Effects of breastfeeding and sucking habits on malocclusion in a birth cohort study

OBJECTIVE: To estimate the prevalence of malocclusion and to examine the effects of breastfeeding and non-nutritive sucking habits on dentition in six-year-old children. METHODS: A cross-sectional study was carried out nested into a birth cohort conducted in Pelotas, Southern Brazil, in 1999. A sample of 359 children was dentally examined and their mothers interviewed. Anterior open bite and posterior cross bite were recorded using the Foster & Hamilton criteria. Information regarding breastfeeding and non-nutritive sucking habits was collected at birth, in the first, third, sixth and 12th months of life, and at six years of age. Control variables included maternal schooling and child's birthweight, cephalic perimeter, and sex. Data were analyzed by Poisson regression. RESULTS: Prevalence of anterior open bite was 46.2%, and that of posterior cross bite was 18.2%. Non-nutritive sucking habits between 12 months and four years of age and digital sucking at age six years were the main risk factors for anterior open bite. Breastfeeding for less than nine months and regular use of pacifier between age 12 months and four years were risk factors for posterior cross bite. Interaction between duration of breastfeeding and the use of pacifier was identified for posterior cross bite. CONCLUSIONS: Given that breastfeeding is a protective factor for other diseases of infancy, our findings indicate that the common risks approach is the most appropriate for the prevention of posterior cross bite in primary or initial mixed dentition

Efeitos da amamentação e dos hábitos de sucção sobre as oclusopatias num estudo de coorte

OBJECTIVE: To estimate the prevalence of malocclusion and to examine the effects of breastfeeding and non-nutritive sucking habits on dentition in six-year-old children. METHODS: A cross-sectional study was carried out nested into a birth cohort conducted in Pelotas, Southern Brazil, in 1999. A sample of 359 children was dentally examined and their mothers interviewed. Anterior open bite and posterior cross bite were recorded using the Foster & Hamilton criteria. Information regarding breastfeeding and non-nutritive sucking habits was collected at birth, in the first, third, sixth and 12th months of life, and at six years of age. Control variables included maternal schooling and child's birthweight, cephalic perimeter, and sex. Data were analyzed by Poisson regression. RESULTS: Prevalence of anterior open bite was 46.2%, and that of posterior cross bite was 18.2%. Non-nutritive sucking habits between 12 months and four years of age and digital sucking at age six years were the main risk factors for anterior open bite. Breastfeeding for less than nine months and regular use of pacifier between age 12 months and four years were risk factors for posterior cross bite. Interaction between duration of breastfeeding and the use of pacifier was identified for posterior cross bite. CONCLUSIONS: Given that breastfeeding is a protective factor for other diseases of infancy, our findings indicate that the common risks approach is the most appropriate for the prevention of posterior cross bite in primary or initial mixed dentition.OBJETIVO: Analisar a prevalência de oclusopatias e o efeito da amamentação e dos hábitos de sucção não nutritivos aos seis anos de idade. MÉTODOS: Foi realizado um estudo transversal aninhado numa coorte de nascidos vivos em Pelotas, RS, em 1999. Crianças com seis anos de idade (n=359) foram examinadas e suas mães entrevistadas. Utilizaram-se os critérios de Foster & Hamilton para a definição dos desfechos mordida aberta anterior e mordida cruzada posterior. Informações sobre amamentação e hábitos de sucção não nutritivos foram coletadas ao nascimento, ao primeiro, terceiro, sexto e 12º meses de vida e aos seis anos de idade. As variáveis de controle incluíram escolaridade materna, peso ao nascer, perímetro cefálico e sexo da criança. Foi realiza a regressão de Poisson. RESULTADOS: A prevalência de mordida aberta anterior foi 46,2% e a de mordida cruzada posterior foi 18,2%. Presença de hábitos de sucção não nutritivos entre 12 meses e quatro anos de idade e presença de sucção digital aos seis anos de idade foram os fatores de risco para mordida aberta anterior. Amamentação por menos do que nove meses e uso regular de chupeta entre 12 meses e quatro anos de idade foram os fatores de risco para mordida cruzada posterior. Identificou-se interação entre duração da amamentação e uso de chupeta para mordida cruzada posterior. CONCLUSÕES: Considerando que a amamentação é um fator de proteção às outras doenças da infância, a abordagem dos fatores de risco comuns pode ser o meio mais apropriado para a prevenção de mordida cruzada posterior na dentição decídua ou início da dentição mista

Estudo longitudinal das crianças nascidas em 1982 em Pelotas, RS, Brasil: metodologia e resultados preliminares

A cohort of 6,011 urban children born in 1982 in the hospitals of Pelotas, Rio Grande do Sul, was followed up so that their morbidity, mortality and growth could be assessed. These children accounted for over 99% of all births in the city. A 30% sample of the children were visited at home when approximately 12 months old, and the whole population was visited at about 20 months of age. It was possible to locate 81% of the children at 12 months. This proportion increased to 86% at 24 months, due to a change in the logistics of the field work which then included visiting all 69,000 households in the city to locate children whose families had moved within the urban area. The methodology and main difficulties encountered are discussed, and the characteristics at birth of children who were located at the first follow-up visit was compared to those of children lost to follow-up. Children who were not located tended to come from poorer families but the overall differences were not very marked, with more than 75% of children in any of the major socio-economic subgroups being located. The potential use of the large amount of information available on each child is demonstrated by the study of the relationships between birthweight, family income and nutritional status at 9-15 months of age. Birthweight is shown to be a very strong predictor of weight for age, length for age and, to a lesser extent, weight for length, there being virtually no malnutrition among children born with more than 3,000 g. Birthweight is also shown to be closely associated with weight at 9-15 months within all five family income groups, with a given absolute difference in weight at birth persisting to the end of the first year. However, due to the important effects of income on weight gain, a child born with 2,500 g in the lowest income group would be on average 1,200 g below the standard NCHS weight at 12 months, whereas a child with the same birthweight from the highest income group would have caught up with the standard. This study has shown that it is possible to identify a population based cohort of children and to follow them up for two years in a medium-sized Brazilian city.Tentou-se acompanhar a morbi-mortalidade e o crescimento de uma coorte de 6.011 crianças urbanas nascidas em 1982 nos hospitais de Pelotas, RS, através de visitas domiciliares aos 12 meses (para uma amostra de 30% das crianças) e aos 20 meses (para toda a população). Estas crianças representaram mais de 99% de todos os nascimentos urbanos naquele ano. Foi possível localizar 81% das crianças aos 12 meses e 86% aos 20 meses, devido a uma mudança na estratégia de trabalho de campo. A metodologia empregada e as principais dificuldades encontradas são descritas e as características ao nascer das crianças localizadas no acompanhamento são comparadas com as características das crianças não localizadas. A potencialidade de uso dos dados coletados é exemplificada através de alguns resultados preliminares mostrando as associações entre o peso ao nascer, a renda familiar e o estado nutricional aos 12 meses. O estudo mostra que é possível acompanhar, com uma perda relativamente pequena, uma coorte de crianças com base populacional em uma cidade brasileira de tamanho médio

Estudo longitudinal das crianças nascidas em 1982 em Pelotas, RS, Brasil: metodologia e resultados preliminares

A cohort of 6,011 urban children born in 1982 in the hospitals of Pelotas, Rio Grande do Sul, was followed up so that their morbidity, mortality and growth could be assessed. These children accounted for over 99% of all births in the city. A 30% sample of the children were visited at home when approximately 12 months old, and the whole population was visited at about 20 months of age. It was possible to locate 81% of the children at 12 months. This proportion increased to 86% at 24 months, due to a change in the logistics of the field work which then included visiting all 69,000 households in the city to locate children whose families had moved within the urban area. The methodology and main difficulties encountered are discussed, and the characteristics at birth of children who were located at the first follow-up visit was compared to those of children lost to follow-up. Children who were not located tended to come from poorer families but the overall differences were not very marked, with more than 75% of children in any of the major socio-economic subgroups being located. The potential use of the large amount of information available on each child is demonstrated by the study of the relationships between birthweight, family income and nutritional status at 9-15 months of age. Birthweight is shown to be a very strong predictor of weight for age, length for age and, to a lesser extent, weight for length, there being virtually no malnutrition among children born with more than 3,000 g. Birthweight is also shown to be closely associated with weight at 9-15 months within all five family income groups, with a given absolute difference in weight at birth persisting to the end of the first year. However, due to the important effects of income on weight gain, a child born with 2,500 g in the lowest income group would be on average 1,200 g below the standard NCHS weight at 12 months, whereas a child with the same birthweight from the highest income group would have caught up with the standard. This study has shown that it is possible to identify a population based cohort of children and to follow them up for two years in a medium-sized Brazilian city.Tentou-se acompanhar a morbi-mortalidade e o crescimento de uma coorte de 6.011 crianças urbanas nascidas em 1982 nos hospitais de Pelotas, RS, através de visitas domiciliares aos 12 meses (para uma amostra de 30% das crianças) e aos 20 meses (para toda a população). Estas crianças representaram mais de 99% de todos os nascimentos urbanos naquele ano. Foi possível localizar 81% das crianças aos 12 meses e 86% aos 20 meses, devido a uma mudança na estratégia de trabalho de campo. A metodologia empregada e as principais dificuldades encontradas são descritas e as características ao nascer das crianças localizadas no acompanhamento são comparadas com as características das crianças não localizadas. A potencialidade de uso dos dados coletados é exemplificada através de alguns resultados preliminares mostrando as associações entre o peso ao nascer, a renda familiar e o estado nutricional aos 12 meses. O estudo mostra que é possível acompanhar, com uma perda relativamente pequena, uma coorte de crianças com base populacional em uma cidade brasileira de tamanho médio

Anemia em menores de seis anos: estudo de base populacional em Pelotas, RS

OBJECTIVE: To assess the prevalence of anemia among children under six years of age in a probabilistic sample from an urban area. METHODS: A study was conducted comprising children aged zero to five years in the city of Pelotas, Southern Brazil, in 2004. Data were collected on demographic, socioeconomic, and anthropometric characteristics, morbidity and nutrition using a questionnaire applied to the mothers and guardians. Children's weight and height measurements were obtained. Hemoglobin concentration was measured using the HemoCue portable hemoglobinometer and anemia was defined as hemoglobinOBJETIVO: Analisar a prevalência de anemia em crianças menores de seis anos, em uma amostra probabilística de área urbana. MÉTODOS: Foi realizado estudo com crianças de zero a cinco anos de idade, na cidade de Pelotas, RS, em 2004. Foram coletadas informações sobre características demográficas, socioeconômicas, antropométricas, de morbidade e sobre alimentação, por meio de questionário aplicado às mães ou responsáveis. As crianças foram pesadas e medidas. A concentração de hemoglobina foi medida com hemoglobinômetro portátil, HemoCue e anemia foi definida como valores de hemoglobin

Analysis of the global strategy on diet, physical activity and health of the World Health Organization

O presente documento analisa a Estratégia Global para Alimentação, Atividade Física e Saúde da Organização Mundial da Saúde (EG/OMS), em resposta à demanda da Portaria no 596/GM, de 8 de abril de 2004, do Ministério da Saúde. A análise das evidências científicas que apóiam cada recomendação feita pela EG/OMS foi realizada tendo como referência os critérios definidos pelo Grupo de Peritos do Relatório 916 da OMS, o qual determina a classificação das evidências em convincente, provável, possível e insuficiente. Realizou-se reunião com os componentes do grupo responsável por este documento, para analisar as evidências científicas que apóiam a iniciativa da OMS e classificá-las por consenso, segundo os critérios utilizados na sua elaboração. Projeções para as próximas décadas indicam um crescimento epidêmico das doenças não transmissíveis - particularmente das doenças cardiovasculares, neoplasias e diabetes tipo 2 - na maioria dos países em desenvolvimento. A transição nutricional em curso nesses países, com o aumento expressivo da obesidade, é um dos fatores mais importantes para explicar essa tendência. As recomendações da EG/OMS baseiam-se em evidências científicas convincentes e criam oportunidades para promover a saúde e prevenir o crescimento da obesidade e das doenças não transmissíveis no país e no mundo. A EG/OMS é parte de um grande esforço em prol da alimentação, atividade física e Saúde Pública. __________________________________________________________________________________________________________________ ABSTRACTThe current document analyzes the Global Strategy on Diet, Physical Activity and Health of the World Health Organization (GS/WHO), and is a response to the Brazilian Ministry of Health Directive nº 596/GM, of 8th April 2004. The criteria proposed by the WHO Report 916 were adopted to analyze the scientific evidence supporting each recommendation made by the GS/WHO, which are categorized based on a classification system of: convincing, probable, possible, and insufficient. The technical group analyzed the published evidence supporting GS/WHO recommendations and classified them by consensus, as proposed by WHO Report 916 criteria. Projections for the next decades point to an epidemic of non-transmissible diseases - particularly cardiovascular diseases, cancer and type 2 diabetes - in most developing countries. The dietary transition, due to the observed increases in obesity, is one of the most important reasons for this tendency. Recomendations by GS/WHO are based on convincing scientific evidence and create opportunities for health promotion, and for preventing of obesity and non-communicable diseases in the country and worldwilde. The GS/WHO is part of a greater effort to realize the benefits of diet, physical activity and public health

Análise da associação entre saneamento e saúde nos estados Brasileiros: estudo comparativo entre 2001 e 2006

Em um contexto de baixo investimento em saneamento, Teixeira e Guilhermino (2006) estudaram a associação entre as condições de saneamento e os indicadores epidemiológicos nos estados brasileiros, utilizando dados secundários do banco de dados IDB (2003) do Ministério da Saúde. A partir de 2003, os investimentos em saneamento básico no Brasil aumentaram. Assim, o presente trabalho teve como objetivo testar a hipótese de que a ampliação da cobertura por serviços de saneamento básico no período entre 2001 e 2006 foi um investimento capaz de melhorar os indicadores de saúde nos estados brasileiros. Concluiu-se que houve melhoria nos indicadores de saúde, porém não-expressiva, sendo fundamental a utilização de indicadores epidemiológicos e de desenvolvimento social na decisão sobre a priorização de investimentos em saneamento no Brasil.In a context of poor investment in sanitation, Teixeira e Guilhermino (2006) studied the association between the sanitation conditions and the epidemiological indicators in the Brazilian states, based on secondary data from the database from IDB (2003) of the Ministry of Health. Since 2003, investments in basic sanitation in Brazil had an expressive increase. Thus, the present paper had as a purpose to test the hypothesis that the improvement in the coverage by basic sanitation services from 2001 to 2006 was an investment capable to improve the studied health indicators in the Brazilian states. It has been concluded that there was an improvement in the health indicators, which is still not expressive, being of the most importance the use of epidemiological and social development indicators in the priority of investments in basic sanitation in Brazil