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Neurogastroenterology and Motility Apr 2016Pacifier use is widely prevalent globally despite hygienic concerns and uncertain mechanistic effects on swallowing or airway safety.
BACKGROUND
Pacifier use is widely prevalent globally despite hygienic concerns and uncertain mechanistic effects on swallowing or airway safety.
AIMS
The effects of pacifier and taste interventions on pharyngo-esophageal motility, bolus transit, and respiratory rhythms were investigated by determining the upper esophageal sphincter (UES), esophageal body, esophagogastric junction (EGJ) motor patterns and deglutition apnea, respiratory rhythm disturbances, and esophageal bolus clearance.
METHODS
Fifteen infants (six males; median gestation 31 weeks and birth weight 1.4 kg) underwent high-resolution impedance manometry at 43 (41-44) weeks postmenstrual age. Manometric, respiratory, and impedance characteristics of spontaneous swallows, pacifier-associated dry swallowing and taste (pacifier dipped in 3% sucrose)-associated swallowing were analyzed. Linear mixed and generalized estimating equation models were used. Data are presented as mean ± SEM, %, or median (IQR).
KEY RESULTS
Pharyngo-esophageal motility, respiratory, and impedance characteristics of 209 swallows were analyzed (85 spontaneous swallows, 63 pacifier- swallows, 61 taste- swallows). Basal UES and EGJ pressures decreased upon pacifier (p < 0.05) and taste interventions (p < 0.05); however, esophageal motility, respiratory rhythm, and impedance transit characteristics were similar with both interventions.
CONCLUSIONS & INFERENCES
Oral stimulus with pacifier or taste interventions decreases UES and EGJ basal pressure, but has no effects on pharyngo-esophageal motility, airway interactions, or esophageal bolus transit. A decrease in central parasympathetic-cholinergic excitatory drive is likely responsible for the basal effects.
Topics: Deglutition; Electric Impedance; Esophagus; Female; Humans; Infant, Newborn; Male; Manometry; Pacifiers; Peristalsis; Pharynx; Respiration; Taste
PubMed: 26727930
DOI: 10.1111/nmo.12748 -
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 -
Frontiers in Pediatrics 2021It is well recognized that pacifier habit leads to occlusal and orofacial functional changes in children. However, the effects of the interruption of prolonged pacifier...
It is well recognized that pacifier habit leads to occlusal and orofacial functional changes in children. However, the effects of the interruption of prolonged pacifier habit on the development of the dento-facial complex has not yet been fully characterized. Thus, the aim of this study was to investigate the influence of pacifier removal on aspects of oro-dentofacial morphology and function in preschool children. For that, a pacifier group ( = 28) and a control group ( = 32) of 4-year-old children with and without pacifier habit, respectively, were followed up by a group of dentists and speech therapists at baseline, 6 and 12 months after habit removal. Bite force and lip pressure were assessed using digital systems, and the evaluation of breathing and speech functions was performed using validated protocols, together with the measurements of dental casts and facial anthropometry. The Two-way mixed model ANOVA was used in data analysis. After 12 months, a decrease in malocclusion frequency was observed in pacifier group. Additionally, a change over time was observed in facial, intermolar and palate depth measurements, as well in bite and lip forces and speech function scores, increasing in both groups ( < 0.01). The upper and lower intercanine widths and breathing scores differed between groups at baseline and changed over time reducing the differences. The presence of speech distortions was more frequent in the pacifier group at baseline and decreased over time ( < 0.05). The interruption of pacifier habit improved the maxillary and mandibular intercanine widths, as well as the breathing and speech functions, overcoming the oro-dentofacial changes found. This clinical trial was registered in the Brazilian Clinical Trials Registry (ReBEC; http://www.ensaiosclinicos.gov.br/), protocol no. RBR-728MJ2.
PubMed: 34589451
DOI: 10.3389/fped.2021.703695 -
Acta Paediatrica (Oslo, Norway : 1992) Jan 2016We conducted a literature review on the effect of breastfeeding and dummy (pacifier) use on sudden infant death syndrome (SIDS). From 4343 abstracts, we identified 35... (Review)
Review
UNLABELLED
We conducted a literature review on the effect of breastfeeding and dummy (pacifier) use on sudden infant death syndrome (SIDS). From 4343 abstracts, we identified 35 relevant studies on breastfeeding and SIDS, 27 on dummy use and SIDS and 59 on dummy use versus breastfeeding.
CONCLUSION
We found ample evidence that both breastfeeding and dummy use reduce the risk of SIDS. There has been a general reluctance to endorse dummy use in case it has a detrimental effect of breastfeeding. However, recent evidence suggests that dummy use might not be as harmful to breastfeeding as previously believed.
Topics: Breast Feeding; Humans; Infant; Pacifiers; Sudden Infant Death
PubMed: 26175065
DOI: 10.1111/apa.13124 -
American Family Physician May 2009Sudden infant death syndrome is the leading cause of death among healthy infants, affecting 0.57 per 1,000 live births. The most easily modifiable risk factor for sudden... (Review)
Review
Sudden infant death syndrome is the leading cause of death among healthy infants, affecting 0.57 per 1,000 live births. The most easily modifiable risk factor for sudden infant death syndrome is sleeping position. To reduce the risk of sudden infant death syndrome, parents should be advised to place infants on their backs to sleep and avoid exposing the infant to cigarette smoke. Other recommendations include use of a firm sleeping surface and avoidance of sleeping with soft objects, bed sharing, and overheating the infant. Pacifier use appears to decrease the risk of sudden infant death syndrome, but should be avoided until one month of age in infants who are breastfed. The occurrence of apparent life-threatening events does not increase the risk of sudden infant death syndrome, and home apnea monitoring does not lower the risk of sudden infant death syndrome. Supine sleeping position has increased the incidence of flattening of the occiput (deformational plagiocephaly), but this condition can be prevented and treated by encouraging supervised "tummy time," meaning that when awake, infants should spend as much time as possible on their stomachs. All apparent deaths from sudden infant death syndrome should be carefully investigated to exclude other causes of death, including child abuse. Families who have an infant die from sudden infant death syndrome should be offered emotional support and grief counseling.
Topics: Humans; Infant; Infant, Newborn; Risk Factors; Sudden Infant Death; Supine Position
PubMed: 19496386
DOI: No ID Found -
The Cochrane Database of Systematic... Apr 2017Sudden infant death syndrome (SIDS) has been most recently defined as the sudden unexpected death of an infant less than one year of age, with onset of the fatal episode... (Review)
Review
BACKGROUND
Sudden infant death syndrome (SIDS) has been most recently defined as the sudden unexpected death of an infant less than one year of age, with onset of the fatal episode apparently occurring during sleep, that remains unexplained after a thorough investigation, including the performance of a complete autopsy and a review of the circumstances of death and clinical history. Despite the success of several prevention campaigns, SIDS remains a leading cause of infant mortality. In 1994, a 'triple risk model' for SIDS was proposed that described SIDS as an event that results from the intersection of three factors: a vulnerable infant; a critical development period in homeostatic control (age related); and an exogenous stressor. The association between pacifier (dummy) use and reduced incidence of SIDS has been shown in epidemiological studies since the early 1990s. Pacifier use, given its low cost, might be a cost-effective intervention for SIDS prevention if it is confirmed effective in randomised controlled trials.
OBJECTIVES
To determine whether the use of pacifiers during sleep versus no pacifier during sleep reduces the risk of SIDS.
SEARCH METHODS
We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 2), MEDLINE via PubMed, Embase, and CINAHL to 16 March 2016. We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials.
SELECTION CRITERIA
Published and unpublished controlled trials using random and quasi-random allocations of infants born at term and at preterm (less than 37 weeks' gestation) or with low birth weight (< 2500 g). Infants must have been randomised by one month' postmenstrual age. We planned to include studies reported only by abstracts, and cluster and cross-over randomised trials.
DATA COLLECTION AND ANALYSIS
Two review authors independently reviewed studies from searches. We found no eligible studies.
MAIN RESULTS
We identified no randomised controlled trials examining infant pacifiers for reduction in risk of SIDS.
AUTHORS' CONCLUSIONS
We found no randomised control trial evidence on which to support or refute the use of pacifiers for the prevention of SIDS.
Topics: Humans; Infant; Infant, Newborn; Infant, Premature; Pacifiers; Sudden Infant Death; Term Birth
PubMed: 28378502
DOI: 10.1002/14651858.CD011147.pub2 -
Brazilian Dental Journal 2018The immaturity of born to preterm infants may predispose to sucking difficulties. This research aimed to evaluate if pacifier use is associated with preterm birth and...
The immaturity of born to preterm infants may predispose to sucking difficulties. This research aimed to evaluate if pacifier use is associated with preterm birth and influenced in type of infant feeding. This comparative cross-sectional study was conducted in Belo Horizonte, Brazil and evaluated 250 children aged 3 to 5 years. As a sample, two groups were established: the normal term children group (n=125) was selected at a day-care centre and the group of preterm children (125) was identified at a public university hospital with a preterm care project from birth to seven years of age. To collect data, a pre-tested questionnaire regarding information on gestational age, infant development, infant feeding and non-nutritive sucking habits was used for both groups. Bivariate and multivariate Poisson regression was used for the statistical analysis. Pacifier use was more prevalent in the preterm group (PR=1.20, 95% CI=1.02-1.42) who used the bottle (PR=1.38, 95% CI=1.15-1.64) and were breastfed for less than six months (PR=1.19, 95% CI=1.01-1.41). The majority of breastfed infants were of normal term birth (PR=1.14, 95% CI=1.04-1.20) and had monthly family income greater than USD 450.28 (RP= 1.10, 95% CI=1.01-1.20). In this study, pacifier use was more prevalent among preterm infants and associated with less than six months of breastfeeding and used of bottle. Monthly family income was associated with a prevalence of breastfeeding.
Topics: Breast Feeding; Child, Preschool; Cross-Sectional Studies; Female; Humans; Infant; Infant, Newborn; Infant, Premature; Male; Pacifiers; Retrospective Studies; Surveys and Questionnaires
PubMed: 30462766
DOI: 10.1590/0103-6440201801962 -
The Cochrane Database of Systematic... Aug 2016To successfully initiate and maintain breastfeeding for a longer duration, the World Health Organization's Ten Steps to Successful Breastfeeding recommends total... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
To successfully initiate and maintain breastfeeding for a longer duration, the World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of artificial teats or pacifiers for breastfeeding infants. Concerns have been raised that offering the pacifier instead of the breast to calm the infant may lead to less frequent episodes of breastfeeding and as a consequence may reduce breast-milk production and shorten duration of breastfeeding.
OBJECTIVES
To assess the effect of restricted versus unrestricted pacifier use in healthy full-term newborns whose mothers have initiated breastfeeding and intend to exclusively breastfeed, on the duration of breastfeeding, other breastfeeding outcomes and infant health.
SEARCH METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2016) and reference lists of retrieved studies.
SELECTION CRITERIA
Randomised and quasi-randomised controlled trials comparing restricted versus unrestricted pacifier use in healthy full-term newborns who have initiated breastfeeding.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The quality of the evidence was assessed using the GRADE approach.
MAIN RESULTS
We found three trials (involving 1915 babies) for inclusion in the review, but have included only two trials (involving 1302 healthy full-term breastfeeding infants) in the analysis. Meta-analysis of the two combined studies showed that pacifier use in healthy breastfeeding infants had no significant effect on the proportion of infants exclusively breastfed at three months (risk ratio (RR) 1.01; 95% confidence interval (CI) 0.96 to 1.07, two studies, 1228 infants), and at four months of age (RR 1.01; 95% CI 0.94 to 1.09, one study, 970 infants, moderate-quality evidence), and also had no effect on the proportion of infants partially breastfed at three months (RR 1.00; 95% CI 0.98 to 1.02, two studies, 1228 infants), and at four months of age (RR 0.99; 95% CI 0.97 to 1.02, one study, 970 infants). None of the included trials reported data on the other primary outcomes, i.e. duration of partial or exclusive breastfeeding, or secondary outcomes: breastfeeding difficulties (mastitis, cracked nipples, breast engorgement); infant's health (dental malocclusion, otitis media, oral candidiasis; sudden infant death syndrome (SIDS)); maternal satisfaction and level of confidence in parenting. One study reported that avoidance of pacifiers had no effect on cry/fuss behavior at ages four, six, or nine weeks and also reported no effect on the risk of weaning before age three months, however the data were incomplete and so could not be included for analysis.
AUTHORS' CONCLUSIONS
Pacifier use in healthy term breastfeeding infants, started from birth or after lactation is established, did not significantly affect the prevalence or duration of exclusive and partial breastfeeding up to four months of age. Evidence to assess the short-term breastfeeding difficulties faced by mothers and long-term effect of pacifiers on infants' health is lacking.
Topics: Breast Feeding; Female; Humans; Infant; Infant, Newborn; Lactation; Motivation; Pacifiers; Randomized Controlled Trials as Topic; Time Factors
PubMed: 27572944
DOI: 10.1002/14651858.CD007202.pub4 -
Breastfeeding Medicine : the Official... Jan 2020Due to the inconclusive evidence supporting the traditional recommendation to avoid early pacifier use among breastfeeding newborns, this study aims to understand what...
Due to the inconclusive evidence supporting the traditional recommendation to avoid early pacifier use among breastfeeding newborns, this study aims to understand what information mothers are receiving from hospital based care providers and their perspectives about pacifier use in the newborn period. Interviews with mothers of healthy, term newborns during the postpartum hospitalization were conducted in this qualitative study. Qualitative data analysis yielded several major themes that included the following: (1) pacifiers are beneficial for the maternal/infant experience, (2) concerns that pacifiers may interfere with breastfeeding, and (3) concerns about long-term use (including reliance and effect on teeth). Given the maternal perception of benefit and the paucity of high-quality evidence showing harm, further research on the effects of early pacifier use is needed.
Topics: Adolescent; Adult; Breast Feeding; Female; Humans; Infant; Infant Care; Infant, Newborn; Interviews as Topic; Mothers; Pacifiers; Postpartum Period; Qualitative Research; Time Factors; Young Adult
PubMed: 31859530
DOI: 10.1089/bfm.2019.0174