Representações De Pediatras Acerca Das Alternativas De Alimentos Lácteos Diante Do Desmame Inevitável

Abstract

Objective: To analyze pediatricians’ representations on the nutritional alternatives that are adopted when weaning becomes inevitable.Methods: This is a mixed cross-sectional analytical study with probabilistic sampling. Fifty-seven randomly selected pediatricians were interviewed with the use of a semi-structured script for thematic analysis. The technique of free evocations was used, and the terms were processed using software EVOC 2005. The thematic categories were established on software NVivo10, and their co-occurrence matrix was exported and analyzed in terms of their simple similarity hierarchy on software CHIC.Results: In the pediatricians’ representations, whole milk was cited as a foodstuff with high allergenic risk (35.1%) and nutritionally inappropriate, and they did not recommend its use if weaning occurred before 1 year of age. The infant formula, referred by 98.3% of the pediatricians as the best alternative at the moment of weaning, was cited by 38.1% of them owing to its nutritional adequacy. The points quoted as unfavorable to the use of the formula were the price, the possibility of causing allergy and the risk of the inadequate use of such a highly industrialized product.Conclusions: The pediatricians’ representations show that they are sensitive to the importance of breast-feeding and at the same time, to the sociocultural difficulties inherent in the practice. Generally speaking, the interviewed pediatricians recommend the use of milk formulas, and not of whole cow’s milk, if weaning occurs before the end of the first year of life.

Perfil clínico e nutricional de crianças com alergia à proteína do leite de vaca

“…4 A maioria dos casos de APLV são diagnosticados ainda na lactação, no momento de substituição do leite materno por fórmulas lácteas ou na introdução da alimentação complementar, sendo esse período da vida em que se observa rápida velocidade de crescimento e desenvolvimento, enfatizando, assim, a elevada relevância da doença. 15,16 Um dos tratamentos mais eficaz até hoje para pacientes alérgicos à proteína do leite de vaca é a dieta de exclusão, no entanto, essa eliminação deve ser feita com cautela, visto que pode resultar em efeitos colaterais importantes, como desnutrição, deficiência de cálcio, ferro ou outros micronutrientes e macronutrientes, além de alterações no hábito alimentar. 9,17,18,19 Ao excluir o leite de vaca, é necessário realizar a substituição deste alimento para as crianças menores de seis meses ou então a complementação para as maiores de seis meses, que no caso, é feita por fórmulas à base de proteína isolada de soja, de proteínas extensamente hidrolisadas ou de aminoácidos, a depender de critérios clínicos.…”