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Biomedical subjects

E R Giugliani

Publications and source records attributed to E R Giugliani.

At least 19 recordsLinked to original sources

[Evolution of breastfeeding pattern].

OBJECTIVE: To follow the evolution of the breastfeeding practice among women in a childbirth clinic and evaluate the actions for its promotion. METHODS: Two cohorts of children born in an school hospital of Porto Alegre, Brazil, in different periods of time were compared regarding the prevalence of breastfeeding during the first six months of life, and the percentage of early cessation of breastfeeding. Both were prospective studies, including 202 children in the cohort of 1987, and 187 children in the cohort of 1994. All participants were healthy children, with birth weight of 2500g or more, were being breastfed and their parents were living in the same house. The 1987 study children were followed up through mail, and the 1994 study ones by home visits. RESULTS: Survival analysis showed similar frequencies of breastfeeding in the two cohorts. The prevalence of exclusive breastfeeding, although for a short period in both groups, was higher in the population studied in 1994, especially among children whose mothers were better educated. There was no rate difference of early cessation of breastfeeding between the two cohorts (36% for the 1987 cohort and 39% for the 1994 cohort). CONCLUSIONS: The results revealed a certain degree of apathy in regard of the promotion of breastfeeding during the studied period, giving support to actions to promote breastfeeding, especially among poor families.

Brazil↗

[Breast-feeding in clinical practice]

OBJECTIVE: To present an updated review on practical aspects of breast-feeding promotion and management. METHODS: Review of relevant publications from scientific journals, technical books and publications by international organizations. RESULTS: Nowadays, exclusive breast-feeding is recommended for a period of approximately 6 months, and maintenance of complementary breast-feeding should continue for 2 or more years. Despite abundant scientific evidence on the superiority of breastmilk over other types of milk, the number of women who breast-feed their infants according to present recommendations is still low. Health care providers can improve this scenario by encouraging breast-feeding and helping nurturing mothers to overcome breast-feeding hindrances. Therefore, health professionals must have the necessary knowledge and skills for managing the different stages of lactation. This way, they will be able to provide prenatal counseling, guidance and help during the breast-feeding initiation period, careful evaluation of breast-feeding techniques and adequate interventions in the event of any problems associated with breast-feeding. This article is concerned with some important topics related to breast-feeding in clinical practice. CONCLUSION: Breast-feeding is the ideal method for infant feeding, and it can certainly be facilitated by health care providers through adequate clinical practice.

Journal Article↗

[Complementary feeding]

OBJECTIVE: To present an updated review about complementary feeding in infants and children under 2 years old. METHODS: Relevant materials from scientific journals, technical books and publications by international organizations were used. The most important source of data was a publication by the World Health Organization on complementary feeding carried out in Montpellier, France, in December 1995. RESULTS: In recent years, new findings on ideal infant feeding have buried former concepts and practices. The value of exclusive breast-feeding during the first months of life and the introduction of timely and adequate complementary feeding has been acknowledged. Complementary foods are defined as any solid or liquid foods with nutritional value other than breastmilk, offered to breast-fed infants It is recommended that complementary feeding be initiated around the 6th month of life. These foods should be rich in energy, proteins and micronutrients, free from contamination, easily digestible and in adequate amount. On recommending a healthy diet, the availability, accessibility and cultural values of food should be taken into consideration. CONCLUSION: Health professionals have an important role in the improvement of infant nutrition. Those in charge of child care have to be properly advised and warned of the importance of a healthy diet for current and future health status.

Journal Article↗

Does parental breastfeeding knowledge increase breastfeeding rates?

OBJECTIVE: Although improving mothers' knowledge about breastfeeding can increase rates and duration of breastfeeding, little is known about the influence of fathers' knowledge. The purpose of this study was to assess the knowledge of mothers and fathers about breastfeeding before and after receiving postpartum advice and its relationship to the frequency of breastfeeding. METHODS: A clinical trial was performed with mothers and fathers of normal children born at the Hospital de Clínicas de Porto Alegre, Brazil, between July 1994 and March 1995. The study intervention consisted of postpartum advice supplied by means of a video film discussing basic topics of breastfeeding, an explanatory leaflet, and open discussion after viewing the video. The first 208 couples comprised the control group, the next 197 comprised experimental group 1, and the remaining 196 comprised experimental group 2. Immediately after delivery, mothers and fathers in the three groups answered a test on breastfeeding knowledge; they completed the same test at the end of the first month. All families received home visits at the end of the first, second, fourth, and sixth months, or until breastfeeding ceased. Logistic regression was used to evaluate the association between the mothers' and fathers' knowledge and frequency of breastfeeding. RESULTS: Postpartum advice increased the breastfeeding knowledge of mothers and fathers. The mothers with the highest level of knowledge had a 6.5 times higher chance of exclusively breastfeeding at the end of the third month, and 1.97 times higher chance of continuing breastfeeding to the end of the sixth month compared with other mothers. The fathers' knowledge also significantly influenced breastfeeding rates. The children whose fathers knew more had a 1.76 higher chance of being exclusively breastfed at the end of the first month, and 1.91 higher chance of receiving maternal milk at the end of the third month. CONCLUSION: A simple, inexpensive strategy can increase the level of breastfeeding knowledge of mothers and fathers and, consequently, have a positive impact on the frequency of breastfeeding.

Adult↗

Poverty levels and children's health status: study of risk factors in an urban population of low socioeconomic level.

To test the hypothesis that the low socioeconomic population living in shanty towns in Porto Alegre presents different levels of poverty which are reflected on its health status, a cross-sectional study was designed involving 477 families living in Vila Grande Cruzeiro, Porto Alegre, Brazil. The poverty level of the families was measured by using an instrument specifically designed for poor urban populations. Children from families living in extreme poverty (poorest quartile) were found to have higher infant mortality rate, lower birth weights, more hospitalizations, and higher malnutrition rates, in addition to belonging to more numerous families. Thus, the shanty town population of Porto Alegre is not homogeneous, and priority should be given to the more vulnerable subgroups.

Birth Weight↗

Are fathers prepared to encourage their partners to breast feed? A study about fathers' knowledge of breast feeding.

In order to study fathers' knowledge of breast feeding and its relationship with paternal factors, fathers of 92 breast feeding and 89 non-breast feeding newborns were compared. Paternal factors included previous children and the way they were fed, participation in prenatal care, attendance at prenatal classes, breast feeding information provided by health professionals, use of reading materials and interest in learning more about the subject. The results indicated that fathers had poor knowledge about breast feeding, especially those whose children were being bottle fed. After adjustments for confounders, fathers who had previous breast-fed child(ren), had attended prenatal classes and who received information about breast feeding from medical personnel had a significantly higher chance of having a better knowledge of breast feeding. It seems that fathers need to be better prepared to assume their new role as breast feeding supporters. Prenatal care was shown to be a good opportunity to improve fathers' knowledge of breast feeding.

Adult↗

Effect of breastfeeding support from different sources on mothers' decisions to breastfeed.

A cross-sectional study compared 100 breastfeeding and 100 non-breastfeeding new mothers in order to investigate the relationship between mothers' choice of breastfeeding and support from health professionals and lay people, taking into account potentially confounding sociodemographic influences. The importance of the male partners' opinion about breastfeeding was also examined. A favorable attitude of partners towards breastfeeding was the most important factor associated with breastfeeding (odds ratio = 32.8). Prenatal class attendance and breastfeeding support from lay people increased the odds of breastfeeding 2.7 and 3.3 times, respectively. Breastfeeding orientation provided by doctors, nurses, and nutritionists was not associated with the maternal decision to breastfeed. The results point toward the need for reevaluation of prenatal care interventions, inclusion of fathers in breastfeeding educational programs, and emphasis on community-based programs.

Adult↗

[Follow-up of children with moderate or severe malnutrition in the peripheral population (Brazil)].

What happens to children who develop moderate or severe malnutrition? What is done for them? Keeping in mind these questions, the present research was undertaken with the following objectives: to assess the nutritional status of children who develop moderate or severe malnutrition before the age of 5 years, after a period from 2 to 4 years after diagnosis; to assess the nutritional status of the under 5-year old siblings of these children; to study the influence of nutritional programs available in the community for the improvement of the nutritional status of the malnourished children; and to identify factors interfering with nutrition of these children during the study period. After a period of 2 to 4 years from the time of diagnosis of moderate or severe malnutrition the authors tried to locate the families of 61 malnourished children of Porto Alegre, RS (Brazil). The mothers their substitutes were interviewed and the children and siblings under 5 years of age were weighed and measured. Thirty-nine children were located. Of these, 4 (10%) died and 22 (56%) presented an increase of at least 10% in weight for age. Of the 35 children who survived, 29 (82%) still presented some degree of malnutrition (weight/age < or = 90% of the standard), 25 (71%) were stunted (height/age < or = 95%), and 5 (14%) were wasted (weight/height < or = 90%). The nutritional status of the 5-year old siblings was similar to that of the malnourished children.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Weight↗

Serum vitamin B12 levels in parturients, in the intervillous space of the placenta and in full-term newborns and their interrelationships with folate levels.

Serum vitamin B12 levels were determined in a group of 51 parturients as well as in their babies and placentas. The results obtained showed that newborns had 2.3 times higher vitamin B12 levels than their mothers and that the concentrations of this vitamin in the intervillous space of the placenta was 1.3- and 3.2-fold those encountered in the blood of newborns and mothers, respectively. These findings indicate that vitamin B12 accumulation by the placenta may represent an important factor in providing sufficient amount of this essential nutrient to the fetus. The relationship between folate and vitamin B12 concentration in the maternal, fetal and placental sera was also investigated. The highly significant correlation coefficient encountered and significantly higher serum folate concentrations in the group of parturients who received vitamin B12 supplementation during pregnancy indicate a close metabolic interrelationship between vitamin B12 and folate.

Female↗

Serum and red blood cell folate levels in parturients, in the intervillous space of the placenta and in full-term newborns.

Folates, essential nutrients for man, are especially important during gestation. Serum and red blood cell folate levels were measured in 51 parturients and in their respective placentas and concepts, with the objective to further elucidate the mechanisms of folate transfer from mother to fetus. The interrelationships between the three compartments with respect to folate levels were also studied (Tab. I). Serum and red blood cell folates were measured by radioimmunoassay in samples of venous blood from the mother, from the intervillous space of the placenta, and from the umbilical cord. Higher folate levels were detected in newborns than in their mothers both in serum (3.9 times) and red blood cells (2.3 times). Serum folate levels were higher in the intervillous space of the placenta than in newborns (1.3 times) or mothers (4.5 times) Fig. 1, 2). These data suggest that the placenta concentrates folates, thus offering high concentrations of this vitamin to the fetus. It is possible that folate-binding proteins existing in the placenta participate in the mechanism of folate concentration in this organ. However, despite the existence of a transfer mechanism that benefits the fetus, a significant positive correlation was observed between serum folate levels of mothers, newborns and placentas.

Chorionic Villi↗

Clinical and biochemical effects of long-term vitamin A administration to a patient with Hurler-Scheie compound.

Vitamin A decreased the urinary excretion of total mucopolysaccharides in a patient with Hurler-Scheie compound (type IH-S mucopolysaccharidosis). Vitamin A was administered orally in daily doses of 1,000 to 2,000 IU/kg body weight for 10 years. Adverse clinical responses such as irritability, bone pain, dizziness, vomiting and diarrhea appeared in the patient and were controlled by reduction of the dose administered. No clinical improvement was observed, although it is possible that the clinical course of the disease may have been retarded.

Adolescent↗

Risk factors for early termination of breast feeding in Brazil.

A prospective study was undertaken to identify possible factors related to the duration of breast feeding. Two hundred and thirty-eight mothers who had delivered normal single babies with birth weights greater than 2.5 kg and had initiated breast feeding were randomly selected at the maternity hospital, Hospital de Clinicas de Porto Alegre, Brazil, and followed by mail questionnaires until termination of breast feeding, or until the end of the first year. If no reply was received, telephone contact or home visits were made. The group of mothers who stopped breast feeding prior to the end of the third month was compared with those who extended breast feeding beyond three months with respect to socioeconomic, biological, environmental, medical and psychological factors. The variables with a significant coefficient of association with early termination of breast feeding were maternal education, past experience with breast feeding, help of a maid, help with housework provided by a relative, breast feeding orientation during prenatal care and encouragement from the husband. These factors act simultaneously, with interactions among them.

Brazil↗