of demographic or anthropometric characteristics. In 14 domains, children with defecation disorders scored lower than healthy children. When subsets were compared, statistically significant differences were detected between children with nonretentive functional soiling (lower scores) and those with functional constipation. Physical and psychosocial scores for the entire sample were lower than those for the group of healthy children used as controls. Conclusions:The CHQ-PF50 ® was considered adequate for demonstrating compromised quality of life in children with functional defecation disorders, as has been reported for other diseases, being a useful tool for making treatment decisions and for patient follow-up.J Pediatr (Rio J). 2006;82(6):421-5: Quality of life, defecation disorders, constipation.

de sobrepeso/obesidade entre as crianças com constipação crônica funcional está dentro dos valores esperados para a população pediátrica brasileira.Palavras-chave: obesidade; sobrepeso; constipação intestinal; epidemiologia. AbstRAct Objective:To determine the prevalence of overweight/ obesity in a group of children with chronic functional constipation.Methods: Retrospective chart review of 257 children with chronic functional constipation as defined by Rome II criteria, 2-15 years old, assisted in a tertiary pediatric gastroenterology clinic. Demographic, clinical, diagnostic and anthropometric information was extracted from the charts. Body mass index (BMI) was calculated and The Centers for Disease Control's BMI growth reference was used to determine age and gender-specific BMI percentiles of the children. Overweight/obesity was classified as a BMI of ≥85 th percentile, and euthrophy as BMI ≥5 th and <85 th percentile.Results: There was no statistically significant difference for demographics and clinical variables between the subgroups overweight/obesity and eutrophy. In constipated children, prevalence of overweight/obesity was 24.4%. Prevalence of overweight/obesity did not differ Artigo Original Rev Paul Pediatr 2008;26(4):357-60. Rev Paul Pediatr 2008;26(4):357-60.

Neste trabalho apresentamos um caso de hiperplasia nodular focal que foi diagnosticado aos seis anos de idade e que está sendo acompanhado até o momento presente. Para o diagnóstico foram imprescindíveis as técnicas de imagem, tendo importância de realce a cintilografia hepatoesplênica e a tomografia computadorizada. Apresentamos, também, revisão da literatura sobre o assunto.

Background: Preventing the development of iron deficiency anemia during infancy requires the appropriate complementary foods with high energy, nutrient density, and adequate iron content, as well as high nutrient bioavailability. We aimed to evaluate iron intake, bioavailability, and absorption from foods, in healthy infants and toddlers at a Well Child Clinic. Methods: This observational, cross-sectional, descriptive study evaluated 96 consecutive infants and toddlers, 6 to 12 months of age (group I) and 13 to 36 months of age (group II) that were brought for regular pediatric visits and introduced to complementary foods. Quantitative 24-h dietary recalls were obtained, and iron intakes quantified for lunch and dinner. Iron bioavailability and absorption were calculated and analyzed by Monsen's and FAO/WHO's methods according to enhancing factors: meat, poultry, and fish (MPF) and vitamin C. Results: There were no significant differences in demographic, clinical, and anthropometric variables between groups. Vitamin C intake was not different between groups, but MPF was significantly lower in group I. The proportion of children with recommended RDA iron intake was lower (p < 0.05) in group I (16 %) than that in group II (47 %). Group I had lesser MPF intake and iron absorption and a higher proportion of children with low bioavailability in lunch and dinner when compared to group II (p < 0.05). Conclusions: Inclusion of low-cost meat, especially chicken meat and vitamin C-rich foods, at the same meal, both in lunch and dinner, would be of particular advantage to ensure an adequate intake of bioavailable iron during complementary feeding.