OBJETIVO: Comparar a eficácia da fototerapia simples (1 painel) versus dupla (2 painéis) na redução da hiperbilirrubinemia não-hemolítica em recém-nascidos a termo. MÉTODOS: Os recém-nascidos a termo foram randomizados prospectivamente para receber fototerapia simples ou dupla. Os níveis de bilirrubina foram medidos no momento da internação e em intervalos de 12 horas, assim como em seguimento 48 horas após a alta. RESULTADOS: Trinta e sete pacientes receberam fototerapia simples, e 40, dupla. A redução média dos níveis de bilirrubina nas primeiras 24 horas de tratamento foi maior no grupo que recebeu fototerapia dupla (5,1±2,2 mg/dL versus 4,3±2,1 mg/dL), porém sem significância estatística (p = 0,18). As taxas de readmissão foram similares e nenhum dos grupos apresentou efeitos adversos. CONCLUSÃO: A fototerapia dupla não foi mais eficaz do que a fototerapia simples no tratamento da hiperbilirrubinemia não-hemolítica em recém-nascidos a termo. Entretanto, nossos resultados sugerem que a fototerapia dupla possa ser mais eficaz em recém-nascidos a termo com níveis de bilirrubina mais altos no momento da internação.

OBJECTIVES: To compare the effectiveness of single (1 panel) vs. double (2 panels) phototherapy in reducing nonhemolytic hyperbilirubinemia in term newborns. METHODS: Term newborns with hyperbilirubinemia were prospectively randomized to receive double or single phototherapy. Bilirubin levels were measured at admission and at 12-hour intervals, as well as at a follow-up 48 hours after discharge. RESULTS: Thirty-seven patients received single and 40 double phototherapy. The mean decrease in bilirubin level in the first 24 hours of treatment was greater in the double phototherapy group (5.1±2.2 mg/dL vs. 4.3±2.1 mg/dL), but without statistical significance (p = 0.18). Readmission rates were similar and no adverse effects were found in either group. CONCLUSIONS: Double-surface was not more effective than single-surface phototherapy in the treatment of nonhemolytic hyperbilirubinemia in term newborns. However, our results suggest that double phototherapy may be more effective in those term newborns with higher bilirubin levels at admission.

Objective. To determine the influence of joined mother-child hospital lodging (JL) on the frequency of exclusive human lactation (EHL) from birth to four months of age. Material and methods. Non-randomized cohort study performed at the lactation clinic of the "Luis Castelazo Ayala" Hospital of the Mexican Social Security Institute from January 1993 to October 1994 which included 178 healthy mother-child pairs (MCP) with term pregnancy. The jointly lodged group (JL) consisted of 90 MCP in which mothers received assessment for lactation; 88 MCP were lodged separately and no assessment was provided. Results were statistically analyzed to determine frequency and variable associations. Results. Feeding was recorded as either EHL, powdered milk or both. Groups with or without JL were stratified by form of birth, either labor or Cesarean section. With the Mantel-Haenszel X² and logarithmic range, differences were significant with p<0.05. During the study, global lactation was similar among groups. In the first month, EHL was higher in the JL group, 61 vs 42% independently of the form of birth (p<0.05). The only variable which influenced EHL was JL. Conclusions. Mother-child JL favours EHL during the first month post-partum.

Objetivo. Conocer la influencia del alojamiento conjunto (AC) madre-hijo, en la frecuencia de lactancia humana exclusiva (LHE), desde el nacimiento hasta los cuatro meses de vida. Material y métodos. Estudio de cohortes no aleatorizado realizado en la clínica de lactancia del Hospital "Luis Castelazo Ayala", del Instituto Mexicano del Seguro Social, de enero de 1993 a octubre de 1994, en el que participaron 178 binomios madre-hijo (BMH) sanos con gestación de término. El grupo con alojamiento conjunto (AC) se integró con 90 BMH, y la madre recibió asesoría para lactar; 88 se atendieron en forma separada, sin asesoría para lactar. Se realizó análisis estadístico de los datos para apreciar frecuencia y asociaciones de las variables. Resultados. La alimentación se registró como LHE, fórmula o ambas. Los grupos con y sin AC se estratificaron por la forma de nacimiento, parto o cesárea. Con X² de Mantel-Haenszel y de rango logarítmico se aceptaron diferencias con p< 0.05. Durante el estudio la lactancia global fue semejante entre los grupos. En el primer mes la LHE fue mayor en el grupo con AC, 61 vs 42%, independientemente de la forma de nacimiento (p< 0.05). El AC fue la única variable que influyó para que se diera LHE. Conclusiones. El AC madre-hijo favorece la LHE en el primer mes posnacimiento.