Suggested citation: Sanches MT. Clinical management of oral disorders in breastfeeding. J Pediatr (Rio J). 2004;80(5 Suppl):S155-S162. AbstractObjective: To address aspects associated with the early detection and clinical management of oral disorders in breastfeeding.Source of data: Review of bibliographic sources (research articles, technical books, dissertations and national and international publications) focused on the clinical management of oral disorders in breastfed babies.Summary of the findings: Suction disorders may lead to inadequate actions that can compromise the mother/ baby relation during breastfeeding. Healthcare professionals may have an important role in these cases, as they can early detect such disorders. For that end, they must be able to assess breastfeeding and be prepared to manage oral disorders clinically. In the clinical management of babies with breastfeeding difficulties significant aspects of the oral physiology and breastfeeding observation should be considered. We stress the importance of an interdisciplinary team work and the need for oral training and specialized care in most complex cases. Conclusion:The baby s oral disorders in breastfeeding can be corrected if they were early detected. Healthcare professionals may help mothers and babies to overcome these problems if they have knowledge that enable them to perform right clinical procedures.J Pediatr (Rio J). 2004;80(5 Suppl):S155-S162: Breastfeeding, newborn, suction behavior.

Análise de implantação da Rede Amamenta Brasil: desafios e perspectivas da promoção do aleitamento materno na atenção básica Deployment analysis of the Brazilian Breastfeeding Network: challenges and prospects for promoting breastfeeding in primary careAnálisis sobre la implementación de la Red Amamanta Brasil: desafíos y perspectivas de la promoción de la lactancia materna en la atención primaria

Objective: To evaluate the impact of kangaroo care on exclusive breastfeeding in low birth weight newborns until 6 months of life. Methods:Prospective study carried out with 43 newborns (23 allocated in the kangaroo group and 23 in a control group) weighing < 2,000 g and staying in the neonatal unit for at least 7 days. Exclusive breastfeeding rates between the groups were compared until the age of 6 months. The chi-square test for categorical variables was used and the statistical significance level was 0.05. Results:Exclusive breastfeeding rates were higher in the kangaroo group at hospital discharge (82.6 vs. 0%; p = 0.00), at 40 weeks of gestational age (73.9 vs. 31.6%; p = 0.01), at 3 months (43.5 vs. 5.0%; p = 0.005), and at 6 months (22.7 vs. 5.9%; p = 0.20). Conclusion:Kangaroo care showed to be a facilitator of exclusive breastfeeding for low birth weight newborns until 6 months of life.J Pediatr (Rio J). 2010;86(3):250-253: Kangaroo care, exclusive breastfeeding, low birth weight.

Objective: To evaluate the impact of kangaroo care on exclusive breastfeeding in low birth weight newborns until 6 months of life. Methods:Prospective study carried out with 43 newborns (23 allocated in the kangaroo group and 23 in a control group) weighing < 2,000 g and staying in the neonatal unit for at least 7 days. Exclusive breastfeeding rates between the groups were compared until the age of 6 months. The chi-square test for categorical variables was used and the statistical significance level was 0.05.Results: Exclusive breastfeeding rates were higher in the kangaroo group at hospital discharge (82.6 vs. 0%; p = 0.00), at 40 weeks of gestational age (73.9 vs. 31.6%; p = 0.01), at 3 months (43.5 vs. 5.0%; p = 0.005), and at 6 months (22.7 vs. 5.9%; p = 0.20). Conclusion:Kangaroo care showed to be a facilitator of exclusive breastfeeding for low birth weight newborns until 6 months of life. ResumoObjetivo: Avaliar o impacto do método canguru sobre o aleitamento materno exclusivo nos 6 primeiros meses de vida em recém-nascidos de baixo peso. Métodos:Estudo prospectivo realizado com 43 bebês (23 do grupo canguru e 20 do grupo-controle) com peso < 2.000 g e permanência na unidade neonatal por pelo menos 7 dias. Os grupos foram comparados quanto à frequência da amamentação exclusiva até o sexto mês de vida, utilizando-se o teste do qui-quadrado, adotando-se nível de significância de 0,05. Resultados:A amamentação exclusiva foi superior no grupo canguru à alta (82,6 versus 0%; p = 0,00), às 40 semanas de idade gestacional (73,9 versus 31,6%; p = 0,01), aos 3 meses (43,5 versus 5,0%; p = 0,005) e aos 6 meses (22,7 versus 5,9%; p = 0,20) de vida. Conclusão:O método canguru foi facilitador da amamentação exclusiva para bebês de baixo peso até o sexto mês de vida.J Pediatr (Rio J). 2010;86(3):250-253: Método canguru, aleitamento materno exclusivo, baixo peso ao nascer.

Objectives: to evaluate the effectiveness of Family Health Strategy (FHS) on child's health indicators in São Paulo State. Methods: longitudinal ecological study involving all the towns in São Paulo State from 1998 to 2009. The outcomes were the coefficients of infant mortality and its components and the rate for pneumonia and diarrhea hospitalizations. The main independent variable was "FHS coverage"; the covariates considered the context of sociodemographic and the health system. Negative binomial regression models of fixed effects and STRATA 11.1 statistical program were used. Results: FHS coverage above 50% showed a protective effect in relation to the postneonatal mortality (RR: 0.93; CI 95%: 0.87-1.00) and coverage up to 50% (RR 0.88 CI95% 0.82-0.99) or above 50% (RR: 0.87; CI95%: 0.82-0.92) were protective factors for pneumonia hospitalizations. Conclusions: the effectiveness of FHS on the outcomes related to child's health may vary according to local and regional contexts.

The baby's oral disorders in breastfeeding can be corrected if they were early detected. Healthcare professionals may help mothers and babies to overcome these problems if they have knowledge that enable them to perform right clinical procedures.