Abstract
Congenital Zika Syndrome (CZS) is a condition that has emerged only recently, bringing together multiple changes, including significant changes in the stomatognathic system, which may compromise sucking behavior and consequently the breastfeeding practice. The aim of this study was to investigate the breastfeeding behaviors in children with CZS. A longitudinal study was carried out in two reference centers in Northeastern Brazil. The nonprobabilistic sample consisted of 79 children diagnosed with physical, neurological, and behavioral alterations compatible with CZS. Information regarding the child, nutritive, and nonnutritive sucking behavior and changes related to the sucking reflex was collected. Data were presented through descriptive and inferential statistics. In the bivariate analyses, the chi-squared test was used and 5% significance level was adopted. The majority of children had severe microcephaly (59.7%). Breastfeeding was performed at birth in most of CZS children (89.9%) but only 36.6% of them presented exclusive breastfeeding in the six months of life. Bottle feeding and pacifier were used in 89.9% and 55.7%, respectively. Sucking and swallowing difficulties and occurrence of gastroesophageal reflux were observed in 27.8%, 48.0%, and 29.2% of children, respectively. Early weaning was associated with bottle feeding (p=0.005) and pacifier sucking (p=0.003). Although breastfeeding practice at birth constitutes a behavior adopted by most of mothers, adherence to this exclusive habit until the first six months of life was low since the children presenting a large number of comorbidities with direct interference in the suction reflex, sucking, and swallowing difficulty.
Highlights
IntroductionE World Health Organization [5], the United Nations Children’s Fund [6], and the Brazilian Ministry of Health [7] advocate exclusive breastfeeding until six months of age and complementary feeding until at least the second year of life
Breastfeeding has multiple benefits in the short or long term, providing advantages for both infant and mother. ere are reports about the effects of breastfeeding on the decline of infection rates and positive impact on physical, cerebral, and cognitive development of infants [1,2,3,4].e World Health Organization [5], the United Nations Children’s Fund [6], and the Brazilian Ministry of Health [7] advocate exclusive breastfeeding until six months of age and complementary feeding until at least the second year of life
In Brazil, the estimated average time of exclusive breastfeeding for children younger than 6 months was 41%, and significant differences were identified among the five Brazilian macro-regions, and even among the states that compose the same region
Summary
E World Health Organization [5], the United Nations Children’s Fund [6], and the Brazilian Ministry of Health [7] advocate exclusive breastfeeding until six months of age and complementary feeding until at least the second year of life. Even considering this strong recommendation, it is estimated that in low- and middle-income countries, only 37% of children younger than 6 months are exclusively breastfed; an even lower percentage is observed in highincome countries [8]. A marked oral dysfunction has been described, with dystonic movements of the tongue, lack of pharyngeal sensitivity, increased risk of aspiration, and episodes of severe dysphagia [14, 15]
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