The offer of the maternal breast to the baby is an unquestionable right of mothers and their children, and all efforts should be made to promote, follow and maintain exclusive breastfeeding for up to 6 months and supplement it until the child completes 2 years of age. Many publications are available in the literature about the qualities of breast milk, its benefits and health repercussions, stimulating the practice of breastfeeding and supporting campaigns for its implementation. However, although it is widely known that breastfeeding is an important step in the reproductive process of women and its practice offers benefits to both mother and child, most of the available information highlights the benefits of breast milk for children, while mention of the effects of breastfeeding on the health of the mother is usually neglected. Thus, the objective of the present study is to highlight the multiple benefits of breastfeeding for the physical and emotional health of the nursing mother. The authors consulted articles published in the databases PubMed, Virtual Health Library and Web of Science using the keywords breastfeeding, breast milk, lactation and maternal health. Palavras-Chave► aleitamento materno ► leite materno ► período pós-parto ResumoA oferta do seio materno às crianças é um direito inquestionável das mães e de seus filhos, e todos os esforços devem ser feitos no sentido de promover, acompanhar e manter o aleitamento materno exclusivo até os 6 meses e complementado até que a criança complete 2 anos de idade. A literatura apresenta incontáveis publicações acerca das qualidades do leite materno, seus benefícios e repercussões para a saúde, estimulando a prática do aleitamento materno e embasando campanhas. Porém, mesmo sendo de conhecimento geral que a amamentação é uma importante etapa no processo reprodutivo da mulher e que sua prática oferece benefícios para mãe e filho, a grande maioria das informações destacam os benefícios que o leite materno oferece às crianças, esquecendo-se de mencionar todas as repercussões que o aleitamento materno traz para a saúde da mãe. Assim, o objetivo deste artigo é destacar os inúmeros benefícios que o aleitamento materno proporciona à saúde física e emocional da lactante. Para tanto, os autores consultaram artigos publicados nas bases de dados PubMed, Biblioteca Virtual de Saúde e Web of Science utilizando as palavras-chave aleitamento materno, leite materno, lactação e saúde materna.

Objective To identify factors that contribute to the increased susceptibility and severity of COVID-19 in obese children and adolescents, and its health consequences. Sources Studies published between 2000 and 2020 in the PubMed, MEDLINE, Scopus, SciELO, and Cochrane databases. Summary of findings Obesity is a highly prevalent comorbidity in severe cases of COVID-19 in children and adolescents; social isolation may lead to increase fat accumulation. Excessive adipose tissue, deficit in lean mass, insulin resistance, dyslipidemia, hypertension, high levels of proinflammatory cytokines, and low intake of essential nutrients are factors that compromise the functioning of organs and systems in obese individuals. These factors are associated with damage to immune, cardiovascular, respiratory, and urinary systems, along with modification of the intestinal microbiota (dysbiosis). In severe acute respiratory syndrome coronavirus 2 infection, these organic changes from obesity may increase the need for ventilatory assistance, risk of thromboembolism, reduced glomerular filtration rate, changes in the innate and adaptive immune response, and perpetuation of the chronic inflammatory response. Conclusions The need for social isolation can have the effect of causing or worsening obesity and its comorbidities, and pediatricians need to be aware of this issue. Facing children with suspected or confirmed COVID-19, health professionals should 1) diagnose excess weight; 2) advise on health care in times of isolation; 3) screen for comorbidities, ensuring that treatment is not interrupted; 4) measure levels of immunonutrients; 5) guide the family in understanding the specifics of the situation; and 6) refer to units qualified to care for obese children and adolescents when necessary.

Background: Vitamin A deficiency (VAD) is endemic in Brazil and health professionals have difficulty in recognizing its subclinical form. In addition, serum retinol concentrations do not always represent vitamin A status in the organism. Objective: To identify VAD in preschool children by the serum 30-day dose-response test ( þ S30DR) and to examine its potential as a tool for the assessment of vitamin A status in the community. Design: A prospective transverse study in which blood samples were obtained from 188 preschool children for the determination of serum retinol concentrations and the children were submitted to ocular inspection and anthropometric measurements. Information about the presence of diarrhea and/or fever during the 15 days preceding the study was also obtained. The children received an oral dose of 200,000 IU vitamin A immediately after the first blood collection. A second blood sample was obtained 30-45 days after supplementation in order to determine the þ S30DR. Results: In all, 74.5% (140/188; 95% confidence interval: 68.3-80.7%) of the children presented þ S30DR values indicative of low hepatic reserves. The mean serum retinol concentration was significantly lower before supplementation (0.92 and 1.65 mmol/l, respectively; Po0.0001). No child presented xerophthalmia; 3.7% (7/188) of the children were malnourished. The presence of fever and/or diarrhea during the 15 days preceding the first blood collection did not affect the þ S30DR value. Conclusions: The prevalence of VAD in the study group was elevated. þ S30DR proved to be a good indicator of subclinical VAD in children from an underdeveloped country. Sponsorship: The study was supported

Objective: To review scientific literature in order to check how infant development surveillance is being carried out in Brazil.Data sources: Search on databases (PubMed, Medline, SciELO and CAPES Database Thesis) for studies on medical practices related to surveillance and monitoring of child development in Brazil from 2000 to 2011. The terms used for research were: child development surveillance, early intervention, developmental screening, and developmental screening tests. There were ten texts on the subject under study. Original articles, reviews, and thesis were analyzed, as well as the reference lists of publications on the topic.Data synthesis: Studies on monitoring of child development in Brazil showed major failures from pediatrician formation to clinical practice.Conclusions: It is urgent to offer continued medical education to pediatricians in order to update their knowledge about child development monitoring, especially due to the increasing numbers of preterm infants.Key-words: infant development; child care; education, medical. RESUMOObjetivo: Revisar a literatura científica para verificar como a vigilância do desenvolvimento infantil vem sendo realizada no Brasil. Silvio Cesar Zeppone et al estudios de las prácticas médicas respecto a la vigilancia y monitoración del desarrollo infantil en Brasil de 2000 a 2011. Los términos usados para la investigación fueron: vigilancia de desarrollo infantil, intervención temprana, screening de desarrollo y pruebas de screening de desarrollo. Se encontraron 10 textos relativos al tema en estudio. Artículos originales, de revisión y tesis fueron revisados, así como las listas de referencias de las publicaciones sobre el tema. Fontes de dados:Síntesis de los datos: Los estudios sobre la práctica de la monitoración del desarrollo infantil en Brasil señalan una importante falla desde la formación del médico pediatra hasta la práctica clínica respecto a este tema.Conclusiones: Hay necesidad urgente, principalmente frente a una población emergente de prematuros, que los pediatras realicen un reciclaje del conocimiento sobre el tema desarrollo infantil.Palabras clave: desarrollo infantil; cuidado del niño; educación médica.

Estudou-se a incidência de casos de mordeduras caninas atendidas em uma unidade básica de saúde da cidade de Ribeirão Preto, SP, no período de 1993 a 1997, entre crianças com idades de 0 a 15 anos. Os dados encontrados mostraram a importância de se promover programas educativos sobre os riscos dessas ocorrências para evitar acidentes causados por contatos com cães.

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ResumoObjetivo: Avaliar fatores determinantes de anemia e deficiência de ferro em crianças das duas creches da cidade de Pontal, sudeste do Brasil.Métodos: Estudo transversal foi realizado avaliando-se 192 crianças com idades entre 12 e 72 meses. Dados pessoais (idade, sexo, uso de ferro medicamentoso, duração do aleitamento materno, tipo de parto, cuidados pré-natais, peso e estatura) e dados sócio-econômicos (número de co-habitantes, escolaridade dos pais e renda per capita familiar) foram obtidos e correlacionados com hemoglobina, receptores de transferrina, ferritina e anemia ferropriva.Resultados: A idade foi a variável mais afetada pelo estado nutricional de ferro, correlacionando-se com maiores valores de hemoglobina e ferritina e menores valores de receptor de tranferrina, sendo que menos anemia ferropriva foi detectada quanto maior a idade. As outras variáveis estudadas não apresentaram correlação com o estado nutricional de ferro.Conclusão: Os dados sugerem que as estratégias de controle para essa população de crianças pré-escolares devem ser direcionadas especialmente para aquelas de menor idade. AbstractObjective: To examine the determining factors of anemia and iron deficiency in children attending two day care centers in the town of Pontal, southeast of Brazil.Methods: Cross-sectional study was conducted in 192 children aged 12 to 72 months. Personal data (age, sex, use of medicinal iron supplements, duration of breast-feeding, type of delivery, prenatal care, weight, and height), and socioeconomic data (number of coinhabitants, parental schooling, and per capita family income) were obtained and evaluated together with hemoglobin, serum transferrin receptor, ferritin, and iron deficiency anemia.Results: Age was the variable that most affected iron nutritional status, with higher hemoglobin values, lower transferrin receptor concentrations, higher ferritin values and lower iron deficiency anemia being detected with increasing age. The other studied variables did not show any correlation with iron nutritional status. Conclusion:The obtained data suggest that control strategies for this preschool population should be especially directed at younger children.