This article aims to analyze the association between guidance on breastfeeding in primary health care and exclusive breastfeeding. It involved a cross-sectional study conducted in 2013 in the city of Rio de Janeiro, Brazil, by means of interviews with 429 mothers of infants below six months of age in primary care units. We estimated adjusted prevalence ratios by Poisson regression. In the final model, the variables associated with the outcome (p ≤ 0.05) were retained. The prevalence of exclusive breastfeeding was 50.1%. In multivariate analysis, guidance on exclusive breastfeeding in primary care was directly associated with the outcome (PR = 1.32). Maternal income < 1 minimum wage (PR = 0.77), previous breastfeeding experience for less than 6 months (PR = 0.73), not living with a partner (PR = 0.76), non-exclusive breastfeeding at discharge (PR = 0.78), alcohol consumption (OR = 0.57), guidance on pumping breast milk (PR = 0.53), pacifier use (PR = 0, 74) and baby's age in months (PR = 0.78) were associated inversely with the outcome. Guidance on exclusive breastfeeding favored it, while inadequate guidance and practices were associated with a lower prevalence of the outcome.

ResumoObjetivo: Comparar as prevalências de aleitamento materno e das queixas principais nas consultas de puericultura de uma unidade básica de saúde do município do Rio de Janeiro, nos períodos pré e pós-certificação da Iniciativa Unidade Básica Amiga da Amamentação.Métodos: Foram analisadas informações de 121 e 200 crianças assistidas pela unidade antes e após sua certificação, respectivamente. Classificou-se o tipo de alimentação em aleitamento materno exclusivo, aleitamento materno predominante e aleitamento materno, e utilizou-se a 10ª Classificação Internacional de Doenças para categorização das queixas que motivaram as consultas de puericultura.Resultados: Observou-se um aumento estatisticamente significativo da prevalência de aleitamento materno exclusivo tanto nos menores de 4 meses (68 versus 88%; p < 0,0001) quanto entre as crianças com idade entre 4 e 6 meses (41 versus 82%; p < 0,0001). Além disso, foi expressivo o aumento da prevalência de aleitamento materno em crianças maiores de 6 meses, especialmente entre os 9 e 12 meses de vida (24 versus 82%; p < 0,0001). Houve, também, diminuição nas consultas motivadas por alguma doença após a certificação da unidade nos lactentes com mais de 4 meses. Conclusão:A implantação da Iniciativa Unidade Básica Amiga da Amamentação mostrou-se estratégia importante para o aumento das taxas de aleitamento materno e para a diminuição de consultas motivadas por doenças nos lactentes menores de 1 ano assistidos nesta unidade. Results: A statistically significant increase was observed in the prevalence of exclusive breastfeeding, both among those less than 4 months old (68 vs. 88%; p < 0.0001) and among children aged from 4 to 6 months (41 vs. 82%; p < 0.0001). Furthermore, an impressive increase was observed in the prevalence of breastfeeding in children more than 6 months old, especially those aged 9 to 12 months (24 vs. 82%; p < 0.0001). After certification, there was also a reduction in the number of consultations motivated by some type of disease among infants more than 4 months old. Conclusion: Implementation of the Breastfeeding FriendlyPrimary Care Initiative proved to be an important strategy for increasing the rate of breastfeeding and reducing consultations due to disease among infants less than one year old cared for at this health center.J Pediatr (Rio J). 2008;84(2):147-153: Breastfeeding, primary healthcare, child health, public health.

Objective: To identify and analyze the scientific evidence of nutritional interventions performed in children and adolescents with Autism Spectrum Disorder. Data sources: A systematic review was conducted in the MEDLINE, Cochrane Library, Embase, LILACS, Google Scholar, PubMed, PsycINFO and Periódicos CAPES databases, using a search strategy to identify studies published between January 2003 and March 2018, in Portuguese, English and Spanish. Were included studies that described nutritional interventions in children and adolescents with autism spectrum disorders and assessed autistic behavior and/or gastrointestinal symptoms. We excluded other review articles and studies that did not include a control group in the research design. The studies were reviewed for descriptive information, and the quality of evidence was assessed through the GRADE system. Data synthesis: 18 studies were included in the review, being 16 randomized clinical trials, 1 case-control study and 1 open-label trial. As a result, the implementation of a gluten-free and casein-free diet was the most used intervention among the studies. Of the total, 10 studies showed a positive association of intervention with the evaluated results, while 8 did not find of a significant association. Conclusions: Although some authors report progress in the symptoms associated with autism in individuals with Autistic Spectrum Disorder undergoing nutritional interventions, there is little scientific evidence to support the use of nutritional supplements or dietary therapies in children and adolescents with autism.

Given the contribution of BFPCI to the practice of EBF, a greater investment in the expansion and sustainability of this initiative is recommended, as well as its association with other strategies to promote, protect, and support breastfeeding.

Objective: To compare the prevalence rates of breastfeeding and the principal causes of consultations at the infant and neonatal clinic of a basic healthcare center in the city of Rio de Janeiro, before and after its being accredited by the Breastfeeding Friendly Primary Care Initiative. Methods:Information was analyzed from 121 and 200 children followed-up at the healthcare center before and after certification, respectively. Type of feeding was classified as exclusive breastfeeding, predominant breastfeeding or breastfeeding, and the 10th International Classification of Diseases was used to classify the complaints causing consultations.Results: A statistically significant increase was observed in the prevalence of exclusive breastfeeding, both among those less than 4 months old (68 vs. 88%; p < 0.0001) and among children aged from 4 to 6 months (41 vs. 82%; p < 0.0001). Furthermore, an impressive increase was observed in the prevalence of breastfeeding in children more than 6 months old, especially those aged 9 to 12 months (24 vs. 82%; p < 0.0001). After certification, there was also a reduction in the number of consultations motivated by some type of disease among infants more than 4 months old. Conclusion:Implementation of the Breastfeeding Friendly Primary Care Initiative proved to be an important strategy for increasing the rate of breastfeeding and reducing consultations due to disease among infants less than one year old cared for at this health center.