Length of stay in a neonatal intensive care unit and its association with low rates of exclusive breastfeeding in very low birth weight infants

OBJECTIVE: To identify the inpatient maternal and neonatal factors associated to the weaning of very low birth weight (VLBW) infants. METHODS: One hundred nineteen VLBW (<1500 g) infants were monitored from July 2005 through August 2006, from birth to the first ambulatory visit after maternity discharge. This maternity unit uses the Kangaroo Method and the Baby Friendly Hospital Initiative. Out of 119 VLBW infants monitored until discharge, 88 (75%) returned to the facility, 22 (25%) were on exclusive breastfeeding (EB), and 66 (75%) were weaned (partial breastfeeding or formula feeding). RESULTS: Univariate analysis found an association between weaning and lower birth weight, longer stays in the neonatal intensive care unit (NICU), and longer hospitalization times, in addition to more prolonged enteral feeding and birth weight recovery period. Logistic regression showed length of NICU stay as being the main determinant of weaning. CONCLUSION: The negative repercussion on EB of an extended stay in the NICU is a significant challenge for health professionals to provide more adequate nutrition to VLBW infants.

Length of stay in a neonatal intensive care unit and its association with low rates of exclusive breastfeeding in very low birth weight infants

OBJECTIVE: To identify the inpatient maternal and neonatal factors associated to the weaning of very low birth weight (VLBW) infants. METHODS: One hundred nineteen VLBW (<1500 g) infants were monitored from July 2005 through August 2006, from birth to the first ambulatory visit after maternity discharge. This maternity unit uses the Kangaroo Method and the Baby Friendly Hospital Initiative. Out of 119 VLBW infants monitored until discharge, 88 (75%) returned to the facility, 22 (25%) were on exclusive breastfeeding (EB), and 66 (75%) were weaned (partial breastfeeding or formula feeding). RESULTS: Univariate analysis found an association between weaning and lower birth weight, longer stays in the neonatal intensive care unit (NICU), and longer hospitalization times, in addition to more prolonged enteral feeding and birth weight recovery period. Logistic regression showed length of NICU stay as being the main determinant of weaning. CONCLUSION: The negative repercussion on EB of an extended stay in the NICU is a significant challenge for health professionals to provide more adequate nutrition to VLBW infants.

Caracterização do repertório acústico do botocinza, sotalia guianensis, e impacto de embarcações no nordeste do brasil

The wide distribution along the Brazilian coast of specie Sotalia guianensis has been growing interest in searchers on the ecology of this species, addition to commercial interests by whalewatching. This work described the accoustic repertory of S. guianensis and their behavior associated and found if underwater noises affect this repertorie in Pipa-RN. It were analyzed 18:49h of recordings maked between april and june/2009. It were found 3258 whistles, 289 calls, 873 clicks and no gargle. The frequencies range of guiana dolphins was 1 a 48kHz and may be related to system response recorder and population s regionalization. The frequencies overlaps the noise made by motorboats, schooners and water bomb. The behavior travelling ocurred siletly in 72,58% and socialization presented no sound (56,4%) and presence of sound (43,6%). This great absence of sound may be relacioned to saving energy, probably because in this behaviors they can use physical and visual contacts. The foraging presented highest records of all class noise with 46,84% clicks, 33,84% whistles and 9,02% calls. All this sounds occurred differently in each behavior (travelling: x2 = 134,35 df = 3 p = 0,0001; foraging: x2 = 19,83 df = 3 p= 0,00018 and socialization x2 = 60,35 df = 3 p = 0,0001). It was possible to determine that underwater noise cause changes in the repertorie and does a considerable increase in whistle s number and reduce clicks. Also occurs changes in some whistles (FI: t=2,42, p=0,015; FF: t= -2,22, p=0,025), calls (FMI: t= -3,13, p=0,001; FMA: t= -3,49, p=0,0005; FD: t= -2,21, p=0,027; D: t=2,89, p=0,004) and clicks parameters (D: t= -3,85, p=0,0001; I: t= -5,32, p=0,0001) during presence of noise. These changes may be a strategy of these animals to win this sound barrier. We can not say which noise has more impact, ix however the water bomb seems to affect more the clicks and the motorboats seems to affect the others sounds. Little is know about auditive sensibility of this specie, but daily exposure to this noise may cause damage and this specie appears to have residence. The specie conservation is necessary because the population already seems to suffer damage as decrease in length of stay, number of individuals entering the inlet and the apparent diminution in the foragind during vessels presence and control standards and ambiental education can help. So, we can advance in knowledge about the ecology of this specie especially when it come to bioacoustics and their behaviors associated and reveals some of the impacts that the noise have brought to this population

Processo de cuidar de crianças hospitalizadas com câncer

The objective was to understand the process of care in the perception of hospitalized children with cancer. This is a descriptive study of qualitative approach. Data were collected between the months of October 2013 and January 2014, through photographic records and semi-structured interview consisting of questions relating to the identification of age, sex, diagnosis and length of stay and a script of questions related to the recorded pictures. Eight children were included aged between six and twelve who were admitted to a pediatric oncology sector, located in the city of Natal / RN. The criteria used in the sample were: being hospitalized for cancer treatment; and present favorable physical conditions for carrying out the data collection. For the treatment of collected material was used content analysis, thematic modality. The study followed the ethical and legal principles governing scientific research with human beings and took place with the approval of the project by the Ethics and Research Committee of the Northern League Riograndense against Cancer, with opinion registered under number 329 015 and CAAE 16097613.9.0000.5293. According to the results it was found that, for the child, the care happens through technical activities, such as making procedures and the use of personal protective equipment, as well as through the dialogic relationship, which favors the establishment of confidence in care professional. Caring also means developing activities that promote well-being, the fun and the social and cognitive development, highlighting thus the playful, during hospitalization, as an auxiliary tool in the care process. During hospitalization, the child identifies two individuals responsible for their care, accompanying family and professional, and nursing professionals the most cited in moments of care. , Also of note, the promotion of care, in the perception of the child related to the infrastructure of the institution, environmental cleaning, personal hygiene, the medicalization and the food. It is concluded that care understood by the child, whilst still maintaining relations with the biomedical model, points to a new perspective that should consider the biological, social and psychological of acquiring cancer without unlink them of the development child. 9 Moreover, we see the child as an active social actor in this process, and therefore needs to be heard and answered their needs