Qualidade do leite humano no município de Maceió e desenvolvimento de aplicativo móvel para captação de doadoras

Abstract

Since expressed human milk (EHM) is a food for vulnerable neonates, especially those admitted to intensive care units (ICUs), it is important to ensure its quality. Resolution171/2006 of ANVISA (National Health Surveillance Agency) establishes the norms for the collection of donated Human Milk (HM) and the reference of its physical-chemical parameters (dirtiness, off-flavor, color, acidity in Dornic degrees and crematocrit) and microbiological (total coliforms present/absent), for approval before and after pasteurization. ANVISA also recommends that all data from donors of EHM samples and respective analysis results should be deposited in a secure information system. However, in addition to the presence of coliform contaminants, other groups of bacteria can be present and deteriorate the EHM. Thus, this study first aimed to correlate the conditions of EHM collection with its physical-chemical and microbiological quality (raw and pasteurized), and then generate an application with the purpose of improving the logistics of collection and transport of EHM to the Bank (HMB). Therefore, part of the study was prospective, quantitative and cross-sectional, conducted at the HMB of the “Professor Alberto Antunes” University Hospital(HUPAA) of the Federal University of Alagoas (UFAL) and at the “Laboratory of Biochemistry of Parasitism and Environmental Microbiology” (LBPMA) of the Institute of Chemistry and Biotechnology (IQB) of the same university, involving 32 donors. To this end, there was an analysis of the collection situations through recorded interviews, using a form of health conditions and collection prepared according to the “Global Human Milk Network”. Inaddition, the isolation and quantification of heterotrophic bacteria (mesophilic, thermophilic, psychrophilic) and thermoduric bacteria from the EHM samples previously approved in the physical-chemical tests were carried out. From the questionnaires, 28.13% of the donors showed a significant increase (p<0.001) in the frequency of weekly postpartum indispositions, while 68.75% described a significant decrease (p<0.001) in sleep time in relation to the period before pregnancy, 56.25% reported some problem with the act of breastfeeding and 60% did not discard the first drops of milk before collection. From the analyses, it was found that the crematocrit did not vary significantly in relation to data obtained from donor interviews, suchas pre-pregnancy BMI (body mass index), donor age and newborn age and classification. All samples passed the total coliform test, and there was no significant difference between samples from domestic and non-domestic donors (and their replications) in terms of lowcounts of mesophilic and thermophilic bacteria. In view of the interaction of these results, a mobile application called Lactababy-Maceió was designed to attract potential donors, recording and monitoring household collection data, shared health guidance, recording and forecasting EHM transport. In this way, the application was validated and was considered adequate by the evaluators, obtaining 80% in the degree of agreement between them.