Introdução da alimentação complementar em recém-nascido pré-termo e com baixo peso

Abstract

Introduction: Infant nutrition in the first 1000 days is crucial for proper growth and development from childhood to adulthood, especially for preterm newborns (PTNB). The main sources of nutrition are breastfeeding and complementary feeding, but recommendations on the ideal time to introduce complementary feeding in PTNB are still scarce. Objective: To analyze the association between sociodemographic factors, maternal and neonatal characteristics and the time of introduction of complementary feeding in preterm and underweight newborns. Methods: This is a prospective cohort study carried out with 79 PTNB weighing less than or equal to 1800 grams. Data were collected at hospital discharge and at the 6th, 9th and 12th month of corrected gestational age (CGA). For data collection, a semi-structured questionnaire was used to assess neonatal characteristics (gender, gestational age, birth weight, type of food offered at hospital discharge, length of stay and Score for Neonatal Acute Physiology - Perinatal (SNAPPE II) , maternal (age, schooling, parity, type of delivery, maternity leave, maternal work), the time of introduction to complementary feeding, the types of foods introduced and the parents' perception of the behavior of newborns during feeding. In addition, to assess the risk of developmental delay, the Survey of Wellbeing of Yong Children (SWYC-BR) was used. To analyze the variables, Cox Proportional Hazards regression was applied. Results: The introduction of complementary feeding was observed early in the PTNBs analyzed, with the offer of solids and pasty from the fourth month of IGC and liquids from the third month of IGC. There was also a positive influence of gestational age (RR = 1.25; CI95% 1.02-1.52) throughout the process of introducing complementary foods, in which the higher the gestational age, the longer it took to introduce complementary foods. In solid and pasty foods, those with longer hospitalization time (RR= 1.03; 95%CI 1.1-1.05) and breastfeeding (RR = 2.97; 95%CI 1.24-7.09) delayed longer to introduce complementary foods. For liquid foods, less severe preterm newborns (SNAPPE II [RR = 0.96; 95%CI 0.94-0.98]) and mothers who were breastfeeding at discharge (RR = 11.49; 95%CI 0.94-0.98) also took longer to start the introduction of complementary feeding. Conclusion: Complementary feeding was introduced early in the PTNBs in the study. Factors such as gestational age, length of stay and breastfeeding influenced the process of introducing complementary foods, delaying the start of the offer. Guidelines for better guidance of professionals and parents and/or guardians about the ideal moment of introducing food, if necessary.