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Saliva measurements serve as a noninvasive tool for clinically monitoring newborns (NB) and children, a vulnerable population with promising potential for both research and clinical practice. Saliva acts as a repository for various inflammatory biomarkers involved in diverse biological functions. Particularly for children, it offers numerous advantages when compared to plasma and urine sampling. Nevertheless, there is a significant knowledge gap regarding detectable levels of cytokines in the saliva of newborns and children, as well as studies aiming to assess the relationship of this content with physiological and pathological processes. OBJECTIVES: To characterize the levels of 11 inflammatory mediators (IFNg, IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17, TNF, and VEGF) in saliva samples from NB on the first and second day of hospitalization in the Neonatal Intensive Care Unit (NICU). METHOD: Exploratory study, descriptive, nested within a primary clinical, observational, and prospective study, conducted in the NICU of a public hospital in São Paulo, Brazil. Demographic data and vital signs were recorded in the clinical records of 90 NB, and five saliva samples from 5 NB were collected between the first and second day of life (D1-D2) at approximately 8-hr intervals (8-9 am, 4-5 pm, and 11-12 pm). Saliva samples were used for the measurement of 11 cytokines (IFNg, IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17, TNF, and VEGF). RESULTS: Five NBs participated in this exploratory study, and the vital signs showed variability from the first (D1) to the second day (D2) of hospitalization, variability similar to that of the total population of the primary study. The presence and levels of the 11 cytokines were detected in the saliva samples, as well as a statistical correlation between 10 cytokines (IFNg, IL1b, IL2, IL4, IL6, IL10, IL12, IL17, TNF, and VEGF) and vital signs. CONCLUSIONS: The novelty of measuring inflammatory mediators in saliva samples from hospitalized NBs in the NICU is highlighted, providing support and new perspectives for the development of clinical and experimental research and an opportunity for developing and implementing new salivary biomarkers in different population segments.

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OBJECTIVES: to understand the challenges in mothers' daily life and strategies adopted to reconcile activities outside the home and continued breastfeeding. METHODS: a cross-sectional, qualitative study. Theoretical-methodological assumptions were discursive practices and production of meanings in everyday life. Participants were 22 women from a specific social media group who had breastfed at least one child for >7 months. Data were collected between November 2020 and March 2021. RESULTS: themes: Around the world of activities outside the home; Work environment: routines, opportunities and difficulties to maintain breastfeeding. FINAL CONSIDERATIONS: women's experiences reveal a daily life with difficulties in reconciling the desire to breastfeed and the work scenario. Support network and adaptation to children's food routine were strategies adopted to minimize risks of weaning. The results show the need to consolidate policies to encourage continued breastfeeding in the labor market.

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Resumo Objetivo Analisar a relação entre os sintomas de ansiedade materna com a autoeficácia para a amamentação e a duração do aleitamento materno exclusivo. Métodos Estudo de coorte prospectivo, desenvolvido num Centro de Aleitamento Materno de um hospital universitário do município de São Paulo. A amostra foi constituída por 83 puérperas, acompanhadas até 210 dias após o parto. Foram utilizadas a Subescala de Ansiedade da Escala de Depressão Pós-natal de Edimburgo e a Escala de Autoeficácia para Amamentação. Resultados A média de escore total de ansiedade foi 3,76 pontos e da autoeficácia materna para amamentar 128,58. Ao longo dos meses os sintomas de ansiedade e a autoeficácia para amamentação apresentaram comportamento semelhante e não significativos estatisticamente. São fatores de risco associados ao incremento dos sintomas ansiosos: aborto, história prévia de depressão, queixa em relação a si mesma, relacionamento familiar e conjugal insatisfatório, piora na relação com o parceiro após o nascimento do bebê e menor autoeficácia materna para amamentação, refletidos nos domínios técnico e pensamentos intrapessoais. O tempo entre a interrupção do aleitamento materno exclusivo e a ansiedade não foi estatisticamente diferente. Conclusão As puérperas investigadas apresentaram elevada prevalência de sintomatologia ansiosa, com interferência significativa na percepção e confiança em sua capacidade e habilidade materna de amamentar com sucesso o bebê. Não houve associação entre os sintomas de ansiedade e o desmame precoce.

Resumen Objetivo Analizar la relación entre los síntomas de ansiedad materna y la autoeficacia para la lactancia y la duración de la lactancia materna exclusiva. Métodos Estudio de cohorte prospectivo, realizado en un Centro de Lactancia Materna de un hospital universitario en el municipio de São Paulo. La muestra estuvo compuesta por 83 puérperas, a quienes se les realizó un seguimiento hasta los 210 días después del parto. Se utilizó la Subescala de Ansiedad de la Escala de Depresión Posnatal de Edimburgo y la Escala de Autoeficacia para la Lactancia. Resultados El promedio de la puntuación total de ansiedad fue de 3,76 puntos y de autoeficacia materna para la lactancia 128,58. A lo largo de los meses, los síntomas de ansiedad y la autoeficacia para la lactancia presentaron un comportamiento semejante y no significativo estadísticamente. Los factores de riesgo asociados al aumento de los síntomas ansiosos son: aborto, historia previa de depresión, queja con relación a sí misma, relación familiar y conyugal insatisfactoria, deterioro en la relación con la pareja luego del nacimiento del bebé y menor autoeficacia materna para la lactancia, reflejados en los dominios técnico y pensamientos intrapersonales. El tiempo entre la interrupción de la lactancia materna exclusiva y la ansiedad no fue estadísticamente diferente. Conclusión Las puérperas investigadas presentaron una elevada prevalencia de sintomatología ansiosa, con interferencia significativa en la percepción y confianza de su capacidad y habilidad materna de amamantar con éxito al bebé. No hubo asociación entre los síntomas de ansiedad y el destete temprano.

Abstract Objective To analyze the relationship of maternal anxiety symptoms with breastfeeding self-efficacy and duration of exclusive breastfeeding. Methods Prospective cohort study developed in a Breastfeeding Center of a university hospital in the city of São Paulo. The sample consisted of 83 postpartum women in follow-up for 210 days after delivery. The Anxiety Subscale of the Edinburgh Postnatal Depression Scale and the Breastfeeding Self-Efficacy Scale were used. Results The mean total score for anxiety was 3.76 points and for maternal self-efficacy to breastfeed was 128.58. Over the months, anxiety symptoms and breastfeeding self-efficacy showed similar behavior and were not statistically significant. The following risk factors were associated with the increase in anxiety symptoms: abortion, previous history of depression, complaints about oneself, unsatisfactory family and marital relationships, worsening of the relationship with the partner after the baby was born and lower maternal breastfeeding self-efficacy, reflected in the technique domain and intrapersonal thoughts domain. The time between cessation of exclusive breastfeeding and anxiety was not statistically different. Conclusion The investigated postpartum women had a high prevalence of anxiety symptoms, with significant interference in the perception and confidence in their ability and maternal capability to successfully breastfeed the baby. There was no association between anxiety symptoms and early breastfeeding cessation.

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ABSTRACT Objectives: to understand the challenges in mothers' daily life and strategies adopted to reconcile activities outside the home and continued breastfeeding. Methods: a cross-sectional, qualitative study. Theoretical-methodological assumptions were discursive practices and production of meanings in everyday life. Participants were 22 women from a specific social media group who had breastfed at least one child for >7 months. Data were collected between November 2020 and March 2021. Results: themes: Around the world of activities outside the home; Work environment: routines, opportunities and difficulties to maintain breastfeeding. Final Considerations: women's experiences reveal a daily life with difficulties in reconciling the desire to breastfeed and the work scenario. Support network and adaptation to children's food routine were strategies adopted to minimize risks of weaning. The results show the need to consolidate policies to encourage continued breastfeeding in the labor market.

RESUMEN Objetivos: comprender los desafíos del cotidiano de la madre y las estrategias adoptadas para conciliar las actividades fuera del hogar y la continuación de la lactancia materna. Métodos: estudio transversal, cualitativo. Los supuestos teórico-metodológicos fueron: prácticas discursivas y producción de sentidos en la vida cotidiana. Las participantes fueron 22 mujeres, de un grupo específico de redes sociales, que habían amamantado al menos a un niño durante más de 7 meses. Los datos se recopilaron entre noviembre de 2020 y marzo de 2021. Resultados: temas: En torno al mundo de las actividades fuera del hogar; Ambiente de trabajo: rutinas, oportunidades y dificultades para mantener la lactancia materna. Consideraciones Finales: la experiencia de las mujeres revela un cotidiano con dificultades para conciliar el deseo de amamantar y el escenario laboral. La red de apoyo y la adaptación a la rutina alimentaria del niño fueron estrategias adoptadas para minimizar los riesgos del destete. Los resultados muestran la necesidad de consolidar políticas para incentivar la continuación de la lactancia materna en el mercado laboral.

RESUMO Objetivos: compreender os desafios do cotidiano materno e as estratégias adotadas para conciliação entre as atividades fora do lar e a amamentação continuada. Métodos: estudo transversal, qualitativo. Pressupostos teórico-metodológicos foram: práticas discursivas e produção de sentidos no cotidiano. Participaram 22 mulheres, de um grupo de mídia social específico, que amamentaram pelo menos um filho por > sete meses. Dados foram coletados entre novembro de 2020 e março de 2021. Resultados: temas: A volta ao mundo das atividades fora do lar; Ambiente no trabalho: rotinas, oportunidades e dificuldades para manter a amamentação. Considerações Finais: a vivência das mulheres revela um cotidiano com dificuldades de conciliar o desejo de amamentar e o cenário laboral. Rede de apoio e a adaptação na rotina alimentar da criança foram estratégias adotadas para minimizar os riscos de desmame. Os resultados mostram a necessidade de consolidação das políticas de incentivo ao aleitamento continuado no mercado de trabalho.

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Resumo Objetivo Identificar os principais biomarcadores salivares descritos, assim como as técnicas empregadas para coleta das amostras de saliva, em estudos relacionados à avaliação da dor em pacientes submetidos a procedimentos dolorosos ou portadores de patologias dolorosas. Métodos Revisão integrativa da literatura, realizada pelas buscas bibliográficas nas bases Biblioteca Virtual em Saúde (BVS), MEDLINE/PubMed, CINAHL e EMBASE, com recorte temporal de 2009 a 2019 e período de coleta de dados entre outubro e novembro de 2019. Foram utilizados Descritores em Saúde (DeCs)e Medical SubjectHeadings (MeSH), para responder à pergunta norteadora: Quais são e como são utilizados os biomarcadores salivares na avaliação da dor? Foi realizada uma análise descritiva dos artigos, sendo os dados extraídos e registrados em uma planilha desenvolvida para o presente estudo. Resultados Das 126 publicações identificadas, 22 artigos foram incluídos para a análise. Constatou-se que os artigos são, majoritariamente, desenvolvidos com adultos durante realização de procedimentos dolorosos ou portadores de patologias dolorosa. Os principais biomarcadores salivares avaliados foram a alfa-amilase e o cortisol, e as principais técnicas para coleta de saliva foram o Salivette® e a coleta passiva. Conclusão Os estudos indicam que a mensuração objetiva da dor é um desafio. Os principais biomarcadores salivares descritos são o cortisol e a alfa-amilase, sendo o Salivette®a principal técnica utilizada para coleta das amostras de saliva. A dosagem das moléculas salivares é incipiente e empregada de forma complementar na avaliação da dor em pacientes de diferentes faixas estárias, submetidos à procedimentos dolorosos ou portadores patologias dolorosas.

Resumen Objetivo Identificar los principales biomarcadores salivales descriptos, así como las técnicas utilizadas para la recolección de las muestras de saliva en estudios relacionados con la evaluación del dolor en pacientes sometidos a procedimientos dolorosos o con patologías dolorosas. Métodos Revisión integrativa de la literatura, realizada por medio de búsquedas bibliográficas en las bases Biblioteca Virtual em Saúde (BVS), MEDLINE/PubMed, CINAHL y EMBASE, con un recorte temporal del 2009 al 2019 con un período de recolección de datos de octubre a noviembre de 2019. Se utilizaron Descriptores en Salud (DeCs) y Medical SubjectHeadings (MeSH), para responder a la pregunta orientadora: ¿Cuáles son los biomarcadores salivales en la evaluación del dolor y cómo se utilizan? Se realizó un análisis descriptivo de los artículos y los datos extraídos y registrados en una planilla desarrollada para el presente estudio. Resultados De las 126 publicaciones identificadas, se incluyeron 22 artículos para análisis. Se constató que los artículos están, mayoritariamente, desarrollados con adultos durante la realización de procedimientos dolorosos o con patologías dolorosas. Los principales biomarcadores salivales evaluados fueron alfa-amilasa y cortisol, y las principales técnicas para la recolección de saliva fueron Salivette® y la recolección pasiva. Conclusión Los estudios indican que la medición objetiva del dolor es un desafío. Los principales biomarcadores salivales que se describen son el cortisol y la alfa-amilasa y Salivette® la principal técnica utilizada para la recolección de muestras de saliva. La dosificación de las moléculas salivales es incipiente y utilizada de forma complementaria en la evaluación del dolor en pacientes de distintos grupos de edad, sometidos a procedimientos dolorosos o con patologías dolorosas.

Abstract Objective To identify the main salivary biomarkers described and the techniques used for saliva sample collection in studies related to pain assessment in patients undergoing painful procedures or experiencing painful diseases Methods An integrative literature review was conducted via bibliographic searches in the Virtual Health Library (VHL), MEDLINE/PubMed, CINAHL, and EMBASE databases for the period from 2009 to 2019; data were collected in October and November 2019. The DeCs health descriptors and the Medical Subject Headings (MeSH) were used to answer the guiding question: "Which salivary biomarkers are used in pain assessment and how are they employed?" A descriptive analysis of the articles was performed; data were collected and recorded in a spreadsheet developed for the present study. Results Of the 126 published articles identified, 22 articles were included for analysis. The articles were mainly regarding adults undergoing painful procedures or patients experiencing painful diseases. The main salivary biomarkers evaluated were alpha-amylase and cortisol, and the main saliva collection techniques were Salivette® and passive collection. Conclusion The studies indicated that objective pain measurement is a challenge. The main salivary biomarkers evaluated were cortisol and alpha-amylase, and the main technique employed for saliva sample collection was Salivette®. The dosage of salivary molecules is emerging for use as a complement in pain assessment in patients of different ages undergoing painful procedures or experiencing painful diseases.

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OBJECTIVE: To characterize painful procedures, analgesic strategies, vital signs, and pain scores in hospitalized newborns. METHOD: This is a primary, observational, prospective clinical study, developed in a Brazilian public hospital. Demographic data, painful procedures, pain relief measures, vital signs, and pain scores were collected from the clinical records of 90 newborns admitted to the intensive care unit and evaluated between admission and the third day of admission. For statistical analysis, the software Statistic Package for the Social Sciences and the R Software were used. RESULTS: Newborns underwent 2,732 painful procedures, 540 non-pharmacological and 216 pharmacological strategies. The most frequently performed procedure was the heel prick (20.96%). The most commonly recorded non-pharmacological strategy was dim lighting (28.33%) and continuous fentanyl (48.83%) was the main pharmacological measure adopted. Pain score and vital signs show variability in the period evaluated. CONCLUSION: Despite the high number of painful procedures, pain assessment records do not reflect procedural pain and the use of analgesic strategies was insufficient.

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OBJECTIVE: The objective of this protocol is to evaluate the effectiveness of photobiomodulation therapy for the treatment of nipple pain or nipple trauma in women during the breastfeeding period. INTRODUCTION: One approach that has been reported on the management of nipple pain or nipple trauma in lactating women is the use photobiomodulation therapy to heal the injury or to decrease pain intensity. However, studies have achieved different results, due to variations in the treatment protocol, such as the source of light used, the application mode, the irradiation, or the light dose parameters, leading to varying outcomes. INCLUSION CRITERIA: This review will consider studies that evaluate photobiomodulation therapy for the treatment of nipple pain or nipple trauma in lactating women in the postpartum period that compare the intervention to standard care, placebo, or other type of treatment. The following outcomes will be considered: intensity of nipple pain, healing of nipple trauma, exclusive breastfeeding rate, quality of life, and satisfaction of the women with treatment. There will be no publication time limit, and studies published in any language will be considered for inclusion. METHODS: This review will be conducted in accordance with JBI methodology for systematic reviews of effectiveness. The search strategy will search both published and unpublished studies, and the process of study selection, critical appraisal, data extraction, and data synthesis will be performed in accordance to the JBI approach. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019147401.

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ABSTRACT Objective: To characterize painful procedures, analgesic strategies, vital signs, and pain scores in hospitalized newborns. Method: This is a primary, observational, prospective clinical study, developed in a Brazilian public hospital. Demographic data, painful procedures, pain relief measures, vital signs, and pain scores were collected from the clinical records of 90 newborns admitted to the intensive care unit and evaluated between admission and the third day of admission. For statistical analysis, the software Statistic Package for the Social Sciences and the R Software were used. Results: Newborns underwent 2,732 painful procedures, 540 non-pharmacological and 216 pharmacological strategies. The most frequently performed procedure was the heel prick (20.96%). The most commonly recorded non-pharmacological strategy was dim lighting (28.33%) and continuous fentanyl (48.83%) was the main pharmacological measure adopted. Pain score and vital signs show variability in the period evaluated. Conclusion: Despite the high number of painful procedures, pain assessment records do not reflect procedural pain and the use of analgesic strategies was insufficient.

RESUMEN Objetivo: Caracterizar los procedimientos dolorosos, estrategias analgésicas, señales vitales y los scores de dolor en recién nascidos hospitalizados. Método: Estudio clínico primario, de observación, prospectivo, desarrollado en un hospital público brasileño. Datos demográficos, procedimientos dolorosos, medidas de alivio del dolor, señales vitales y scores de dolor fueron seleccionados de las historias clínicas de 90 recién nacidos admitidos en la unidad de cuidados intensivos y evaluados entre la admisión y el tercer día de hospitalización. Para el análisis estadístico fueron utilizados el programa Statistic Package for the Social Sciences y el Software R. Resultados: Los recién nacidos fueron sometidos a 2.732 procedimientos dolorosos, 540 estrategias no farmacológicas y 216 farmacológicas. El procedimiento más realizado fue la punción del talón (20,96%). La estrategia no farmacológica más común fue la reducción de luminosidad (28,33%) y el fetanyl continuo (48,83%) fue la principal medida farmacológica adoptada. Conclusión: A pesar del número elevado de procedimientos dolorosos, los registros de evaluación del dolor no reflejan el dolor procedural y el uso de las estrategias analgésicas fue insuficiente.

RESUMO Objetivo: Caracterizar os procedimentos dolorosos, estratégias analgésicas, sinais vitais e os escores de dor em recém-nascidos hospitalizados. Método: Estudo clínico primário, observacional, prospectivo, desenvolvido em um hospital público brasileiro. Dados demográficos, procedimentos dolorosos, medidas de alívio da dor, sinais vitais e escores de dor foram coletados dos prontuários clínicos de 90 recém-nascidos admitidos na unidade de terapia intensiva e avaliados entre a admissão e o terceiro dia de internação. Para a análise estatística foram utilizados o programa Statistic Package for the Social Sciences e o Software R. Resultados: Os recém-nascidos foram submetidos a 2.732 procedimentos dolorosos, 540 estratégias não farmacológicas e 216 farmacológicas. O procedimento mais realizado foi a lancetagem de calcâneo (20,96%). A estratégia não farmacológica mais comumente registrada foi a redução de luminosidade (28,33%) e o fentanil contínuo (48,83%) foi a principal medida farmacológica adotada. O escore de dor e os sinais vitais apresentam variabilidade no período avaliado. Conclusão: A despeito do número elevado de procedimentos dolorosos, os registros de avaliação da dor não refletem a dor procedural e o uso das estratégias analgésicas foi insuficiente.

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Objetivo:conhecer as representações sociais de doadoras sobre a doação de leite humano em um hospital universitário. Método:trata-se de uma pesquisa qualitativa utilizando como marco conceitual a Teoria das Representações Sociais. Para a análise qualitativa foi utilizado o método de análise de conteúdo. Resultados: participaram do estudo 30 doadoras de um banco de leite humano de um hospital universitário público do Sul do Brasil. Os temas relacionados à doação que emergiram das falas dessas doadoras foram: banco de leite humano: lugar de acolhimento e aprendizagem; doar o leite materno: dá trabalho e exige compromisso e ser doadora é compartilhar o que tem e ajudar a quem precisa. Conclusão: a doação de leite humano esteve relacionada ao sentimento de orgulho e compartilhamento, tendo a família importante papel nesse processo. Além disso, observou-se a pertinência do acolhimento e apoio recebido no banco de leite como forma de fortalecer o vínculo entre doadora e instituição e estimular tal prática.

Objective: to know the social representations of donors about human milk donation in a university hospital. Method:This is a qualitative research using the Theory of Social Representations as a conceptual framework. For the qualitative analysis, the content analysis method was used. Results: participants were thirty donors from a human milk bank in a public university hospital in southern Brazil. The themes related to donation that emerged from the speeches of these donors were: human milk bank: place of welcoming and learning; to donate breast milk: it takes work and requires commitment and being a donor is sharing what you have and helping those in need. Conclusion: the donation of human milk was related to the feeling of pride and sharing, with the family having an important role in this process. In addition, it was observed the importance of the welcoming and support received at the milk bank as a way to strengthen the bond between donor and institution and encourage such practice.

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INTRODUCTION: Female sexual dysfunction is a public health problem. Evidence suggests that the population of nursing women is more vulnerable to the phenomenon due to breast feeding. Thus, this protocol was developed to explore the factors that contribute to the development of sexual dysfunction in breastfeeding women. METHODS AND ANALYSIS: The systematic scoping review will be conducted in six stages, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The databases used will be: PubMed, Excerpta Medica Database, Cumulative Index for Nursing and Allied Health Literature, PsycINFO, Science Direct, Web of Science and Google Scholar. The searches were made until 1 June 2018, and no retrospective time limit was used. For the organisation of the literature retrieved from the databases, the EndNote Basic manager will be used. The Cochrane model will be used for the data extraction. The analysis of the quantitative data will be carried out through descriptive statistics and the qualitative data will be submitted to thematic analysis. The methodological quality of the empirical studies will be evaluated using the Mixed Methods Appraisal Tool. ETHICS AND DISSEMINATION: As it will be a review study, without human involvement, there will be no need for ethical approval. The results will be disseminated in a scientific journal, as well as in various media, such as: conferences, seminars, congresses or symposia.

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