Orientador: Cleide Enoir Petean Trindade / Banca: Stella Zanchetta / Banca: Saskia Maria Wegerink Fekete / Resumo: O objetivo desse estudo foi determinar os efeitos da intervenção fonoaudiológica na introdução da alimentação oral em Recém-Nascidos de Pré-Termo com idade pós-conceptual menor ou igual a 34 semanas, e avaliar o tempo de início da alimentação, o período de transição de alimentação por via gástrica (VG) para via oral total (VO), o tempo para atingir alimentação por via oral total, as intercorrências durante o estudo e a comparação entre o peso na entrada e término do estudo e a prevalência do aleitamento materno na alta hospitalar. Os resultados mostraram que a intervenção fonoaudiológica afetou o início da alimentação por via oral (VO) em mamadeira com redução de 6 dias em relação ao grupo controle. O início do aleitamento materno reduziu-se em 8 dias, e, para atingir alimentação oral total houve redução de 6 dias, embora não tenha afetado o tempo de transição da alimentação da via gástrica para a via oral, nem o tempo de internação hospitalar e o peso na alta hospitalar, isso em virtude da rotina hospitalar. Ocorreu menor número de episódios de intercorrências como: quedas de saturação de oxigênio e vômito, durante a internação, no grupo intervenção. Houve também maior prevalência do aleitamento materno no Grupo Intervenção no momento da alta hospitalar. Concluiu-se que quanto mais precocemente se iniciar a intervenção fonoaudiológica, mais cedo o recém-nascido de pré-termo será capaz de alimentar-se oralmente de forma segura e eficaz. / Abstract: The objective of this study was to determine the effects of the intervention by speech specialists in the introduction of the oral feeding in preterm infants and to evaluate the time of the begining of the feeding, the period of feeding transition for gastric feeding and orally total feeding, the time to reach feeding orally total, the interconnects during the study and the comparison among the weight in the entrance and end of the study in the groups and the prevalence of the maternal breastfeeding in the hospital discharge. The intervention of speech specialists reduced by 6 days the beginning of oral feeding by bottle and by 8 days the beginning of maternal breastfeeding and 6 days the time to reach total oral feeding. However the time of transition from gastric to oral feeding total hospital staying once weight at hospital discharge were not affected by the oral intervention. Less episodes of decreases in oxygen saturation and vomiting episodes during hospitalization occurred in the intervention group. As an important conclusion it was observance a higher prevalence of maternal breastfeeding in the intervention group at the moment of the hospital discharge. It was concluded that the earlier the intervention of speech specialists, the earlier the preterm infants will be able to be fed orally in a safe effective way. / Mestre

Made available in DSpace on 2014-06-11T19:28:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-07-21Bitstream added on 2014-06-13T20:36:49Z : No. of bitstreams: 1 correia_kba_me_botfm.pdf: 363151 bytes, checksum: 1410d2b31d375a09c8a75196d3be943f (MD5) / O objetivo desse estudo foi determinar os efeitos da intervenção fonoaudiológica na introdução da alimentação oral em Recém-Nascidos de Pré-Termo com idade pós-conceptual menor ou igual a 34 semanas, e avaliar o tempo de início da alimentação, o período de transição de alimentação por via gástrica (VG) para via oral total (VO), o tempo para atingir alimentação por via oral total, as intercorrências durante o estudo e a comparação entre o peso na entrada e término do estudo e a prevalência do aleitamento materno na alta hospitalar. Os resultados mostraram que a intervenção fonoaudiológica afetou o início da alimentação por via oral (VO) em mamadeira com redução de 6 dias em relação ao grupo controle. O início do aleitamento materno reduziu-se em 8 dias, e, para atingir alimentação oral total houve redução de 6 dias, embora não tenha afetado o tempo de transição da alimentação da via gástrica para a via oral, nem o tempo de internação hospitalar e o peso na alta hospitalar, isso em virtude da rotina hospitalar. Ocorreu menor número de episódios de intercorrências como: quedas de saturação de oxigênio e vômito, durante a internação, no grupo intervenção. Houve também maior prevalência do aleitamento materno no Grupo Intervenção no momento da alta hospitalar. Concluiu-se que quanto mais precocemente se iniciar a intervenção fonoaudiológica, mais cedo o recém-nascido de pré-termo será capaz de alimentar-se oralmente de forma segura e eficaz. / The objective of this study was to determine the effects of the intervention by speech specialists in the introduction of the oral feeding in preterm infants and to evaluate the time of the begining of the feeding, the period of feeding transition for gastric feeding and orally total feeding, the time to reach feeding orally total, the interconnects during the study and the comparison among the weight in the entrance and end of the study in the groups and the prevalence of the maternal breastfeeding in the hospital discharge. The intervention of speech specialists reduced by 6 days the beginning of oral feeding by bottle and by 8 days the beginning of maternal breastfeeding and 6 days the time to reach total oral feeding. However the time of transition from gastric to oral feeding total hospital staying once weight at hospital discharge were not affected by the oral intervention. Less episodes of decreases in oxygen saturation and vomiting episodes during hospitalization occurred in the intervention group. As an important conclusion it was observance a higher prevalence of maternal breastfeeding in the intervention group at the moment of the hospital discharge. It was concluded that the earlier the intervention of speech specialists, the earlier the preterm infants will be able to be fed orally in a safe effective way.

Ce travail de thèse a pour objectifs de caractériser quels types de textures sont acceptés à un âge donné entre 4 et 36 mois et d’identifier quels sont les facteurs (caractéristiques de enfants, leurs capacités orales et les pratiques maternelles d’alimentation) contribuant à l’acceptabilité des textures en France. Pour répondre à ces objectifs, une enquête transversale à destination de mères ayant des enfants âgés entre 4 et 36 mois (n=3079 réponses analysées) mesurant l’acceptabilité déclarée, ainsi qu’un suivi longitudinal d’enfants âgés entre 6 et 18 mois (n=49) mesurant l’acceptabilité réelle ont été conduits. Les résultats de l’enquête qui couvrait une large gamme de textures montrent que pendant la première année les enfants sont principalement exposés à des aliments sous forme de purées, alors que les morceaux et les doubles textures (purée avec morceaux) sont introduits après 12 mois. Le développement des compétences orales de l’enfant (nombre de dents, capacité à se nourrir seul) et certaines pratiques maternelles d’alimentation, tel l’âge de diversification et le mode de préparation des aliments, sont associés à une plus grande exposition aux textures alimentaires. L’acceptabilité des aliments de différentes textures est dépendante du développement oral de l’enfant et est fortement associée à l’exposition de l’enfant aux différentes textures. Les résultats de l’étude expérimentale révèlent que la majorité des textures alimentaires proposées lors des séances sont acceptées dès 6 mois. A chaque âge d’étude, l’acceptabilité et les comportements oraux varient suivant les textures ; à partir de 10 mois les enfants ont plus recours à la mastication qu’à la succion. Comme observé dans l’enquête, l’exposition aux différentes textures s’avère le meilleur prédicteur de l’acceptabilité des textures avec l’âge. La prise en compte de ces résultats détaillés pourrait permettre d’établir de nouvelles recommandations concernant l'introduction des textures en France et de développer des produits destinés aux jeunes enfants qui intégreront ces enseignements. / This thesis aimed to characterize which food textures are accepted at a given age between 4 to 36 mo of age, and to identify factors (children’s characteristics, feeding skills and maternal feeding practices) that contribute to food texture acceptance in France. To meet these purposes a cross-sectional survey intended for mothers having children aged between 4 and 36 mo (n=3079 answers analysed) measuring declared acceptance and a prospective longitudinal study with children aged between 6 and 18 mo (n=49) measuring actual acceptance were carried out. Results from the survey, which covered a larger range of food textures, showed that over the first year, infants were mainly exposed to foods in pureed forms, whereas pieces and double textures (e.g. puree with pieces) were introduced after 12 mo. Factors such as the development of feeding skills (number of teeth; ability to eat autonomously) and some maternal feeding practices (age of CF, type of food preparation) were associated with a higher food texture exposure. The acceptance of food with different textures increased steadily up to 3 years, with a sharper increase for soft and hard solid foods from 13-15mo. The acceptance was dependent of the child’s feeding skills readiness, and was strongly associated with the child exposure to food with different textures. Results from the experimental study showed that most of the food textures offered in the study were accepted by children from 6 mo onward. At each studied age, children’s food acceptance and feeding behaviours varied according to the food textures; from 10 mo, chewing predominated over sucking. As found in the survey approach, the food texture exposure was the best predictor of food texture acceptance. Taking into account these detailed results could make it possible to establish new guidelines with regards to food texture introduction in France, and to develop food products for infants and toddlers including these learning.