Disfunção motora oral e dificuldade alimentar durante a alimentação complementar em crianças nascidas pré-termo
Oral motor disorder and feeding difficulty during the introduction of complementary feeding in preterm infants
Carla Steinberg, Larissa Menezes, Ana Caline Nóbrega
Resumo
Objetivo: Investigar a associação entre a disfunção motora oral e a dificuldade alimentar durante o processo de introdução de alimentação complementar em crianças nascidas pré-termo. Método: Trata-se de um estudo transversal, observacional e quantitativo. Nele, foram incluídos prematuros em acompanhamento em um ambulatório de seguimento de recém-nascidos de alto risco, que já tinham iniciado a alimentação complementar e possuíam até 24 meses de idade gestacional corrigida. A dificuldade alimentar foi investigada mediante a percepção da mãe quanto à presença de comportamentos defensivos do filho. A medida do desempenho das habilidades motoras orais foi obtida a partir da aplicação de uma adaptação do Protocolo de Avaliação Clínica da Disfagia Pediátrica (PAD-PED). Resultados: A amostra foi composta por 62 díades de crianças com média de 13,5 meses de idade gestacional corrigida (IGC). A alimentação complementar foi introduzida no sexto mês de IGC por quase metade das mães, e a maioria delas informou algum tipo de dificuldade nessa introdução. A prematuridade extrema revelou associação com o comportamento alimentar defensivo (p=0,005), assim como a introdução inicial de alimentos na consistência liquidificada (p=0,001), o tempo prolongado de uso de sonda enteral (p=0,044), a pressão positiva em vias aéreas (CPAP) (p=0,013) e a nutrição parenteral (p=0,039). Conclusão: Não foi encontrada uma associação significativa entre a disfunção motora oral e a dificuldade alimentar.
Palavras-chave
Abstract
Purpose: To investigate the association between oral motor disorder and feeding difficulty during the process of introducing complementary feeding in preterm infants. Methods: This is a cross-sectional, observational and quantitative study. Preterm infants who had already begun complementary feeding and were up to 24 months corrected gestational age, were followed up at an outpatient clinic for high-risk newborns. The feeding difficulty was assessed using the mother’s perception of the presence of defensive behaviors in their child. The measurement of the oral motor skills performance was obtained through the application of an adaptation of the Clinical evaluation protocol of pediatric dysphagia (PAD-PED). Results: The sample consisted of 62 dyads of children with a mean corrected gestational age (CGA) of 13.5 months. Complementary feeding was introduced at sixth month CGA by almost half of the mothers and the most of them reported some sort of difficulty with this activity. Extreme prematurity revealed an association with defensive feeding behavior (p = 0.005), as well as with the initial introduction of food with liquid consistency (p = 0.001), the extended period of time using enteral tube feeding (p = 0.044), the continuous positive airway pressure (CPAP) (p = 0.013) and parenteral nutrition (p = 0.039). Conclusion: There was no significant association between oral motor disorder and feeding difficult.
Keywords
Referências
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Submetido em:
07/07/2019
Aceito em:
17/02/2020
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