Este trabalho analisou a prevalência de cárie e sua correlação com fatores sociodemográficos e cuidados de higiene bucal em 145 crianças com fissura labiopalatina (GF) na faixa etária de 7 a 66 meses, comparando os resultados com 130 crianças sem fissura (GC), na mesma faixa etária. A prevalência de cárie foi avaliada pelo índice ceo-d, e as famílias responderam um questionário contendo perguntas sobre hábitos dietéticos e de higiene bucal e fatores sociodemográficos. Os resultados foram avaliados por estatística descritiva e comparados pelos testes qui-quadrado, Mann-Whitney, Kruskal-Wallis e coeficiente de correlação de Spearman. O índice ceo-d médio foi 1,5 para o GF e 0,8 para o GC, sem diferença estatística (p=0,072). A maioria (99% no GF e 98,5% no GC) relatou realizar higiene bucal na criança, havendo receio em realizar este procedimento por 26,6% no GF e 6,3% no GC (p<0,001). A introdução de açúcar foi mais precoce no GF (p<0,001), enquanto a mamadeira de madrugada após os seis meses de idade foi mais frequente no GC (p=0,023). A higiene bucal foi iniciada mais precocemente no GF (p<0,001). A análise da ocorrência de cárie por dente revelou maior prevalência no GF para os dentes 55 (p=0,025), 52 (p<0,001), 51 (p=0,022), 62 (p<0,001) e 65 (p=0,006). Foi observada correlação significativa entre cárie e o aumento da idade e número de dentes presentes para o GF (p<0,001 para ambos) e GC (p=0,002 e p=0,004, respectivamente). Foi observada associação significativa entre cárie e renda familiar apenas para o GC (p=0,028). / This study analyzed the prevalence of dental caries and its correlation with sociodemographic factors and oral hygiene care in 145 children with cleft lip and palate (GF) aged 7 to 66 months, compared to 130 children without clefts (GC), at the same age range. The caries prevalence was analyzed by the dmft index, and the families responded to a questionnaire containing questions on dietary and oral hygiene habits and sociodemographic factors. The results were assessed by descriptive statistics and compared by the chi-square, Mann- Whitney and Kruskal-Wallis tests and Spearmans correlation coefficient. The mean dmft was 1.5 for GF and 0.8 for GC, without statistical difference (p=0.072). Most individuals (99% in GF and 98.5% in GC) reported performing oral hygiene in the child, with fear to perform this procedure by 26.6% in GF and 6.3% in GC (p<0.001). The introduction of sugar occurred earlier in GF (p<0.001), while bottle feeding at night after six months of age was more frequent in GC (p=0.023). The oral hygiene was initiated earlier in GF (p<0.001). Analysis of the occurrence of caries per tooth revealed higher prevalence in GF for the teeth 55 (p=0.025), 52 (p<0.001), 51 (p=0.022), 62 (p<0.001) and 65 (p=0.006). Significant correlation was observed between dental caries and increase in age and in number of present teeth for GF (p<0.001 for both) and GC (p=0.002 and p=0.004, respectively). Significant association between dental caries and family income was only observed for GC (p=0.028).

Objetivos: Verificar os efeitos do acompanhamento fonoaudiológico no desenvolvimento das habilidades de alimentação do bebê no primeiro ano de vida. Métodos: Estudo de coorte prospectivo realizado entre abril de 2010 a maio de 2011, com binômios mãe/bebê inicialmente em uma maternidade na zona sul do município de São Paulo e acompanhados durante 12 meses. O grupo estudo foi constituído de RNs com 24 a 48 horas de vida, filhos de mães primigestas e maiores de 18 anos de idade, com escore 11 de acordo com o Escala de Avaliação Motora-Oral em Berçário, submetidos a acompanhamento fonoaudiológico. O grupo controle foi obtido de bebês nascidos na mesma maternidade, com APGAR 9 e > 2.500g., de mães com mesmas características, contatadas aos 12 meses. Resultados: A prevalência de desmame foi semelhante em ambos os grupos, entretanto o aleitamento materno apresentou Md de 7m e 5m nos grupos estudo e controle respectivamente (p=0,04). A introdução da consistência alimentar sólida foi em média 7,8m e 9,6m (p<0,01). Os copos de transição foram utilizados por 92,9% e 70,2% (p=0,01) e canudos por 59,5% e 27,7% (p=0,003). A prevalência do uso de chupeta foi 54,0% e 27,7% (p=0,01) aos 12 meses. Conclusões: O grupo acompanhado mostrou melhora no desempenho do aleitamento materno aos 2 meses. Comparado ao grupo controle, apresentou desmame mais tardio; redução do tempo de introdução da consistência sólida, mais utilização dos utensílios e menor prevalência do uso de chupeta aos 12m / Objectives: Investigate the effects of speech therapy in the development of feeding skills of the baby in the first year of life Methods: A prospective cohort study between April 2010 and May 2011 whit mother / baby binomial in a maternity hospital in the southern area of São Paulo and followed during 12 months. The study group consisted of newborns with 24 to 48 hours of life, children of primigravid mothers older than 18 years of age, wich had a score 11 according to the Oral-Motor in Nursery Assessment Scale undergoing speech therapy. The control group was obtained from babies born at the same hospital, with Apgar 9 and > 2,500 g, from mothers with similar characteristics who were contacted at 12 months. Results: The prevalence of weaning was similar in both groups, however breastfeeding presented Md of 7m and 5m in the study and control groups respectively (p = 0.04). The introduction of solid consistency food was at 7.8 m and 9.6 m (p <0.01). The glass transition were used by 92.9% and 70.2% (p = 0.01) and straws by 59.5% and 27.7% (p = 0.003). The prevalence of pacifier use was 54.0% and 27.7% (p = 0.01) at 12 months. Conclusions: The study group, compared to the control, presented: improvement in the performance of breastfeeding at 2 months, later weaning, reducing time for introduction of solid consistency food, wider use of utensils and lower prevalence of pacifier use at 12m

Introdução. O aleitamento materno destaca-se em termos nutricionais e de proteção contra doenças; sua prática deve ser mantida após os seis meses, enquanto o lactente recebe alimentos complementares. A alimentação adequada e saudável é essencial para o pleno desenvolvimento infantil. Considerando que o consumo alimentar é influenciado por fatores individuais, sociais e ambientais, conhecer os mesmos é fundamental para promover e proteger a saúde no início da vida. Objetivo Geral. Analisar o consumo alimentar de lactentes paulistas no segundo semestre de vida. Métodos. Estudo transversal com dados relativos a 75 municípios que participaram da Pesquisa de Prevalência de Aleitamento Materno em Municípios Brasileiros de 2008. Foram avaliados 14326 lactentes paulistas de seis meses completos a doze meses incompletos. Através do questionário aplicado, foram obtidas diversas informações sobre consumo alimentar dos lactentes. A tese gerou três manuscritos: 1. Descreve os alimentos consumidos pelos lactentes paulistas e alguns indicadores de consumo: diversidade mínima, adequação da dieta, dieta minimamente aceitável, consumo de alimento ricos em ferro, dentre outros. 2. Avalia a influência da amamentação sobre o consumo de bebidas ou alimentos adoçados (refrigerante, suco industrializado, água de coco em caixinha ou alimentos adoçados com açúcar, mel, melado ou adoçante). 3. Avalia a influência dos determinantes individuais e contextual sobre o consumo de alimentos ultraprocessados (refrigerante; suco industrializado, água de coco em caixinha; bolacha, biscoito, salgadinho) e sobre o consumo concomitante de frutas, legumes e verduras (FLV). Os determinantes individuais corresponderam às características dos lactentes e maternas, e o determinante contextual correspondeu ao porte populacional do município. Utilizou-se análise de regressão de Poisson multinível, sendo incluídas no modelo múltiplo as variáveis que apresentaram p<0,20 na análise ajustada pela idade do lactente. Para todos os artigos, adotou-se nível de significância de 5 por cento . Resultados. São descritos de acordo com cada manuscrito produzido: 1. A maioria dos lactentes não apresentou classificação positiva para diversidade mínima (68,2 por cento ), adequação da dieta (72,7 por cento ), dieta minimamente aceitável (71,1 por cento ) ou para alimentos ricos em ferro (60,0 por cento ). 2. Após controle dos fatores de confusão, o consumo de alimentos ou bebidas adoçados foi menos prevalente entre lactentes amamentados (RP=0,87; IC95 por cento =0,830,91). 3. A escolaridade e faixa etária maternas mostraram efeito dose-resposta negativo e positivo, respectivamente, para ultraprocessados e para FLV (p de tendência<0,001 para ambas variáveis em relação aos dois desfechos). O consumo de FLV foi menos prevalente entre lactentes filhos de mulheres multíparas (p<0,001) e entre aqueles acompanhados em locais públicos (p<0,001); porém, estes lactentes apresentaram maiores prevalências de consumo de ultraprocessados (respectivamente: p<0,001 e p=0,001). O porte populacional mostrou relação dose-resposta negativa para ultraprocessados (p=0,081), e positiva para FLV (p<0,001). Conclusões. A alimentação dos lactentes paulistas encontra-se aquém das recomendações preconizadas pelos órgãos governamentais. A proteção da amamentação sobre o consumo de bebidas ou alimentos adoçados evidencia mais um benefício da continuidade dessa prática. Verificou-se que a condição socioeconômica é importante fator associado ao consumo alimentar de lactentes. Os resultados permitem destacar grupos que deveriam ser priorizados nas ações nutricionais educativas sobre alimentação infantil. / Introduction. Breastfeeding stands out in terms of nutrition and protection against diseases; this practice should be maintained after the first six months of life, while the infant receives complementary foods. Adequate and healthy feeding is essential for thorough infant and child development. Considering that food consumption is influenced by individual, social and environmental factors, knowing them is essential to promote and protect health in early life. General Objective. To analyze the food consumption of infants in the second semester of life. Methods. Study based on information from the Survey of Breastfeeding Prevalence in Brazilian Municipalities of 2008, referring to 75 municipalities in São Paulo. A total of 14326 infants from six to twelve months of age that were born in São Paulo were evaluated. From the questionnaire applied, several information about food consumption of the infants were obtained. The thesis resulted in three manuscripts: 1. It describes the foods consumed by the infants and some consumption indicators: minimum dietary diversity, dietary adequacy, minimum acceptable diet, consumption of iron-rich foods, among others. 2. It evaluates the influence of breastfeeding on the sweetened drinks or foods consumption (soft drinks, industrialized juice, industrialized coconut water or foods sweetened with sugar, honey, molasses or sweetener). 3. It evaluates the influence of individual and contextual determinants on ultraprocessed foods consumption (soft drink, industrialized juice, industrialized coconut water, wafer, biscuits, salty snacks) and on concomitant consumption of fruits and vegetables (FV). The individual determinants corresponded to the characteristics of infants and mothers, and the contextual determinant corresponded to the population size of the municipality. Multilevel Poisson regression analysis was performed, and the variables that presented p<0.20 in the analysis adjusted only for infant age were included in the multiple model. A significance level of 5 per cent was adopted for all manuscripts. Results. They were described according to each manuscript produced: 1. The majority of infants did not show positive classification for minimum dietary diversity (68.2 per cent ), dietary adequacy (72.7 per cent ), minimum acceptable diet (71.1 per cent ) or for iron-rich foods (60.0 per cent ). 2. After controlling for confounding factors, the consumption of sweetened drinks or foods was less prevalent among breastfed infants (RP=0.87; IC95 per cent =0.830.91). 3. Maternal schooling and maternal age range showed negative and positive dose-response effects, respectively, for ultraprocessed foods and for FV (p tend<0.001 for both variables in relation to the both outcomes). The consumption of FV was less prevalent among infants who were born from multiparous women (p<0,001) and among those followed in public establishments (p<0,001); however, these infants showed higher prevalences of ultraprocessed foods consumption (respectively: p<0.001 and p=0.001). The population size showed negative dose-response for ultraprocessed (p=0.081), and positive for FV (p<0.001). Conclusions. The feeding of the infants from São Paulo falls short of the recommendations made by health authorities. Protection of breastfeeding on the sweetened drinks or foods consumption shows an additional benefit of the continuity of this practice. Socioeconomic status is an important factor associated with infant feeding. The results enable to highlight groups that should be prioritized in educational nutritional actions on infant feeding

Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2015-12-08T14:11:10Z No. of bitstreams: 1 Débora Mascarenhas.pdf: 1133365 bytes, checksum: 7879b99d930a694a220069dc4fa03910 (MD5) / Made available in DSpace on 2015-12-08T14:11:10Z (GMT). No. of bitstreams: 1 Débora Mascarenhas.pdf: 1133365 bytes, checksum: 7879b99d930a694a220069dc4fa03910 (MD5) Previous issue date: 2006 / Mestrado Profissional em Enfermagem Assistencial / Situação problema: O prematuro internado com risco de desmame precoce. As mães dos prematuros vivenciam situações e necessidades diferentes na amamentação, em relação às mães de recém-nascidos a termo. O fato de ter um filho prematuro internado pode gerar um grau de estresse muito grande, e muitas vezes isso se dá devido à gravidade do estado de saúde do bebê. Com a internação, a separação mãe/filho ocasiona uma gama de situações conflituosas no seu ambiente familiar. Esses fatores são complicadores da disponibilidade e desejo de amamentar, o que faz com que muitas delas abandonem o aleitamento materno durante a internação do prematuro na UTIN. Este estudo foi desenvolvido junto às mães dos recém-nascidos internados, a fim de fornecer orientações e de proporcionar segurança, para que as mesmas se sentissem capazes de continuar aleitando o seu bebê durante o período de internação do mesmo. Objetivo: O objetivo geral da pesquisa foi aplicar a prescrição de enfermagem Aconselhamento para Lactação junto às mães dos prematuros e recém-nascidos de risco internados em uma Unidade de Terapia Intensiva Neonatal com vista a diminuir o desmame precoce. Tendo como objetivo específico, verificar se esta prescrição foi capaz de propiciar o aumento dos dias de aleitamento humano para o recém-nascido de risco internado. Material e método: Trata-se de uma pesquisa quantitativa, quase experimental, realizada em uma Unidade de Terapia Intensiva Neonatal de um Hospital Público do Município do Rio de Janeiro. A população do estudo foi composta pelas mães dos recém-nascidos internados na UTIN no período de maio/agosto de 2005. Durante este período foi extraído um total de 30 mães, formando o grupo teste da pesquisa. O grupo controle foi extraído aleatoriamente dos casos de prontuários do período de janeiro/abril de 2005, e para cada pessoa do grupo teste foi selecionado dois controles, totalizando assim (60 prontuários). Foram utilizados 4 instrumentos para coleta de dados, construídos com base em revisão bibliográfica da Classificação das Intervenções de Enfermagem (NIC) e na Classificação dos Resultados de Enfermagem (NOC). Tratamento Estatístico: Compararam-se os grupos teste e controle utilizando como análise estatística o teste de t de Student para as variáveis contínuas, teste X2 para as categóricas, considerando as diferenças como estatisticamente significativas com valor de p < 0,05 e os respectivos intervalos de confiança no nível de 95%. Principais resultados: Evidenciaram que as causas do desmame precoce giram em torno de mitos, tabus, 2 experiências bem e mal sucedidas, idade materna relacionada às primigestas, inexperiências com a amamentação, nível socioeconômico, falta de orientações e intervenções, que tanto reforçavam quanto prejudicavam a amamentação. A família mostrou-se ferramenta importante de interferência sobre a amamentação. Conclusões: É imprescindível a mobilização dos gestores e profissionais de saúde na intensificação as estratégias empregadas a esta população, levando em conta os seus aspectos culturais, crenças e tradições da comunidade assistida. Cabe à enfermagem um trabalho de orientação mais intensivo nas consultas do pré-natal em prol do aleitamento materno, onde as famílias sejam incluídas nas atividades com o propósito de promover uma integralidade no desenvolvimento dessas atividades / Situation problem: The premature interned with risk of it weans precocious. The mothers of the premature ones live situations and different needs in the breast-feeding, in relation to the mothers of newly born to term. The fact of having an interned premature son can generate a degree of very big stress, and a lot of times that gives due to the gravity of the baby's health condition. With the internment, the separation mother/son causes a range of conflicting situations in her family atmosphere. Those factors complicated of the readiness and desire of breastfeeding, what does with that many of them abandon the maternal breast feeding during the internment of the premature in UTIN. This study was developed with mothers of the interned newly born close to, in order to supply orientations and of providing safety, so that the same ones if they felt capable to continue nursing her baby during the period of internment of the same. Objective: The general objective of the research was to apply the nursing prescription advertisement for Nursing close to the mothers of the premature ones interned in an UTIN with view to decrease weans him/it precocious. Tends as specific objective, to verify this prescription was capable to propitiate the increase of the days of human breast feeding for the newly born interned. Material and method: It is a quantitative research, experimentas , almost accomplished in an UTIN of a Public Hospital of the Municipal district of Rio de Janeiro. The population of the study was composed by the mothers of the newly born interned in the period of May/August of 2005. During this period a total of 30 mothers was extracted, forming the group tests of the research. The group control was extracted random from the cases of handbooks of the period of January/April of 2005, and for each person of the group test it was selected two controls, totaling like this (60 handbooks). 4 instruments were used for collection of data, built with base in bibliographical revision, of the Classification, of the Interventions of Nursing and in the Classification of the Results of Nursing. Statistical Treatment: The groups test and control were compared using as statistical analysis the test of t of Student for the continuous variables, test X2 for the categorical ones, considering the differences as significant statistical with value of p <0,05 and the respective trust intervals in the level of 95%. Main results: They evidenced that the causes of the it weans precocious they 2 rotate in lathe myths, taboos, experiences well and badly happened, age maternal related to the first gestation, inexperiences with the breast-feeding, level economic social, lack of orientations and interventions that so much reinforced as they harmed the breast-feeding. The family was shown important tool of interference on the breast-feeding. Conclusions: It is indispensable the managers' mobilization and professionals of health in the intensification the employed strategies this population, taking into account their cultural aspects, faiths and the attended community's traditions. It falls to the nursing a more intensive orientation work in the consultations of the prenatal on behalf of the maternal breast feeding, where the families are included in the activities with the purpose of promoting an integral in the development of those activities

Magister Scientiae Dentium - MSc(Dent) / The American Academy of Pediatric Dentistry (2005/06) defines Early Childhood Caries (ECC) as the presence of 1 or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child 71 months of age or younger. ECC can cause significant problems in preschool children and is a source of considerable societal costs. The South African national oral health survey conducted between the year 1999 and 2002 reported on the caries prevalence in young children. The caries prevalence was 50% in 4-5 year old children with a mean dmft of 2.4 (van Wyk and van Wyk, 2004).The aim of the study is to assess early childhood caries in children 12-24 months in the Mitchell's Plain district of the Western Cape.Objectives are to determine: a) The prevalence and pattern of early childhood caries. b) The relation between early childhood caries and infant feeding practices. c) The relation between early childhood caries and oral hygiene practices of the child.This study is a cross sectional study of ECC of children 12-24 months of age. Parent/child pair attending the Well Baby Clinic at Eastridge/Mitchell's Plain were informed about the study and invited to participate on a voluntary basis. The data collected consisted of a dental examination of 120 children (stratified by age: 60 in 12-18 months age group and 60 in 19-24 months age group) and a questionnaire completed by the accompanying parent/guardian. The dental examination was conducted using the WHO guidelines (Geneva 1997). Child age, tooth status (sound, decayed, filled, extracted, unerupted), and visible dental plaque on maxillary incisors (Spitz et al, 2006) were recorded.The prevalence of ECC for the sample was 23.3% (dmft =0.88). The maxillary incisors had the highest prevalence of decay (14%) followed by the maxillary molars (4%). There was a significant association (p=.006) between duration (12 months and more) of bottle use and presence of caries (40% caries prevalence). There is no significant difference between the different feeding practices (breast, bottle or both) and the presence of caries. There is a high prevalence of Early Childhood Caries (23.3%) in the 12-24 month age group. Early Childhood Caries was related to prolonged (12 months) bottle feeding. The association between the presence of dental plaque and ECC was the most significant factor (p= .000). / South Africa

The period spanning from the late 1850s to the mid-1860s frames a historical moment in Victorian England when lactation and breastfeeding came under intense public scrutiny in both medical and creative writing. While popular domestic author Isabella Beeton wrote on the dangers that an unwary mother’s milk represented for her child and herself in her serial publication, Mrs. Beeton’s Book of Household Management (1859-1861), prominent physicians C.H.F. Routh and William Acton launched a public dispute in medical journals contesting the physiological and moral dangers that the fallen wet nurse posed for the middle-class household (1859). Meanwhile, the medical community catalogued the bizarre long-term physical and dispositional side-effects of an infant’s consumption of “bad milk” – among them, syphilis, swearing, sexual immorality, and death (Matus 161-162). But it is not only medical writers who were latching on to the breastfeeding debate as a means of voicing social and political concerns of the day; recent literary critics have gestured towards the troubling manifestations of lactation in popular mid-century novels like Charles Dickens’s Dombey and Son (1848) and George Eliot’s Adam Bede (1859) as entry points into Victorian anxieties about classed and gendered embodiment. This project stipulates that the mid-century preoccupation with managing women’s milk represents an intersection of two overlapping cultural paradigms pertaining to female expression: a cultural devaluation of female physiological expression as unconscious if not dangerous leakage, and a deprecation of female linguistic and poetic expression as an analogously unmeditated and potentially disruptive kind of communication. Mid-century manuals, articles, and novels offered public voice to a number of existing anxieties surrounding breastfeeding which accompanied the mid-nineteenth century, a historical moment at the cusp of a waning popularity in wet nursing and at the advent and rise of patented infant formula. This project stipulates that at least three female poets of the mid-nineteenth century employ lactation imagery in their works as a means of recasting a cultural devaluation of female expression – inventing a new critical terminology of feminine poetic signifiers that uses the symbolic medium of breastmilk as its ink. Informed by the medical and cultural context of the High Victorian age, I explore how poets Elizabeth Barrett Browning (1806-1861), Christina Rossetti (1830-1894), and Augusta Webster (1837-1894) not only participate in the preoccupation with unstable bodies and fluids, but capitalize on female leakage in an elaborate rhetorical strategy that embarks on a new embodied female poetics. Barrett Browning’s Aurora Leigh, Rossetti’s “Goblin Market,” and Webster’s Mother and Daughter all enlist the lactating and feeding breast in a series of elaborate metaphors of female identity construction, literary expression, and poetic voice.

Kvinnans amning har många olika hälsofördelar både för den nya mamman men också för hennes nyfödda. Amning har ett antal olika hälsofördelar, till exempel utvecklingen av barnets immunsystem och tarmflora. Genom kvinnans amning främjas deras första kopplings- och interaktionsfas mellan modern och det nyfödda och därmed en större möjlighet till framgångsrik amning. / The woman's breastfeeding has many different health benefits both for the new mother but also for her newborn. Breastfeeding has a number of different health benefits, such as the development of the baby's immune system and intestinal flora, for example. Through the woman's breastfeeding, their first connection and interaction phase between the mother and the newborn is promoted and thus a greater opportunity for successful breastfeeding.

Breast-feeding by Human Immunodeficiency Virus (HIV) positive mothers poses a risk of transmitting HIV infection from the mother to the baby. This study attempted to describe and explore the knowledge of antenatal women in Gaborone, Botswana on the transmission of HIV through breast-feeding. The research results, obtained from interview schedules, revealed that the respondents had: a greater knowledge of transmission of HIV in adults than mother-to-child-transmission (MTCT); a moderate understanding of infant feeding methods; poor understanding of the risk of HIV transmission through different infant feeding methods and feelings that infant feeding method reveals ones HIV status, which indicate stigma and discrimination. The study findings may assist health care providers to intensify educational programmes and counselling in the antenatal clinics and communities to reduce MTCT. / Health Studies / M. A. (Health Studies)

Le tire-lait est un appareil conçu pour aider les mères durant l’allaitement. Selon la recherche préliminaire effectuée, c’est un thème très peu exploré dans les études; il est donc difficile d’affirmer si le produit répond correctement aux besoins reliés à son usage et à son utilité ou comment il s’intègre dans l’allaitement. Les fondements de l’étude exploratoire ont été bâtis sur ces enjeux dans le but de comprendre l’expérience d’usage du tire-lait. Inspirée de l’approche phénoménologique centrée sur l’usager, l’étude a permis d’amasser des données qualitatives à travers des entrevues semi-dirigées auprès de sept participantes. L’analyse de ces données a permis d’identifier les thèmes importants qui ont mené à des constats, rédigés dans une optique de design. L’étude a trouvé que c’est souvent quand la réalité de l’allaitement au sein rattrape les mères qu’elles vont vouloir se procurer un tire-lait, en s’inspirant des marques utilisées dans les hôpitaux par manque de temps. Le tire-lait devient alors principalement utile pour se désengorger et pour la liberté qu’il procure, s’intégrant dans une routine. Le tire-lait est par contre peu ergonomique; il semble y avoir un décalage entre le concept proposé et les manipulations réelles, notamment au niveau de la mise en marche, des bouteilles et des embouts. Ces résultats de l’étude pourraient être intégrés dans le tire-lait pour mieux représenter la réalité du contexte, de la pratique et de l’usage du produit. Ils pourraient ainsi nourrir le processus de conception dans un projet futur afin d’améliorer le design du tire-lait. / The breast pump is an apparatus which can help mothers breast feeding. According to a preliminary study, breast pumping has not been explored a lot in previous studies; thus, it is hard to tell if the product responds well to the needs of its use and utility, or how it is combined with breastfeeding. The basis of the exploratory study was built on those stakes with the purpose of understanding the experience of use of the breast pump. Inspired by the user centered phenomenological approach, qualitative date with semi-structured interviews involving seven participants were cumulated. The analysis of the data made it possible to identify the important themes, which led to statements that have been interpreted from a design perspective. The study found that it is often when the reality of breast feeding overtakes mothers that they will feel the need to get a breast pump, inspired by the brands used in hospitals because au lack of time. The breast pump is mainly used to ease breast congestion and is valued for the liberty it provides, getting integrated in a routine. The breast pump is not ergonomic; there seems to be an offset between its design and its real manipulations. Those results of the study could be integrated in the breast pump to represent better the reality of the context, the practice and the use of the product. They could also nurture the process of conception in future project to improve the breast pump design.

Na última década, Staphlylococcus aureus resistentes à meticilina não multidroga resistente (NM-MRSA) tem sido descrito como um importante agente de infecção de corrente sanguínea em nosso serviço. Este estudo de coorte prospectivo, realizado entre fevereiro de 2009 e janeiro de 2010 na unidade neonatal, avaliou 403 recém-nascidos (RN), suas 382 mães e 148 profissionais da área da saúde (PS). Duzentos e dezessete NB (54%), 187 mães (48%) e 87 PS (59%) foram colonizados por S. aureus (SA). A colonização por S. aureus resistente à meticilina (MRSA) foi maior entre RN (15%) do que entre mães (4.7%) e PS (3.4%). Embora a transmissão da mãe para seu RN tenha ocorrido, na maior parte dos casos, a mãe não foi a responsável pela colonização do RN. Houve dois padrões predominantes de polimorfismo do DNA por eletroforese em campo pulsado (PFGE) entre os RN, e algumas mães e PS foram colonizados por eles. Fatores estatisticamente associados com colonização por MRSA foram baixo nível de escolaridade materna (fator de risco - OR: 2.99; 95%CI: 1.10-8.07) e rinossinusite materna (fator protetor - OR: 0.33; 95%CI: 0.12-0.88). Entre os Rn que permaneceram hospitalizados mais do que 72 horas, o aleitamento materno foi protetor (OR: 0.22; 95%CI: 0.05-0.98). Todos os isolados foram NM-MRSA, portavam poucos fatores de virulência e Staphylococcal Cassete Chromossome mec (SCCmec) tipos IVa e IVd predominaram. Embora não tenham ocorrido casos de infecção, a transmissão nosocomial de MRSA claramente ocorreu na unidade neonatal e aponta para a necessidade de implementação de práticas de controle de infecção, como higienização das mãos para prevenção de infecção cruzada. Outras práticas de promoção à saúde, básicas, mas abrangentes, podem ser fundamentais, como educação e aleitamento materno / In the last decade non-multiresistant methicillin-resistant S. aureus (NM-MRSA) has been described as an important agent in bloodstream infections in our hospital. This prospective cohort study, conducted from February 2009 through January 2010 in the neonatal unit, evaluated 403 newborns (NB), their 382 mothers and 148 health care workers (HCW). 217 NB (54%), 187 mothers (48%) and 87 HCW (59%) were colonized by S. aureus (SA). Methicillin-resistant S. aureus (MRSA) colonization was greater among NB (15%) than mothers (4.7%) and HCW (3.4%). Although mother-to-NB transmission occurred, in most cases mothers were not responsible for NB colonization. There were two predominant PGFE patterns among the NB and some mothers and HCW became colonized by them. Factors significantly associated with MRSA carriage by NB were lower level of maternal schooling (risk factor: OR: 2.99; 95%CI: 1.10-8.07) and maternal rhinosinusitis (protective factor: OR: 0.33; 95%CI: 0.12-0.88). Among NB who remained hospitalized for more than 72 hours, breast feeding was protective (OR: 0.22; 95%CI: 0.05-0.98). All the isolates were NM-MRSA, carried few virulence factors and Staphylococcal Cassete Chromossome mec (SCCmec) types IVa and type IVd predominated. Although there were no cases of infection, nosocomial transmission of MRSA clearly occurred in the neonatal unit and this highlights the need for infection control practices such as hand hygiene to prevent cross-dissemination. Other healthcare practices, which are very basic but also ample in scope, may play a role, such as general education of women and breast feeding