Speech-language-hearing follow-up of preterm children: feeding and neuropsychomotor performance

Abstract

Purpose: to establish the breastfeeding rates at hospital discharge and post-discharge, analyze neuropsychomotor development, and indicate the rehabilitation referral rate of preterm children attended by speech-language-hearing therapists. Methods: a total of 39 preterm children participated in the study. They were born at a Children and Maternity Hospital between August 2016 and January 2017 and were followed up by the speech-language-hearing therapists during the hospital stay. The Spearman’s statistical test was used. The p-value was set at 0.005; the correlation value was: r = 0.10 to 0.39, weak correlation; r = 0.40 to 0.69, moderate correlation; and r = 0.70 to 1, strong correlation. Results: of the 39 participants, 17 (43.6%) were discharged on exclusive breastfeeding; 4 (10.25%), on mixed milk feeding (breast and cup); 14 (35.9%), on mixed milk feeding (breast and baby bottle); and 4 (10.25%), on artificial milk feeding - baby bottle. After introducing solid food, 12.8% remained on breastfeeding, 38.4% on mixed milk feeding, and 48.7% in artificial milk feeding. Complementary feeding was introduced at 5 months (adjusted age). Auditory, motor and language development occurred as expected in 90% of the children, considering the milestone’s adjusted age. Conclusion: at hospital discharge, most infants were on exclusive or mixed breastfeeding. After discharge, mixed breastfeeding lasted longer, and low neuropsychomotor development impairment rates and rehabilitation referral rates were observed.

Introduction of complementary feeding in premature children

“…The following motor development parameters must be analyzed before introducing CF: holding their head and neck up; sitting up without support; having reduced tongue protrusion reflex; manipulating objects, and so forth 14 . A cohort of children followed up at outpatient centers until 2 years old verified that most premature children had adequate milestones and the expected neuropsychomotor development for their age 15 . However, other authors have reported many mothers with at least a high school degree who weaned early 22 .…”

Introdução da alimentação complementar em crianças prematuras

“…A amostra foi composta por 29 crianças, sendo 55,2% (16) início da AC, estão: sustentar cabeça e pescoço; sentar sem apoio; redução do reflexo de protrusão de língua; manipular objetos, entre outros 14 . Em uma coorte de crianças acompanhadas ambulatoriamente até os dois anos de idade, constatou-se que a maioria das crianças prematuras apresentaram o desenvolvimento neuropsicomotor dentro do esperado para idade e marco adequados 15 .…”

Falas maternas sobre alimentação infantil

“…Os impasses que podem surgir nas cenas de alimentação envolvem, portanto, o par alimentador/ alimentado, mãe/criança. Há muitas pesquisas que tratam das questões que se apresentam e que se vinculam à competência e condições da criança 19,20 . Estas pesquisas, no campo da Fonoaudiologia, realçam os aspectos ligados à motricidade orofacial das crianças e, em alguns estudos, as repercussões destas dificuldades nas condutas parentais 19 .…”