Efeitos da estimulação gustativa nos estados comportamentais de recém-nascidos prematuros

Abstract

Purpose: To observe the behavioral states presented by premature newborns in response to gustatory stimulation. Methods: Experimental, analytical and double-blind study. Ninety premature newborns born in a public maternity hospital in Sergipe took part in the test which was filmed and divided into three parts of five minutes. In the first and last, there was no stimulus; in the second, the gustatory stimulation was applied and the newborn children were divided into two groups (water or analysis for sucrose 12%). The observed behavioral states were deep sleep, light sleep, drowsy, alert, agitated/irritated and crying. The data were statistically analyzed. Results: In the sucrose group, during and after stimulation, the correlation was strong in the light sleep and alert behavioral states and decreased in the drowsy, agitated/irritated and crying states. In the water group there was an increase in correlation in the agitated/irritated and crying states after stimulation. Conclusion:The continuity or change of the behavioral state of the premature newborns was positively influenced by the administration of gustatory stimulus, pointing to the possibility of using sucrose in benefit of the favorable behavioral states of that population. Na primeira e na última, não houve estímulo; na segunda aconteceu estimulação gustativa, sendo que os recém-nascidos foram divididos em dois grupos (água ou sacarose para análise 12%). Os estados comportamentais observados foram sono profundo, sono leve, sonolento, alerta, irritado/agitado e choro. Os dados foram analisados estatisticamente. Resultados:No grupo sacarose houve correlação forte nos estados comportamentais sono leve e alerta, durante e após a estimulação, e redução de correlação nos estados sonolento, agitado/irritado e choro.Já no grupo água, após a estimulação houve aumento de correlação nos estados agitado/irritado e choro. Conclusão: A permanência ou mudança do estado comportamental do recém-nascido prematuro foi influenciada positivamente pela administração de estímulo gustativo, apontando para o possível uso da sacarose na contribuição de estados comportamentais favoráveis nessa população.

Acompanhamento fonoaudiológico do aleitamento materno em recém-nascidos nas primeiras horas de vida

“…It is worth mentioning that the most incident behavioral state was the alert, due to the fact that the newborns are being observed precisely in the feeding situation, which requires greater readiness. However, healthy NBs sleep, on average, 90% of the time, in the first days of life (12) and that sleep tends to decrease with the physiological maturation of the infant (19) . It is important that the infants are oriented about this aspect, because in some cases, the maintenance of sleep without the breastfeeding effectiveness can be associated with hypoglycemia, interfering, also, in the maintenance of the rhythm and sustentation of the suction force, making it ineffective (13) .…”

“…NB alert has open or closed eyes, with clear concentration activity and low level of global motor activity (12) . The alert behavioral state was considered the most favorable for the breastfeeding stimulation, in contrast to states of drowsiness, crying, agitation and/or irritation.…”

“…The breastfeeding evaluation allows the health professional to identify anatomical and physiological aspects of the mother--NB that lead to failure of breastfeeding, such as nipple trauma, ineffective sucking pattern, inadequate grasp, and incoordination of suction-swallowing-breathing movements (3,11) . Sleep can also negatively interfere with breastfeeding readiness, rhythm maintenance and suction force support, since healthy newborns sleep on average 90% of the time in the first days of life (12,13) . The influence of each subject's beliefs regarding the difficulty in breastfeeding can also trigger feelings of guilt, frustration, insecurity and anxiety (14,15) .…”

Influência do estado comportamental nos padrões de sucção de recém-nascidos pré-termo

“…Behavioral states are considered as important factors of influence on a range of childhood behaviours (1,2) , including feeding aspects (3)(4)(5) .…”

“…The alertness state is considered ideal for feeding in the literature, as in this state the infant is more conscious and with a higher readiness for feeding (5,9) . Contrarily, the sleep state may interfere with infants' capacities to maintain a rhythm and strength of sucking (10) .…”