Orientador: Delia B. Rodriguez-Amaya / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia de Alimentos / Made available in DSpace on 2018-08-03T02:37:31Z (GMT). No. of bitstreams: 1 Navas_SandraAparecida_M.pdf: 2479689 bytes, checksum: 059ad37b33bafb968f424afd2d492264 (MD5) Previous issue date: 2003 / Resumo: Tendo em vista o fato das crianças serem mais sensíveis aos efeitos adversos de aflatoxina M1 (AFM1) e ocratoxina A (OTA) comparativamente aos adultos, este trabalho teve como objetivo padronizar metodologia para determinação de AFM1 e OTA em leite matemo, avaliar a incidência das citadas toxinas em Banco de Leite Humano do Hospital Regional Sul, da cidade de São Paulo, e correlacionar os resultados obtidos com a alimentação consumida pelas mães. Os métodos estabelecidos para a determinação de AFM1 e OT A envolveram extração da AFM1 com metanol e OT A com bicarbonato de sódio 1 % e metanol, seguido da limpeza por colunas de imunoafinidade com anticorpos especificos para cada micotoxina e separação por cromatografia líquida de alta eficiência e quantificação com detector de fluorescência. A confirmação de AFM1 foi realizada através da reação de derivatização com ácido trifluoroacético (TFA) e para OTA por meio da reação de derivatização com ácido clorídrico concentrado (HCI). O método estabelecido para AFM1 apresentou porcentagem de recuperação e coeficiente de variação de 93,6% e 17,S%, respectivamente para a contaminação de 0,01 ng/mL. Para o método de OTA, os valores correspondentes são 83,9% e 14,1% no mesmo nível de contaminação (0,01 ng/mL). O limite de quantificação para ambos os métodos foi de 0,01 ng/mL. Do total de SO amostras analisadas, apenas uma continha a AFM1 (2% do total), em nível de 0,024 ng/mL e duas com OTA (4% do total), em nível de 0,011 e 0,024 ng/mL. Portanto, houve baixa incidência de AFM1 e OTA em leite materno proveniente do Banco de Leite do Hospital Regional Sul da cidade de São Paulo / Abstract: Since infants are more susceptible than adults to the adverse effects of aflatoxin M1 (AFM1) and ochratoxin A (OTA) , this work was carried out to establish and evaluate methods for the determination of AFM1 and OT A in human milk collected by the Human Milk Bank of the Southern Regional Hospital, city of São Paulo, and correlate the incidence of these mycotoxins to the mothers' diets, information obtained through a questionnaire. The methods established for the determination of AFM1 and OT A involved the extraction of AFM1 with methanol and OT A with 1 % sodium bicarbonate and methanol, followed by clean-up with immunoaffinity columns with antibodies specific for each mycotoxin and quantification by high performance liquid chromatography with a fluorescent detector. Confirmation of the identity of AFM1 was carried out by derivatization with trifluoroacetic acid (TFA) and of OT A by derivatization with concentrated hydrochloric acid (HCI). The method established for AFM1 had mean recovery percentage and coefficient of variation of 93.6% and 17.5%, respectively, at the contamination levei of 0.01 ng/mL. For the OTA method, the corresponding values were 83.9% and 14.1% at the same levei of contamination. The limit of quantification for both methods was 0.01 ng/mL. Of a total of 50 samples analyzed, only one was contaminated with AFM1 (2%), at 0.024 ng/mL and two with OTA at 0.011 and 0.024 ng/ml. There was low incidence of AFM1 and OT A, therefore, in human milk from the Milk Bank of the Southern Regional Hospital, city of São Paulo / Mestrado / Mestre em Ciência de Alimentos

For most of human history, breastfeeding has been the optimal source of nutrition for infants. Human milk contains a variety of important nutritional sources including vitamins, fats, proteins, and immunological components. With the rise of artificial infant formulas, however, breastfeeding as a whole has decreased around the world. Preterm infants are especially susceptible to diseases such as necrotizing enterocolitis in the first few weeks of life. Therefore, they have the most to gain from the extra immunological and nutritional support that is present in human milk. Within the last few decades, donor human milk has been viewed as the next best option if mothers own milk is not available. Donor human milk contains many of the same beneficial milk properties as regular human milk including immunoglobulins and human milk oligosaccharides. Studies have shown decreases in preterm cases of NEC and fewer deaths in infants who received DHM. One argument against the use of DHM is that pasteurization can reduce the beneficial enzymes and immunoglobulins present in samples. However, the increased use of human milk fortifiers has been able to significantly decrease the nutrient gap between regular human milk and donor milk. Overall, DHM along with proper fortification serves as the best and most cost effective way to feed preterm infants if mother’s milk is unavailable.

Premature newborns’ medical need for donor human milk surpasses the supply and the demand for it continues to increase. Lactating mothers with a surplus can help fill the gap and give fragile infants a better chance to grow by donating breast milk. This thesis project examines challenges in the human milk donation process and observes general milk donation operations. It seeks to answer what kind of tools and support are needed to streamline the human milk donation process for lactating mothers who voluntarily donate their extra milk supply. Looking closely at information and communication technologies, the project notes design implications for the development of donor-supported digital tools. Through a user-centered design approach, qualitative interview strategies, and feedback from a milk bank, mockups of a digital waiting room were created to provide informational and social support for donor mothers.

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To determine the relationship between infant-feeding practices and diarrhoeal infections, a descriptive survey was conducted to infants between six to 12 months of age. A guided interview was conducted to 105 mothers of infants who attended the health facilities of Mbabane, Swaziland. The results show that breast-feeding is routinely practiced by the majority of mothers and exclusive breast-feeding is very low, but supplementary feed in the form of formula or solids are introduced by the majority of respondents within the first three months of life. Infants who were given colostrum and breast milk had fewer diarrhoeal attacks. Other factors, for example education and cultural factors influenced the feeding practices and number of diarrhoeal attacks. It is recommended that breast-feeding should be promoted as an important intervention in the control of diarrhoea / Health Studies / M.A. (Nursing Science)

Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2015-04-29T13:22:42Z No. of bitstreams: 1 Emmanuelle Lira Cariry.pdf: 1049232 bytes, checksum: 726b595b78450ce1e1d6d404a2f2153a (MD5) / Made available in DSpace on 2015-04-29T13:22:42Z (GMT). No. of bitstreams: 1 Emmanuelle Lira Cariry.pdf: 1049232 bytes, checksum: 726b595b78450ce1e1d6d404a2f2153a (MD5) Previous issue date: 2013-12-05 / Introdution: The importance of breastfeeding is something unquestionable nowadays. For many years it is common knowledge that is the best food for infants up to 06 months old. Since ancient times, women breastfed their children and, in some occasions, helped feeding other women¿s. Human Milk Banks and their donors are, today, what net-nurses were for more than two thousand years. Objective: Identify perceptions of mothers donors of milk in a human milk bank linked to a midsize Hospital in the hinterlad of Paraiba state. Methodology: The study was conducted by a qualitative approach with 21 milk donors of the Cajazeiras Human Milk Bank. Data collection was carried out by interviews with semi-structured script. The contents of the transcriptions were submitted to analysis and the thematic nuclei found were discussed. Results: the donors were 17 to 41 years old, all of them married or in non-legal consensual marriage and the great majority living only with their companions and children, half of them with paying jobs and the other half as housewives, and the majority of them were women who had more than one children. The following thematic nuclei emerged from the analysis: Altruism or solidarity with the imaginary mother and children, shown by "I donate to help the babies in need"; Social consciousness, avoiding waste, shown by "I had so much milk that it was going to waste"; Empowerment of the breast, or "the babies depend on me to be fed"; Desired pregnancy and history of loss, detected by the recurring stories of losses associated to the idea of a very precious pregnancy, "the doctor said that it was more likely that I would have multiple abortions than giving birth to a living child"; Family support, detecting that family presence can either help ("my mother is my role model and stimulates me a lot") or get in the way ("my mother-in-law was against it, she didn't want me to donate"); and Social support, shown from pre-natal care to the donation itself ("the nurse explained to me that it wouldn¿t lack milk to my baby, that the more you take, the more come"). Conclusion: the perceptions of mothers on milk donation were very positive, surrounded by ideas of solidarity, empathy and pride of their actions and demonstrate also that Health Promotion, from Primary Care at pre-natal care to a good welcome at the Maternity and the Human Milk Bank can be important determinants of the maintenance of breastfeeding and the decision to donate milk. / Introdução: A importância do aleitamento materno é hoje algo indiscutível. Há muitos anos sabe-se que é melhor alimento para menores de 06 meses. Desde a Antiguidade, mulheres amamentavam seus filhos e, em algumas situações, ajudavam a alimentar os de outras mães. Os bancos de leite humano e suas doadoras são, hoje, o que as amas de leite foram por mais de 02 mil anos. Objetivo: Identificar percepções de mães doadoras de leite em um banco de leite humano vinculado a hospital de médio porte no sertão da Paraíba. Método: O estudo foi conduzido por uma abordagem qualitativa com 21 doadoras do Banco de Leite Humano de Cajazeiras. A coleta de dados se deu por entrevistas com roteiro semiestruturado. Os conteúdos das transcrições foram submetidos a análise e foram discutidos os núcleos temáticos encontrados. Resultados: as doadoras tinham idade entre 17 e 41 anos, todas casadas ou em união consensual e a grande maioria residindo apenas com seu companheiro e seu filho ou filhos, metade delas trabalhando fora e a outra metade dona de casa, e a maioria era multípara. Como núcleos temáticos, surgiram das análises dos discursos: Altruísmo ou solidariedade a mãe e criança imaginárias demarcado por "doo para ajudar os bebês que precisam"; Consciência social do não-desperdício constatada pelo "eu tinha tanto leite que iria estragar"; Emponderamento do peito, ou "os bebês dependem de mim para se alimentar"; Gravidez desejada e histórico de perdas, constatado pelas recorrentes histórias de perdas associadas à ideia de uma gravidez muito preciosa, "o médico disse que era mais fácil eu abortar do que ter um bebê"; Suporte familiar, constatando-se que a presença dos familiares tanto pode ajudar muito ("minha mãe é meu exemplo, me estimula muito"), como atrapalhar bastante ("minha sogra era contra, não queria que eu doasse"); e Apoio social, visto no suporte desde o pré-natal até a doação em si ("a enfermeira me explicou que não vai faltar pro meu bebê, que quanto mais tira, mais leite vem"). Conclusões: as percepções das mães sobre a doação de leite foram bastante positivas, cercadas de ideias de solidariedade, empatia e orgulho das ações desempenhadas e demonstram também que as ações de promoção à saúde, desde a atenção básica no pré-natal até um bom acolhimento na maternidade e banco de leite podem ser determinantes importantes na manutenção do aleitamento e na decisão de doar leite.