Advertencias octogonales en los sucedáneos de leche materna: una herramienta para promover una alimentación infantil informada

.Sr. Editor, La alimentación y nutrición saludable durante los primeros años de vida es esencial para garantizar un adecuado crecimiento y desarrollo. Vale la pena recordar que el primer alimento que debe recibir un niño es la leche materna, dado los múltiples beneficios que tiene para los niños, las madres y la sociedad. Uno de los efectos importantes que a largo plazo tiene la ali-mentación con leche materna es la disminución del riesgo de algunas enfermedades crónicas

Indicadores de Lactancia Materna obtenidos en el momento de la vacunación en cuatro Centros de Salud Familiar de la zona Sur de Santiago

ResumenObjetivosComparar datos oficiales de lactancia materna (LM) con los obtenidos por entrevistas realizadas en vacunaciones regulares.Sujetos y métodoSe realizó un estudio descriptivo, con muestreo por conveniencia, en el que se entrevistó a los tutores de los niños que asistieron a vacunarse en 4 Centros de Salud Familiar (Cesfam) del sur de Santiago. Se calcularon la prevalencia de los indicadores de LM y se estratificaron por edad y escolaridad de las madres. Comparamos los resultados con los informados en los REM de cada Cesfam utilizando Chi cuadrado (p<0,05).ResultadosAnalizamos 1.990 casos; la prevalencia de LME fue 43,4%, 34,2% y 8,8% a los 2, 4 y 6 meses respectivamente. La prevalencia de LME, informada por los REM, al sexto mes (41%) es significativamente mayor (p<0,001). Las madres con escolaridad inferior a 12 años tienen una prevalencia menor de la LME al 4.° mes que las de mayor escolaridad (28,4% vs 37,8% respectivamente, p<0,05).ConclusionesLas prevalencias de LME obtenidas en el momento de la vacunación son llamativamente menores a las estadísticas oficiales. Estas diferencias podrían deberse a que este estudio incluye población que no asiste habitualmente a control sano y a que la información de los REM es obtenida por el mismo profesional responsable de la promoción de la LM, lo que podría distorsionar las respuestas. Nuevos estudios son necesarios para mejorar la metodología utilizada para evaluar los indicadores de LM.AbstractObjectivesTo compare official breastfeeding (BF) data with those obtained by interviews conducted during regular vaccination visits.Subjects and methodA pilot descriptive study with convenience sampling was conducted by interviewing guardians of children attending vaccination in four Primary Care Centres in south Santiago. BF prevalence indicators were calculated and stratified by age and education of mothers. A comparison was made between the results and the official ones reported by each Centre. Chi-squared (X2) was calculated to evaluate differences (P<.05)ResultsA total of 1990 cases were analysed, in which exclusive BF prevalence was 43.4%, 34.2% and 8.8%, at 2, 4, and 6 months, respectively. At the sixth month, official data (41%) was significantly higher (P<.001). Mothers with less than 12 years of schooling have a lower prevalence of exclusive BF at the 4th month than those with higher education (28.4% vs 37.8%, respectively, P<.05).ConclusionsEven considering the small size of the sample studied, exclusive BF prevalence obtained is surprisingly lower than official reported data. That difference might be explained by: a) children brought to vaccinations are roughly two fold the number brought to well-child clinics and, b) potential bias in official data obtained by staff in charge of promotion and education on BF practices, which could distort the results. Further studies are needed to improve the methodology for collecting and analysis BF data

Influence of malnutrition on the course of childhood bacterial meningitis

Background: Malnutrition may be an important cofactor explaining poor outcome of childhood bacterial meningitis (BM) in developing countries. We examined its effect in Latin American children. Methods: The weight-for-age z score was determined for 482 children with BM aged 2 months to 5 years. Normal weight (z score from &gt;-1 to &lt;+1), underweight (z score &lt;-1) and overweight (z score &gt;+1) children were compared on admission, in-hospital and at discharge. Using uni-and multivariate analysis, we sought for associations between malnutrition and 3 different outcomes. Results: The mean z score was-0.41 ± 1.54, with a normal distribution. Overall, 260 (54%) patients were of normal weight, 151 (31%) underweight, and 71 (15%) overweight. Compared with others, underweight patients had on admission a lower Glasgow coma score (P = 0.0006) and cerebrospinal fluid glucose concentration (P = 0.03), and a slower capillary filling time (P = 0.02). Their death rate was higher (P = 0.0004) and they surv

Aporte calórico-proteico durante la recuperación nutricional y estado nutricional alcanzado

Hace 30 a&ntilde;os los ni&ntilde;os chilenos que se recuperaban en CONIN recib&iacute;an alimentaci&oacute;n&nbsp;ad libitum, que podr&iacute;a haber favorecido la aparici&oacute;n de sobrepeso y obesidad (SP/OB). Por este motivo el objetivo de este estudio fue evaluar la relaci&oacute;n entre la ingesta energ&eacute;tico-proteica durante la recuperaci&oacute;n nutricional y la aparici&oacute;n de sobrepeso-obesidad (SP/OB) al alta. Se dise&ntilde;o un estudio retrospectivo, anal&iacute;tico del universo formado por las 168 fichas encontradas de menores de 2 a&ntilde;os, desnutridos primarios recuperados en CONIN entre 1977-1982. Se evalu&oacute; el estado nutricional por Semp&eacute; (referencia de crecimiento utilizada en esos a&ntilde;os) y OMS (referencia actual), desde el ingreso hasta el cuarto mes de estad&iacute;a y al alta. Seg&uacute;n referencia de Semp&eacute; la desnutrici&oacute;n al ingreso fue 25% grave, 63% moderada y 12% leve; por OMS (P/T) estas cifras eran 14.9%, 29.2% y 38.1%, respectivamente; el resto era eutr&oacute;fico. Al alta, no hab&iacute;a ni&ntilde;os con SP/OB por P/E (Semp&eacute;), mientras que seg&uacute;n P/T, el 6% ten&iacute;a SP/OB a los 3 meses de tratamiento y el 13,8% al alta. La ingesta alimentaria promedio, aportada&nbsp;ad libitum, fue de 148 kcals/Kg/d&iacute;a y 4 g prot/kg/d&iacute;a. Los ni&ntilde;os con SP/OB tuvieron mayor ganancia de peso diario (30,3 vs 19,2 g/d&iacute;a) que sus pares no obesos y mayor ganancia de peso diario comparado al promedio para la edad (19,7 vs 8,2 g/d&iacute;a). La alimentaci&oacute;n prescrita alcanz&oacute; valores elevados dentro del rango utilizado actualmente; la ingesta real, administrada ad-libitum, fue significativamente menor y se asoci&oacute; a una frecuencia de 13,8% SP/OB.Thirty years ago malnourished Chilean children were recovered by CONIN; they were fed ad libitum and this may have favoured the appearance of overweight-obesity (SP/OB). The objective of this study was to evaluate the relationship between energy-calorie intake during nutritional recovery and the appearance of overweight-obesity (SP/OB). The design was a retrospective, analytical study of the universe formed by the 168 clinical records found, of children below 2 years of age, recovered by CONIN between 1977 and 1982. Nutritional status was assessed using the Semp&eacute; criteria (applied in the period evaluated) and those of WHO, (currently in use), on admission, after 4 month treatment and on discharge. By Semp&eacute; criteria, malnutrition on admission was classified 25% severe, 63% moderate and 12% mild; instead, using WHO standards these figures were 14,9%, 29,2% y 38,1%, respectively; the remaining children were well nourished. On discharge, there was no SP/OB by W/A (Semp&eacute;), but by W/H (WHO) 6% and 13.8% were SP/OB after 3 months and on discharge, respectively. Food intake, administered ad libitum, reached a mean of 148 kcals/kg/d and 4 g prot/kg/d. SP/OB children had greater daily weight gain (30,3 vs 19,2 g/d) than the non-obese children and greater daily weight gain than the mean for age and sex (19,7 vs 8,2 g/d&iacute;a). The prescribed feeding reached values considered high by currently used criteria; actual intake, administered ad-libitum, was significantly lower and was associated with 13.8% of children with overweight-obesity at the time of discharge