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Frontiers in Pediatrics 2020A term neonate is born with the ability to suck; this neuronal network is already formed and functional by 28 weeks gestational age and continues to evolve into... (Review)
Review
A term neonate is born with the ability to suck; this neuronal network is already formed and functional by 28 weeks gestational age and continues to evolve into adulthood. Because of the necessity of acquiring nutrition, the complexity of the neuronal network needed to suck, and neuroplasticity in infancy, the skill of sucking has the unique ability to give insight into areas of the brain that may be damaged either during or before birth. Interpretation of the behaviors during sucking shows promise in guiding therapies and how to potentially repair the damage early in life, when neuroplasticity is high. Sucking requires coordinated suck-swallow-breathe actions and is classified into two basic types, nutritive and non-nutritive. Each type of suck has particular characteristics that can be measured and used to learn about the infant's neuronal circuitry. Basic sucking and swallowing are present in embryos and further develop to incorporate breathing . Due to the rhythmic nature of the suck-swallow-breathe process, these motor functions are controlled by central pattern generators. The coordination of swallowing, breathing, and sucking is an enormously complex sensorimotor process. Because of this complexity, brain injury before birth can have an effect on these sucking patterns. Clinical assessments allow evaluators to score the oral-motor pattern, however, they remain ultimately subjective. Thus, clinicians are in need of objective measures to identify the specific area of deficit in the sucking pattern of each infant to tailor therapies to their specific needs. Therapeutic approaches involve pacifiers, cheek/chin support, tactile, oral kinesthetic, auditory, vestibular, and/or visual sensorimotor inputs. These therapies are performed to train the infant to suck appropriately using these subjective assessments along with the experience of the therapist (usually a speech therapist), but newer, more objective measures are coming along. Recent studies have correlated pathological sucking patterns with neuroimaging data to get a map of the affected brain regions to better inform therapies. The purpose of this review is to provide a broad scope synopsis of the research field of infant nutritive and non-nutritive feeding, their underlying neurophysiology, and relationship of abnormal activity with brain injury in preterm and term infants.
PubMed: 33511093
DOI: 10.3389/fped.2020.599633 -
Anais Da Academia Brasileira de Ciencias 2020Malocclusions are changes in the development of craniofacial structures of high prevalence. Associated risk factors are diverse and nutritional and non-nutritional...
Malocclusions are changes in the development of craniofacial structures of high prevalence. Associated risk factors are diverse and nutritional and non-nutritional suction habits are the most reported. The aim of this study was to estimate the prevalence of malocclusions in the mixed dentition and to study possible association with practices of breastfeeding and suction habits among Brazilian schoolchildren. A cross-sectional study involving a sample of 664 6-year-old children and their families was carried out. Data collection was done through interviews with mothers in the homes and oral examinations of children in schools. Multivariate analyses were performed using the Poisson regression with a robust estimator. The prevalence of overjet over 4 mm was 21.1% and of posterior crossbite was 12.2%; 91.9% of the children were breastfed, 79.0% used a nursing bottle and 49.4% used a pacifier. Significant and independent associations were observed between father's unemployment, private school, interruption of breastfeeding before the fourth month and pacifier use with certain malocclusions. High rates of malocclusion were found in the studied sample. Socioeconomic conditions, breastfeeding practices and suction habits were shown to be statistically associated with their occurrence.
Topics: Bottle Feeding; Brazil; Breast Feeding; Child; Cross-Sectional Studies; Dentition, Mixed; Female; Habits; Humans; Male; Malocclusion; Pacifiers; Prevalence; Risk Factors; Socioeconomic Factors; Time Factors
PubMed: 32321028
DOI: 10.1590/0001-3765202020190833 -
Revista de Saude Publica 2021To describe feeding practices and the risk factors for the mixed breastfeeding and early weaning in the neonatal period.
OBJECTIVE
To describe feeding practices and the risk factors for the mixed breastfeeding and early weaning in the neonatal period.
METHODS
Cohort study, which we collected socioeconomic, demographic, health care and feeding data from 415 mother/child binomials born in four public maternity hospitals in Natal/Brazil. They were followed-up at 48 hours, 7 and 28 days after birth. The association was established using Pearson's Chi-square test and Poisson's regression, after adjusting it to other variables.
RESULTS
The prevalence of mixed breastfeeding in the first 2 days was 47,2% and early weaning in 7 and 28 days was 8,4% and 16,2% in that order. The main reasons for mixed breastfeeding and early weaning were: colostrum deficiency (33.8%), difficulty in latching/sucking (23.5%) and "little milk" (70.0%). The use of formula/milk/porridge remained associated with maternal age ≤ 20 years (RR = 0.64; 95%CI: 0.47-0.86), age 20-29 years (RR = 0,70; 95%CI: 0,57-0,87), primiparity (RR = 1.37; 95%CI: 1.11-1.60) and cesarean delivery (RR = 1.20; 95%CI: 1.00-1.45) at 2 days; absence of paternal support (RR = 4.98; 95%CI: 2.54-9.79) and pacifier use (RR = 3.21; 95%CI: 1.63-6.32) at 7 days; and only pacifier use (RR = 2.48; 95%CI: 1.53-4.02) at 28 days.
CONCLUSIONS
Early weaning was associated with maternal and health care factors, thus suggesting the need to readjust good practices and educational actions to achieve the exclusive offer to the maternal breast in the neonatal period.
Topics: Adult; Brazil; Breast Feeding; Child; Cohort Studies; Female; Humans; Infant; Infant, Newborn; Maternal Age; Pregnancy; Weaning; Young Adult
PubMed: 34706039
DOI: 10.11606/s1518-8787.2021055003248 -
The Journal of Clinical Pediatric... Mar 2024The development of the craniomandibular system is guided by genetic interactions and environmental factors, including specific habits such as breastfeeding, bottle...
The development of the craniomandibular system is guided by genetic interactions and environmental factors, including specific habits such as breastfeeding, bottle feeding, thumb sucking and the use of pacifiers. These habits can have a considerable impact on the growth of the developing jaws and can lead to malocclusion in children. This review aims to investigate potential associations between non-nutritive sucking habits (NNSHs) and malocclusions compared to the presence of nutritive sucking habits (NSHs). To carry out this systematic review, we followed the PRISMA protocol and performed a bibliographic search of the existing literature until April 2023 in the following electronic databases: Medline, PubMed, The Cochrane Library and Embase. Out of a total of 153 records, we included 21 studies. We found that the chances of diagnosing a malocclusion were higher for children with bottle nutrition when compared to breast-fed children. Breastfeeding provides protection against malocclusions. In the same manner, persistent NNSH habits appeared to be associated with increased chances of having malocclusions. The longer the child was breastfed, the shorter the duration of the pacifier habit and the lower the risk of developing moderate/severe malocclusions. The duration of the habits has a positive influence on the appearance of occlusion defects.
Topics: Child; Female; Humans; Sucking Behavior; Malocclusion; Breast Feeding; Bottle Feeding; Habits; Fingersucking; Pacifiers
PubMed: 38548628
DOI: 10.22514/jocpd.2024.029 -
American Journal of Orthodontics and... May 2021Attention deficit-hyperactivity disorder is a behavioral disorder characterized by a lack of focus, impulsive behavior, and or excessive activity. This research aimed to...
INTRODUCTION
Attention deficit-hyperactivity disorder is a behavioral disorder characterized by a lack of focus, impulsive behavior, and or excessive activity. This research aimed to evaluate the association between signs of attention deficit-hyperactivity disorder and malocclusion in schoolchildren.
METHODS
A cross-sectional study was conducted with a representative sample of 633 children aged 7-12 years. The children were clinically examined for malocclusion using the Dental Aesthetic Index. The predominant breathing pattern was also determined. Parents answered a questionnaire addressing socioeconomic characteristics and the presence of nonnutritive sucking habits. The Swanson, Nolan, and Pelham Scale-IV was filled out by both parents and teachers to compare behavioral patterns. The children were submitted to a neuropsychological evaluation using the Raven's Colored Progressive Matrix Test. Data analysis involved the chi-square test and Poisson regression analysis.
RESULTS
The prevalence of malocclusion was 42% higher among children with signs of hyperactivity reported by both parents and teachers (prevalence ratio [PR], 1.42; 95% confidence interval [CI], 1.11-1.81; P = 0.004). In the final Poisson regression model, the prevalence of malocclusion was lower among schoolchildren aged 11 and 12 years (PR, 0.62; 95% CI. 0.52-0.73; P <0.001) and higher among those who used a pacifier for at least 4 years (PR, 1.25; 95% CI, 1.02-1.54; P = 0.029) as well as those classified as mouth breathers (PR, 1.28; 95% CI, 1.09-1.51; P = 0.003).
CONCLUSIONS
The prevalence of malocclusion was higher among children with signs of hyperactivity independently of age, pacifier use, and mouth breathing.
Topics: Attention Deficit Disorder with Hyperactivity; Brazil; Child; Cross-Sectional Studies; Humans; Malocclusion; Pacifiers; Prevalence
PubMed: 33658172
DOI: 10.1016/j.ajodo.2019.11.027 -
Academic Pediatrics 2019Pacifier use decreases the risk of sudden infant death syndrome, but its impact on breastfeeding remains controversial. We evaluated the impact of a pacifier policy...
OBJECTIVE
Pacifier use decreases the risk of sudden infant death syndrome, but its impact on breastfeeding remains controversial. We evaluated the impact of a pacifier policy aligned with the World Health Organization and United Nations Children's Fund Baby-Friendly Hospital Initiative on subsequent pacifier use and breastfeeding at 1 month of age.
METHODS
We conducted a prospective 2-stage (pre- and post-implementation) cohort study of newborns at a birth hospital before and after implementation of a Baby-Friendly-aligned pacifier policy. Consecutive mothers of newborns admitted to the nursery participated in a telephone survey when the infants were 1 month of age.
RESULTS
In total, 342 mothers participated (190 before and 152 after implementation of the policy). Pacifier adoption was delayed in the post-implementation group, but pacifier use by 1 month of age was comparable (78.9% pre-implementation vs 77.6% post-implementation; P = .793). In the pre-implementation group, female and male infants used pacifiers at comparable rates; however, in the post-implementation group, females were significantly less likely to use a pacifier compared to males after controlling for insurance, race, parity, and delivery mode (adjusted odds ratio, 0.35; 95% confidence interval, 0.15-0.83; P = .02). In the post-implementation group, exclusive breastfeeding rates at discharge increased significantly (from 40% to 51.3%; P = .04), but rates were not different at 1 month (23.7% pre-implementation vs 24.3% post-implementation; P = .89).
CONCLUSION
A Baby-Friendly-aligned pacifier policy delayed pacifier adoption but did not impact overall pacifier use or breastfeeding rates at 1 month of age. The finding of lower pacifier use rates among female infants post-intervention requires verification in other populations before evaluating public heath relevance.
Topics: Adult; Age Factors; Breast Feeding; Cohort Studies; Female; Health Policy; Humans; Infant; Infant, Newborn; Male; Pacifiers; Sudden Infant Death
PubMed: 30772504
DOI: 10.1016/j.acap.2019.02.002 -
PloS One 2023Pacifier use can interfere with nurturing care practices such as breastfeeding, soothing, and sleeping. Due to contradicting beliefs, recommendations, and the high...
BACKGROUND
Pacifier use can interfere with nurturing care practices such as breastfeeding, soothing, and sleeping. Due to contradicting beliefs, recommendations, and the high frequency of pacifier use, understanding its associations may support shaping equitable public health recommendations. This study explored the socio-demographic, maternal, and infant characteristics associated with pacifier use among six-months old infants in Clark County, Nevada.
METHOD
Cross-sectional survey was conducted in 2021 with a sample of mothers (n = 276) of infants under six months old in Clark County, Nevada. Participants were recruited through advertisements in birth, lactation, pediatric care centers, and social media. We used binomial and multinomial logistic models to assess the association between pacifier use and the age of pacifier introduction, respectively, with household, maternal, infant, healthcare characteristics, and feeding and sleeping practices.
RESULTS
More than half of the participants offered pacifiers (60.5%). Pacifier use was higher among low-income households (OR (95% CI) 2.06 (0.99-4.27)), mothers who identified as non-Hispanic (OR (95% CI) 2.09 (1.22-3.59)), non-first-time mothers (OR (95% CI) 2.09 (1.11-3.05)), and bottle-feeding infants (OR (95% CI) 2.76 (1.35-5.65)). Compared to those who did not introduce a pacifier, non-Hispanic mothers (RRR (95% CI) 2.34 (1.30-4.21)) and bottle-fed infants (RRR (95% CI) 2.71 (1.29-5.69)) had a higher risk of introducing pacifier within two weeks. Likewise, infants living in food insecure households (RRR (95% CI) 2.53 (0.97-6.58)) and mothers who have more than one child (RRR (95% CI) 2.44 (1.11-5.34)) had a higher risk of introducing a pacifier after two weeks.
CONCLUSION
Pacifier use is independently associated with maternal income, ethnicity, parity, and bottle feeding among six-month-old infants living in Clark County, Nevada. Household food insecurity increased the relative risk of introducing a pacifier after two weeks. Qualitative research on pacifier use among families with diverse ethnic/racial backgrounds is needed to improve equitable interventions.
Topics: Female; Pregnancy; Child; Humans; Infant; Pacifiers; Nevada; Cross-Sectional Studies; Breast Feeding; Mothers; Demography
PubMed: 37104304
DOI: 10.1371/journal.pone.0285097 -
Folia Phoniatrica Et Logopaedica :... 2021Children with and without speech sound disorders (SSDs) are exposed to different patterns of infant feeding (breast/bottle-feeding) and may or may not engage in... (Review)
Review
BACKGROUND
Children with and without speech sound disorders (SSDs) are exposed to different patterns of infant feeding (breast/bottle-feeding) and may or may not engage in non-nutritive sucking (NNS) (pacifier/digit-sucking). Sucking and speech use similar oral musculature and structures, therefore it is possible that early sucking patterns may impact early speech sound development. The objective of this review is to synthesise the current evidence on the influence of feeding and NNS on the speech sound development of healthy full-term children.
SUMMARY
Electronic databases (PubMed, NHS CRD, EMBASE, MEDLINE) were searched using terms specific to feeding, NNS and speech sound development. All methodologies were considered. Studies were assessed for inclusion and quality by 2 reviewers. Of 1,031 initial results, 751 records were screened, and 5 primary studies were assessed for eligibility, 4 of which were included in the review. Evidence from the available literature on the relationship between feeding, NNS and speech sound development was inconsistent and inconclusive. An association between NNS duration and SSDs was the most consistent finding, reported by 3 of the 4 studies. Quality appraisal was carried out using the Appraisal Tool for Cross-Sectional Studies (AXIS). The included studies were found to be of moderate quality. Key Messages: This review found there is currently limited evidence on the relationship between feeding, NNS and speech sound development. Exploring this unclear relationship is important because of the overlapping physical mechanisms for feeding, NNS and speech production, and therefore the possibility that feeding and/or sucking behaviours may have the potential to impact on speech sound development. Further high-quality research into specific types of SSD using coherent clinically relevant assessment measures is needed to clarify the nature of the association between feeding, NNS and speech sound development, in order to inform and support families and health care professionals.
Topics: Child; Cross-Sectional Studies; Fingersucking; Humans; Infant; Pacifiers; Phonetics; Sucking Behavior
PubMed: 32040950
DOI: 10.1159/000505266 -
The Journal of Contemporary Dental... Jan 2021This study aims to test the feasibility and effectiveness of a novel pacifier-based saliva collection method on children and infants in comparison to an oral swab-based...
AIM
This study aims to test the feasibility and effectiveness of a novel pacifier-based saliva collection method on children and infants in comparison to an oral swab-based saliva collection method.
MATERIALS AND METHODS
This study was performed during spring 2018 in a clinical non-sponsored setting at Queen Silvia Children's Hospital pediatric emergency ward. Saliva collection was performed by comparing oral swab (Salimetrics® SalivaBio's Children's Swab) with a pacifier-based saliva collection method (Salivac®). All participating children used both saliva collection systems. The amount of saliva collected in 2 minutes was measured. The amount of time needed for the healthcare professional was recorded. Parental preference was evaluated by a questionnaire.
RESULTS
No statistically significant difference was observed in collected saliva (174 µL for pacifier-based saliva collection and 158 µL for oral swab). The healthcare professional spent significantly less ( < 0.001) mean time with the pacifier-based saliva collection method than with the oral swab (31 vs 150 sec). A total of 48 out of the 52 caretakers preferred the pacifier-based saliva collection method compared to the oral swab.
CONCLUSION
The novel pacifier-based saliva collection method proved to be a feasible, appreciated, and effective way of collecting saliva that simplifies the saliva collection method among children and infants.
CLINICAL SIGNIFICANCE
The pacifier-based saliva collection method simplifies saliva testing. The closed vacutainer system minimizes the risk of saliva contamination and opens up for novel home testing strategies.
Topics: Child; Humans; Infant; Pacifiers; Parents; Saliva; Specimen Handling; Surveys and Questionnaires
PubMed: 34002701
DOI: No ID Found -
Pediatrics Jul 2022Every year in the United States, approximately 3500 infants die of sleep-related infant deaths, including sudden infant death syndrome (SIDS) (International Statistical...
Every year in the United States, approximately 3500 infants die of sleep-related infant deaths, including sudden infant death syndrome (SIDS) (International Statistical Classification of Diseases and Related Health Problems 10th Revision [ICD-10] R95), ill-defined deaths (ICD-10 R99), and accidental suffocation and strangulation in bed (ICD-10 W75). After a substantial decline in sleep-related deaths in the 1990s, the overall death rate attributable to sleep-related infant deaths have remained stagnant since 2000, and disparities persist. The triple risk model proposes that SIDS occurs when an infant with intrinsic vulnerability (often manifested by impaired arousal, cardiorespiratory, and/or autonomic responses) undergoes an exogenous trigger event (eg, exposure to an unsafe sleeping environment) during a critical developmental period. The American Academy of Pediatrics recommends a safe sleep environment to reduce the risk of all sleep-related deaths. This includes supine positioning; use of a firm, noninclined sleep surface; room sharing without bed sharing; and avoidance of soft bedding and overheating. Additional recommendations for SIDS risk reduction include human milk feeding; avoidance of exposure to nicotine, alcohol, marijuana, opioids, and illicit drugs; routine immunization; and use of a pacifier. New recommendations are presented regarding noninclined sleep surfaces, short-term emergency sleep locations, use of cardboard boxes as a sleep location, bed sharing, substance use, home cardiorespiratory monitors, and tummy time. In addition, additional information to assist parents, physicians, and nonphysician clinicians in assessing the risk of specific bed-sharing situations is included. The recommendations and strength of evidence for each recommendation are published in the accompanying policy statement, which is included in this issue.
Topics: Asphyxia; Bedding and Linens; Beds; Child; Humans; Infant; Pacifiers; Risk Factors; Sleep; Sleep Wake Disorders; Sudden Infant Death; United States
PubMed: 35921639
DOI: 10.1542/peds.2022-057991