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Journal of the American Dental... Nov 2019Studies suggest that when children do not achieve the emotional satiety and adequate stimulus provided by breast-feeding, they exhibit sucking behaviors. This study...
BACKGROUND
Studies suggest that when children do not achieve the emotional satiety and adequate stimulus provided by breast-feeding, they exhibit sucking behaviors. This study aimed to estimate the association from 4 through 6 months of exclusive breast-feeding (EB) postpartum and pacifier-sucking behavior at 12 months of life.
METHODS
A cohort study was conducted with 1,037 infants, born alive and monitored up to 12 months. At 4 and 6 months after birth, the children were classified according to the type of breast-feeding they had received: exclusive, predominant, complementary, or none. The prevalence of pacifier-sucking behavior was calculated, and the association between the 2 events was estimated. Mothers' socioeconomic-demographic characteristics, delivery features, and prenatal care, as well as the biological characteristics of the children, were determined. Relative risk (RR) and 95% confidence intervals (95% CI) were calculated.
RESULTS
In comparison with EB infants, the RR of pacifier-sucking behavior at 12 months of life was higher in children receiving complementary breast-feeding or no breast-feeding for both 4 months (RR, 1.68 [95% CI, 1.39 to 2.02] and RR, 2.67 [95% CI, 2.24 to 3.17], respectively) and 6 months (RR, 1.43 [95% CI, 1.03 to 2.00] and RR, 3.30 [95% CI, 2.40 to 4.54], respectively).
CONCLUSIONS AND PRACTICAL IMPLICATIONS
EB for 6 months postpartum is associated with reduced pacifier-sucking behavior, adjusted for maternal color, number of prenatal consultations, and family income. Promotion of EB may reduce the use of pacifiers and their potential deleterious effects on oral health. Dental health care professionals should consider discussing the importance of breast-feeding with their patients with regard to the possible development of sucking habits in their children.
Topics: Breast Feeding; Child; Cohort Studies; Female; Fingersucking; Habits; Humans; Infant; Pacifiers
PubMed: 31526484
DOI: 10.1016/j.adaj.2019.06.002 -
Nutrients Jul 2023Increased dental overjet in adolescence is a clinically relevant outcome associated with the complexity and high cost of treatment, indicating the need for prevention... (Randomized Controlled Trial)
Randomized Controlled Trial
Increased dental overjet in adolescence is a clinically relevant outcome associated with the complexity and high cost of treatment, indicating the need for prevention strategies. We investigated the long-term impact of breastfeeding and pacifier use on increased overjet (IOVJ) in permanent dentition. A prospective cohort nested in a randomized controlled trial was conducted from birth to 12 years of age ( = 214). Breastfeeding and pacifier use were recorded monthly until 12 months. Overjet was assessed at age 12 years. We employed a causal mediation analysis using parametric regression models assuming no interaction between breastfeeding and pacifier usage. We found a total protective effect of breastfeeding on IOVJ (OR 0.49; 95% CI 0.28-0.96), where 63.1% were mediated by pacifier use (OR 0.61; 95% CI 0.44-0.87). Breastfeeding directly decreased the odds of IOVJ by 20%; however, the confidence interval included the null estimate (OR 0.81; 95% CI 0.41-1.60). In conclusion, breastfeeding protects by half of the IOVJ in adolescence through reducing pacifier use. Oral and general health professionals should collaborate to support WHO breastfeeding guidelines during individual patient counseling. Guidelines for practice, policy or public information require messages that include a common risk approach to oral and general health.
Topics: Female; Pregnancy; Humans; Adolescent; Infant; Child; Breast Feeding; Cohort Studies; Prospective Studies; Pacifiers; Parturition
PubMed: 37571340
DOI: 10.3390/nu15153403 -
Acta Medica Portuguesa Jun 2023Exclusive breastfeeding (EBF) is currently recommended until six months of age. The Baby-friendly Hospital (BFH) initiative an international program to promote... (Observational Study)
Observational Study
INTRODUCTION
Exclusive breastfeeding (EBF) is currently recommended until six months of age. The Baby-friendly Hospital (BFH) initiative an international program to promote breastfeeding, was launched in Portugal in 1994. The aim of this study was to identify the prevalence and factors influencing breastfeeding in the first six months of life and to compare the results with a study carried out in 1999 including population from the same geographic area.
MATERIAL AND METHODS
A prospective, longitudinal and observational study was carried out in two hospitals in the Lisbon metropolitan area, one BFH and another non-BFH. It consisted of different questionnaires answered by mothers at three distinct moments (zero, three and six months). The first questionnaire was applied between February and June 2019.
RESULTS
A total of 423 infants were included, 324 from the BFH and 99 from the non-BFH. The breastfeeding rate was 94.3% at discharge, 78.2% at three months and 64.4% at six months, whereas EBF rate was 74.2%, 51.8% and 25.6% respectively. All women on EBF at six months, except one, were breastfeeding on demand. The discontinuation of EBF was associated with delayed skin-to-skin contact, Neonatal Intensive Care Unit admission, pacifier and artificial teats use, mother's return to work earlier and lower education levels. Conversely, factors that promote EBF were older gestational age, adequate birthweight, breastfeeding initiation in the first hour of life, rooming-in practice, shorter hospital stay and absence of infant's illnesses. Compared with 1999, although there was a significant improvement of breastfeeding rates at three and six months, the EBF rate was similar at six months (23%). Both studies identified the mother's lower education level and mother's return to work as contributing factors to breastfeeding discontinuation.
CONCLUSION
Our results are in agreement with previously reported causes of breastfeeding discontinuation and emphasize the importance of sociocultural factors. Compared with 1999, the breastfeeding rates in this Portuguese population increased significantly at three and six months. However, it is still necessary to improve in order to achieve the World Health Organization global target.
Topics: Infant; Infant, Newborn; Female; Humans; Breast Feeding; Prevalence; Prospective Studies; Mothers; Health Promotion
PubMed: 36947662
DOI: 10.20344/amp.18692 -
The Cochrane Database of Systematic... Aug 2023Pain in the neonate is associated with acute behavioural and physiological changes. Cumulative pain is associated with morbidities, including adverse neurodevelopmental... (Review)
Review
BACKGROUND
Pain in the neonate is associated with acute behavioural and physiological changes. Cumulative pain is associated with morbidities, including adverse neurodevelopmental outcomes. Studies have shown a reduction in changes in physiological parameters and pain score measurements following pre-emptive analgesic administration in neonates experiencing pain or stress. Non-pharmacological measures (such as holding, swaddling and breastfeeding) and pharmacological measures (such as acetaminophen, sucrose and opioids) have been used for analgesia. This is an update of a review first published in 2006 and updated in 2012.
OBJECTIVES
The primary objective was to evaluate the effectiveness of breastfeeding or supplemental breast milk in reducing procedural pain in neonates. The secondary objective was to conduct subgroup analyses based on the type of control intervention, gestational age and the amount of supplemental breast milk given.
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase, CINAHL and trial registries (ICTRP, ISRCTN and clinicaltrials.gov) in August 2022; searches were limited from 2011 forwards. We checked the reference lists of included studies and relevant systematic reviews.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) or quasi-RCTs of breastfeeding or supplemental breast milk versus no treatment/other measures in neonates. We included both term (≥ 37 completed weeks postmenstrual age) and preterm infants (< 37 completed weeks' postmenstrual age) up to a maximum of 44 weeks' postmenstrual age. The study must have reported on either physiological markers of pain or validated pain scores.
DATA COLLECTION AND ANALYSIS
We assessed the methodological quality of the trials using the information provided in the studies and by personal communication with the authors. We extracted data on relevant outcomes, estimated the effect size and reported this as a mean difference (MD). We used the GRADE approach to assess the certainty of evidence.
MAIN RESULTS
Of the 66 included studies, 36 evaluated breastfeeding, 29 evaluated supplemental breast milk and one study compared them against each other. The procedures conducted in the studies were: heel lance (39), venipuncture (11), intramuscular vaccination (nine), eye examination for retinopathy of prematurity (four), suctioning (four) and adhesive tape removal as procedure (one). We noted marked heterogeneity in the control interventions and pain assessment measures amongst the studies. Since many studies included multiple arms with breastfeeding/supplemental breast milk as the main comparator, we were not able to synthesise all interventions together. Individual interventions are compared to breastfeeding/supplemental breast milk and reported. The numbers of studies/participants presented with the findings are not taken from pooled analyses (as is usual in Cochrane Reviews), but are the overall totals in each comparison. Overall, the included studies were at low risk of bias except for masking of intervention and outcome assessment, where nearly one-third of studies were at high risk of bias. Breastfeeding versus control Breastfeeding may reduce the increase in heart rate compared to holding by mother, skin-to-skin contact, bottle feeding mother's milk, moderate concentration of sucrose/glucose (20% to 33%) with skin-to-skin contact (low-certainty evidence, 8 studies, 784 participants). Breastfeeding likely reduces the duration of crying compared to no intervention, lying on table, rocking, heel warming, holding by mother, skin-to-skin contact, bottle feeding mother's milk and moderate concentration of glucose (moderate-certainty evidence, 16 studies, 1866 participants). Breastfeeding may reduce percentage time crying compared to holding by mother, skin-to-skin contact, bottle feeding mother's milk, moderate concentration sucrose and moderate concentration of sucrose with skin-to-skin contact (low-certainty evidence, 4 studies, 359 participants). Breastfeeding likely reduces the Neonatal Infant Pain Scale (NIPS) score compared to no intervention, holding by mother, heel warming, music, EMLA cream, moderate glucose concentration, swaddling, swaddling and holding (moderate-certainty evidence, 12 studies, 1432 participants). Breastfeeding may reduce the Neonatal Facial Coding System (NFCS) score compared to no intervention, holding, pacifier and moderate concentration of glucose (low-certainty evidence, 2 studies, 235 participants). Breastfeeding may reduce the Douleur Aigue Nouveau-né (DAN) score compared to positioning, holding or placebo (low-certainty evidence, 4 studies, 709 participants). In the majority of the other comparisons there was little or no difference between the breastfeeding and control group in any of the outcome measures. Supplemental breast milk versus control Supplemental breast milk may reduce the increase in heart rate compared to water or no intervention (low-certainty evidence, 5 studies, 336 participants). Supplemental breast milk likely reduces the duration of crying compared to positioning, massage or placebo (moderate-certainty evidence, 11 studies, 1283 participants). Supplemental breast milk results in little or no difference in percentage time crying compared to placebo or glycine (low-certainty evidence, 1 study, 70 participants). Supplemental breast milk results in little or no difference in NIPS score compared to no intervention, pacifier, moderate concentration of sucrose, eye drops, gentle touch and verbal comfort, and breast milk odour and verbal comfort (low-certainty evidence, 3 studies, 291 participants). Supplemental breast milk may reduce NFCS score compared to glycine (overall low-certainty evidence, 1 study, 40 participants). DAN scores were lower when compared to massage and water; no different when compared to no intervention, EMLA and moderate concentration of sucrose; and higher when compared to rocking or pacifier (low-certainty evidence, 2 studies, 224 participants). Due to the high number of comparator interventions, other measures of pain were assessed in a very small number of studies in both comparisons, rendering the evidence of low certainty. The majority of studies did not report on adverse events, considering the benign nature of the intervention. Those that reported on adverse events identified none in any participants. Subgroup analyses were not conducted due to the small number of studies.
AUTHORS' CONCLUSIONS
Moderate-/low-certainty evidence suggests that breastfeeding or supplemental breast milk may reduce pain in neonates undergoing painful procedures compared to no intervention/positioning/holding or placebo or non-pharmacological interventions. Low-certainty evidence suggests that moderate concentration (20% to 33%) glucose/sucrose may lead to little or no difference in reducing pain compared to breastfeeding. The effectiveness of breast milk for painful procedures should be studied in the preterm population, as there are currently a limited number of studies that have assessed its effectiveness in this population.
Topics: Female; Infant; Infant, Newborn; Humans; Milk, Human; Breast Feeding; Pain, Procedural; Pain; Acetaminophen
PubMed: 37643989
DOI: 10.1002/14651858.CD004950.pub4 -
Biology Mar 2021The aim of the present study was to assess the effects of bisphenol (BP) exposure on pregnancy and neonatal life. We have (a) determined BP (BPA and BPS) concentration...
The aim of the present study was to assess the effects of bisphenol (BP) exposure on pregnancy and neonatal life. We have (a) determined BP (BPA and BPS) concentration levels in a group of newborns and their mothers; (b) identified factors, habits, and devices possibly responsible for BP uptake; and (c) determined the effect of BP exposure. No significant correlations were detected between maternal and neonatal BP concentration levels. In newborns, positive correlations between pacifier use and BPS total ( = 0.04) and free BPS ( = 0.03) concentrations were detected. A significant correlation was also found between oral glucose administration and concentration levels of free BPA ( < 0.05). Our study points to a central role of lifestyle, hospital procedures, and neonatal devices in inducing BP exposure, especially during the perinatal period. This is the first report of BP contamination in newborns due to widely non-alimentary products designed for newborn care, such as glucose-solution containers for BPA and pacifiers for BPS. Further studies are advocated in order to clarify both the impact of other BP forms on human health and development, as well as potential BPA exposure sources during neonatal and childhood life.
PubMed: 33802301
DOI: 10.3390/biology10030188 -
International Journal of Nursing... Dec 2022The Baby-Friendly Hospital Initiative aims to improve breastfeeding by implementing the Ten Steps to Successful Breastfeeding (Ten Steps) into routine breastfeeding... (Review)
Review
BACKGROUND
The Baby-Friendly Hospital Initiative aims to improve breastfeeding by implementing the Ten Steps to Successful Breastfeeding (Ten Steps) into routine breastfeeding support in birth hospitals. Maternal perspective to breastfeeding support is important to consider as mothers and their infants are in the center of that support.
OBJECTIVES
To review and synthesize the existing literature on maternal perceptions and experiences of breastfeeding support in Baby-Friendly hospitals. A sub-aim was to describe differences in breastfeeding support between Baby-Friendly hospitals and non-Baby-Friendly hospitals from maternal perspective.
DATA SOURCES AND REVIEW METHODS
An integrative literature review. A systematic literature search was conducted in October 2021 in five databases: PubMed, CINAHL, Cochrane, Scopus, Web of Science. Original peer-reviewed studies published in English exploring maternal viewpoints on breastfeeding support in Baby-Friendly hospitals were included. Two reviewers independently screened the titles (n=914), abstracts (n=226), and full texts (n=47). The review comprised of seventeen studies and includes both quantitative studies (n=14) and qualitative studies (n=3). Inductive content analysis and descriptive synthesis were conducted.
RESULTS
Most studies (n=14) measured hospitals' compliance with the Ten Steps practices from maternal perspective. Mothers were provided with breastfeeding information and encouragement, however, a qualitative finding indicated that information focused on positive aspects of breastfeeding. Early skin-to-skin contact between the mother and infant was well facilitated although often not lasting more than 30 min. Breastfeeding was facilitated by practical support but according to findings of two qualitative studies, support was not always adequate to address mothers' problems with breastfeeding. Most mothers were exclusively breastfeeding during the hospital stay and no supplemental milk was offered to infant. Mothers were roomed-in together with their infant and were mostly encouraged to breastfeed on demand. Differences between Baby-Friendly hospitals and non-Baby-Friendly hospitals were observed particularly for steps 6 and 9: supplementary feeding and pacifier use were less common in Baby-Friendly hospitals.
CONCLUSIONS
From the maternal perspective, breastfeeding support in the Baby-Friendly hospitals was mainly but not completely in adherence with the Ten Steps practices. Low compliance with some of the Ten Steps indicates a need for a more frequent assessment of the breastfeeding support practices and consideration of strategies facilitating a more sustainable implementation of the initiative. Regardless of some shortcomings with the breastfeeding support, mothers were mainly satisfied with the support in the hospital. Mothers in the Baby-Friendly hospitals perceived that breastfeeding support was more adherent to the Ten Steps compared to mothers in non-Baby-Friendly hospitals.
PubMed: 38745604
DOI: 10.1016/j.ijnsa.2022.100105 -
Journal of Communication Disorders 2021Recently published works suggest that prolonged pacifier use affects abstract word processing later in life. Using the pacifier beyond age 3 years affects the conceptual...
Recently published works suggest that prolonged pacifier use affects abstract word processing later in life. Using the pacifier beyond age 3 years affects the conceptual relations used to define the meaning of words at age 6 years. Similarly, when semantically categorizing a set of abstract, concrete and emotional words, children aged 8 years who used the pacifier for a longer period of time were slower to process abstract stimuli, but not concrete and emotional ones. The children of these studies had typical development and no diagnosis of cognitive or linguistic disorders. These results, although correlational, suggest a possible relationship between extended use of a pacifier and the development of language skills, particularly for abstract words. The first goal of this theoretical work is to outline current evidence suggesting an association between prolonged pacifier use and the processing of abstract words. The second goal is to propose an account of the effect of Age of Pacifier Withdrawal (APW) within the DIVA neurocomputational model of speech development and production (Guenther & Vladusich, 2013). Using the pacifier during social interaction for a longer period might impede the processing of proprioceptive information and speech-motor programs (i.e., by limiting the co-articulation of speech, it could inhibit the building and consolidation of speech-motor articulatory gestures) as well as auditory input (because the child receives inaccurate input about his/her own speech). Thus, it seems useful to explore the auditory speech representation of children who use a pacifier beyond 3 years of age. We suggest that after the first year of life pacifier use should be impeded during social interaction and limited to use at bed time.
Topics: Child; Child, Preschool; Emotions; Female; Gestures; Humans; Linguistics; Male; Pacifiers; Speech
PubMed: 33550069
DOI: 10.1016/j.jcomdis.2021.106085 -
Journal of Dental Research Aug 2023Young children need increased access to dental prevention and care. Targeting high caries risk children first helps meet this need. The objective of this study was to...
Young children need increased access to dental prevention and care. Targeting high caries risk children first helps meet this need. The objective of this study was to develop a parent-completed, easy-to-score, short, accurate caries risk tool for screening in primary health care settings to identify children at increased risk for cavities. A longitudinal, prospective, multisite, cohort study enrolled (primarily through primary health care settings) and followed 985 (out of 1,326) 1-y-old children and their primary caregivers (PCGs) until age 4. The PCG completed a 52-item self-administered questionnaire, and children were examined using the International Caries Detection and Assessment Criteria (ICDAS) at 12 ± 3 mo (baseline), 30 ± 3 mo (80% retention), and 48 ± 3 mo of age (74% retention). Cavitated caries lesion (dmfs = decayed, missing, and filled surfaces; d = ICDAS ≥3) experience at 4 y of age was assessed and tested for associations with questionnaire items using generalized estimating equation models applied to logistic regression. Multivariable analysis used backward model selection, with a limit of 10 items. At age 4, 24% of children had cavitated-level caries experience; 49% were female; 14% were Hispanic, 41% were White, 33% were Black, 2% were other, and 10% were multiracial; 58% enrolled in Medicaid; and 95% lived in urban communities. The age 4 multivariable prediction model, using age 1 responses (area under the receiver operating characteristic curve = 0.73), included the following significant ( < 0.001) variables (odds ratios): child participating in public assistance programs such as Medicaid (1.74), being non-White (1.80-1.96), born premature (1.48), not born by caesarean section (1.28), snacking on sugary snacks (3 or more/d, 2.22; 1-2/d or weekly, 1.55), PCG cleaning the pacifier with juice/soda/honey or sweet drink (2.17), PCG daily sharing/tasting food with child using same spoon/fork/glass (1.32), PCG brushing their teeth less than daily (2.72), PCG's gums bleeding daily when brushing or PCG having no teeth (1.83-2.00), and PCG having cavities/fillings/extractions in past 2 y (1.55). A 10-item caries risk tool at age 1 shows good agreement with cavitated-level caries experience by age 4.
Topics: Pregnancy; Humans; Child; Female; Child, Preschool; Infant; Male; Dental Caries; Cohort Studies; Prospective Studies; Cesarean Section; Primary Health Care; DMF Index
PubMed: 37329133
DOI: 10.1177/00220345231173585 -
Journal of Exposure Science &... May 2022Soil and dust ingestion can be a primary route of environmental exposures. Studies have shown that young children are more vulnerable to incidental soil and dust...
BACKGROUND
Soil and dust ingestion can be a primary route of environmental exposures. Studies have shown that young children are more vulnerable to incidental soil and dust ingestion. However, available data to develop soil and dust ingestion rates for some child-specific age groups are either lacking or uncertain.
OBJECTIVE
Our objective was to use the Stochastic Human Exposure and Dose Simulation Soil and Dust (SHEDS-Soil/Dust) model to estimate distributions of soil and dust ingestion rates for ten age ranges from infancy to late adolescents (birth to 21 years).
METHODS
We developed approaches for modeling age groups previously not studied, including a new exposure scenario for infants to capture exposures to indoor dust via pacifier use and accounting for use of blankets that act as a barrier to soil and dust exposure.
RESULTS
Overall mean soil and dust ingestion rates ranged from ~35 mg/day (infants, 0-<6 m) to ~60 mg/day (toddlers and young children, 6m-<11 yr) and were considerably lower (about 20 mg/day) for teenagers and late adolescents (16-<21 y). The pacifier use scenario contributed about 20 mg/day to the median dust ingestion rate for young infants. Except for the infant age groups, seasonal analysis showed that the modeled estimates of average summer mean daily total soil plus dust ingestion rates were about 50% higher than the values predicted for the winter months. Pacifier use factors and carpet dust loading values were drivers of exposure for infants and younger children. For older children, influential variables included carpet dust loading, soil adherence, and factors that capture the frequency and intensity of hand-to-mouth behaviors.
SIGNIFICANCE
These results provide modeled estimates of children's soil and dust ingestion rates for use in decision making using real-world exposure considerations.
IMPACT STATEMENT
The parameterization of scenarios to capture infant soil and dust ingestion and the application of SHEDS-Soil/Dust to a broader age range of children provides additional estimates of soil and dust ingestion rates that are useful in refining population-based risk assessments. These data illuminate drivers of exposure that are useful to both risk management applications and for designing future studies that improve upon existing tracer methodologies.
Topics: Adolescent; Adult; Age Factors; Child; Child, Preschool; Dust; Eating; Environmental Exposure; Humans; Infant; Soil; Young Adult
PubMed: 35039613
DOI: 10.1038/s41370-021-00406-5 -
Frontiers in Psychology 2020Few things affect us as much as facial expressions, as they inform us about others' feelings and intentions, thereby influencing our own emotions and behaviors. A... (Review)
Review
Few things affect us as much as facial expressions, as they inform us about others' feelings and intentions, thereby influencing our own emotions and behaviors. A substantial body of literature links the critical abilities of recognizing and understanding emotion displays with facial mimicry, a sensorimotor process involving rapid imitation of perceived expressions. For example, blocking or altering facial mimicry in adults leads to disruptions in judgments in emotion recognition or emotional language processing. The present review focuses on pacifier use in infancy, a common practice that has the potential to interfere with infants' facial movements in ways identical to laboratory paradigms designed to block facial mimicry. Despite this similarity and the widespread use of infant soothers, little is known about their long-term effects. Here we review studies exploring the psychological correlates and implications of pacifier use. In particular, we discuss how soothers may interfere with the development of social skills in infants and present evidence linking pacifier use with disrupted adults' mimicry of facial expressions displayed by infants. Other preliminary findings reveal negative correlations between the use of soothers and children's spontaneous facial mimicry as well as emotional competence of young adults. Such studies, although correlational, suggest that this widespread parenting practice may affect the development of social skills by influencing emotional coordination. We discuss the implications of these findings and propose avenues for future research that can provide insights into the role of embodied processes in the development of emotional competence and adult functioning.
PubMed: 32231618
DOI: 10.3389/fpsyg.2020.00387