Impacto do aleitamento materno no crescimento de crianças com microcefalia associada à sindrome congênita pelo vírus zika: uma coorte do nascimento aos 60 meses

Abstract

Congenital Zika Virus Syndrome (CZS) encompasses a series of malformations in children exposed during the intrauterine phase, such as microcephaly, which affects physical and cognitive development and leads to complications in the feeding and growth process. Despite being recommended as the first source of nutrition, it is not known whether breastfeeding has a protective effect on the growth of these children, given the complications imposed by the disease. Therefore, this research aimed to analyze the association between breastfeeding and the growth of children with microcephaly associated with SCZ. To this end, a prospective cohort investigation was carried out with children with microcephaly due to SCZ living in the state of Rio Grande do Norte. To analyze breastfeeding practices, positive responses to the following indicators were used: Colostrum consumption in the first two days of life, exclusive breastfeeding (EBF) in the first 6 months, continued breastfeeding in the second year of life and long-term exclusive breastfeeding (AMELD). The growth result was evaluated by the z-scores of the weight/age, height/age and weight/height indices, and by the presence of growth failure between birth and 6 months and between 6 and 24 months. Associations were explored using covariate-adjusted logistic regression equations. Of the 73 children monitored, the average birth weight was 2621.8 g (± 573.4), length 45.8 cm (43.9-47.3), and the average EBF time was 3. 3 months. More than half of the children received AMELD, and 21.9% were breastfed during the second year of life. In general, the children showed a growth pattern below that expected for their age and sex (z score < -2), with a progressive increase in inadequacies over time. Those who were on AMELD had higher weight/age z-score values over time, and this breastfeeding indicator reduced the chance of developing low weight and low length, simultaneously, at 24 months (RR = 0.163; 95% CI = 0.03-0.996; p=0.049). When breastfed until the second year of life, they had a lower chance of failure to thrive between 6 and 24 months (RR = 0.034; 95% CI = 0.0-0.52; p=0.015). Therefore, encouraging EBF for at least 3 months and continuing until the second year of life can significantly reduce the chance of growth deviations in children with microcephaly due to SCZ.