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Muñoz LE, Kartushina N, Mayor J. Sustained pacifier use is associated with smaller vocabulary sizes at 1 and 2 years of age: A cross-sectional study. Dev Sci 2024:e13477. [PMID: 38270235 DOI: 10.1111/desc.13477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/07/2023] [Accepted: 01/04/2024] [Indexed: 01/26/2024]
Abstract
Pacifier use during childhood has been hypothesized to interfere with language processing, but, to date, there is limited evidence revealing detrimental effects of prolonged pacifier use on infant vocabulary learning. In the present study, parents of 12- and 24-month-old infants were recruited in Oslo (Norway). The sample included 1187 monolingual full-term born (without visual, auditory, or cognitive impairments) infants: 452 (230 girls; 222 boys) 12-month-olds and 735 (345 girls; 390 boys) 24-month-olds. Parents filled out an online Norwegian Communicative Development Inventory (CDI), which assesses the vocabulary in comprehension and production for 12-month-old infants and in production only for 24-month-old infants. CDI scores were transformed into age- and sex-adjusted percentiles using Norwegian norms. Additionally, parents retrospectively reported their child's daytime pacifier use, in hours, at 2-month intervals, from birth to the assessment date. Maternal education was used to control, in the analyses, for the socio-economic status. We found that greater pacifier use in an infant's lifespan was associated with lower vocabulary size. Pacifier use later in life was more negatively associated with vocabulary size than precocious use, and increased the odds of being a low language scorer. In sum, our study moves beyond the findings of momentary effects of experimentally induced "impairment" in articulators' movement on speech perception and suggests that, from 12 months of age, constraints on the infant's speech articulators (pacifier use) may be negatively associated with word comprehension and production. RESEARCH HIGHLIGHT: 1.We examined the relationship between pacifier use and vocabulary sizes in production at 24 months of age and comprehension and production at 12 months of age. 2.Lifespan Pacifier Use (LPU) was negatively correlated with vocabulary sizes in comprehension and production among 12-month-old infants and negatively correlated with production for 24-month-olds. 3.Later pacifier use was found to be more negatively correlated with vocabulary size in infants, as compared to more precocious use. 4.The amount of pacifier use in the 2 months prior to a child's second birthday was predictive of a higher prevalence of low vocabulary scores in 24-month-olds.
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Affiliation(s)
- Luis E Muñoz
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Natalia Kartushina
- Centre for Multilingualism in Society across the Lifespan, University of Oslo, Oslo, Norway
| | - Julien Mayor
- Department of Psychology, University of Oslo, Oslo, Norway
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Feldens CA, Petracco LB, Nascimento GG, Li H, Vítolo MR, Peres KG. Breastfeeding Protects from Overjet in Adolescence by Reducing Pacifier Use: A Birth Cohort Study. Nutrients 2023; 15:3403. [PMID: 37571340 PMCID: PMC10421320 DOI: 10.3390/nu15153403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
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 (n = 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.
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Affiliation(s)
- Carlos Alberto Feldens
- Graduate Program in Dentistry, Univesidade Luterana do Brasil, Canoas 92425-020, Brazil; (C.A.F.); (L.B.P.)
| | - Laura Boianovsky Petracco
- Graduate Program in Dentistry, Univesidade Luterana do Brasil, Canoas 92425-020, Brazil; (C.A.F.); (L.B.P.)
| | - Gustavo G. Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore 168938, Singapore; (G.G.N.); (H.L.)
- Oral Health Academic Programme, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Huihua Li
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore 168938, Singapore; (G.G.N.); (H.L.)
- Oral Health Academic Programme, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Márcia Regina Vítolo
- Graduate Program in Pediatrics—Child and Adolescent Health Care, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre 90050-170, Brazil;
| | - Karen Glazer Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore 168938, Singapore; (G.G.N.); (H.L.)
- Oral Health Academic Programme, Duke-NUS Medical School, Singapore 169857, Singapore
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Pegoraro NDA, dos Santos CM, Colvara BC, Rech RS, Faustino-Silva DD, Hugo FN, Hilgert JB. Prevalence of malocclusion in early childhood and its associated factors in a primary care service in Brazil. Codas 2021; 34:e20210007. [PMID: 34816947 PMCID: PMC9769416 DOI: 10.1590/2317-1782/20212021007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 07/26/2021] [Indexed: 08/22/2023] Open
Abstract
PURPOSE to evaluate the prevalence of malocclusion and its associated factors of children cared for by a PHC Service in Porto Alegre, Brazil. METHODS a cross-sectional study nested in a cohort, carried out in 12 Health Care Practices. Of the 414 children in the cohort examined, 268 were assessed for malocclusion. The presence of anterior open bite, posterior and anterior crossbite was evaluated by the criteria of Foster and Hamilton. Socioeconomic variables, breastfeeding habits and pacifier use information were collected through a standardized questionnaire. Data analysis was performed using a hierarchical approach by Poisson Regression with robust variance. RESULTS out of the total 268 evaluated, 135 (50.4%) were boys, and the average age was 28.6 (± 11.9) months. Out of the 143 (53.4%) cases of malocclusion, 113 were anterior open bite, 16 were anterior crossbite, 27 were posterior crossbite, and 38 had increased overjet. In the final analysis, it was observed that there was a higher prevalence of malocclusion in children who never breastfed (PR = 1.44; 95%CI 1.00-2.08) and who always used a pacifier to sleep (PR = 1.81; 95%CI 1.14-2.86). CONCLUSION the prevalence of malocclusion in this population was high and was associated with behavioral habits, such as the use of pacifier and not breastfeeding.
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Affiliation(s)
| | | | | | - Rafaela Soares Rech
- Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA - Porto Alegre (RS), Brasil
| | - Daniel Demétrio Faustino-Silva
- Programa de Pós-Graduação em Avaliação de Tecnologias para o SUS, Grupo Hospitalar Conceição – GHC - Porto Alegre (RS), Brasil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul – UFRGS - Porto Alegre (RS), Brasil
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Giugliani ERJ, Gomes E, Santos IS, Matijasevich A, Camargo-Figuera FA, Barros AJD. All day-long pacifier use and intelligence quotient in childhood: A birth cohort study. Paediatr Perinat Epidemiol 2021; 35:511-518. [PMID: 33570810 DOI: 10.1111/ppe.12752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/23/2020] [Accepted: 12/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Literature on pacifier use remains controversial, but mostly suggests an inverse association with childhood intelligence. OBJECTIVES The objective of this study was to assess the association between pacifier use and intelligence quotient (IQ) in six-year-old children from a birth cohort. METHODS Data from 3532 children from the 2004 Pelotas (Brazil) Birth Cohort were analysed. Children were recruited and assessed at birth and followed up at 3 months, and 1, 2, 4, and 6 years. Data on pacifier use duration and intensity were obtained via interviews with mothers in all six follow-up visits. IQ was estimated at 6 years using the Wechsler Intelligence Scale for Children and standardised for the analyses. Crude and adjusted coefficients were calculated (linear regression) for all the data collected in follow-up assessments for pacifier use. RESULTS IQ was inversely associated with all pacifier use indicators. Children who used a pacifier all day long (ADL) at any follow-up showed an IQ 0.18 (95% confidence interval [CI] 0.11, 0.24) standard deviations below those who never used it ADL, after adjusting for confounders. The strength of association increased with number of assessments reporting ADL pacifier use, from a reduction in IQ of 0.13 (95% CI 0.06, 0.21) to 0.34 (95% CI 0.15, 0.52) standard deviations for ADL use in one and in all four follow-up visits, respectively. CONCLUSIONS We found a strong association between intense pacifier use up to 4 years of age and lower IQ at 6 years. A dose-response gradient was observed, with greater IQ deficits in children who used a ADL pacifier for longer durations. The mechanisms underlying this association need to be clarified. One hypothesis is that children using a pacifier, especially those who use it more intensely, are less stimulated.
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Affiliation(s)
- Elsa R J Giugliani
- Faculdade de Medicina, Departamento de Pediatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Erissandra Gomes
- Faculdade de Odontologia, Departamento de Cirurgia e Ortopedia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Iná S Santos
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.,Programa de Pós-Graduação em Pediatria e Saúde da Criança, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alicia Matijasevich
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.,Faculdade de Medicina, Departamento de Medicina Preventiva, Universidade de São Paulo, São Paulo, Brazil
| | - Fabio A Camargo-Figuera
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.,Escuela de Enfermería, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Aluísio J D Barros
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
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Moraes RB, Knorst JK, Pfeifer ABR, Vargas-Ferreira F, Ardenghi TM. Pathways to anterior open bite after changing of pacifier sucking habit in preschool children: A cohort study. Int J Paediatr Dent 2021; 31:278-284. [PMID: 32949057 DOI: 10.1111/ipd.12725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/21/2020] [Accepted: 08/24/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Pacifier use is a major cause of anterior open bite (AOB), which negatively impacts the quality of life of children affected. AIM To assess the direct and indirect pathways related to pacifier sucking habit and AOB in preschool children. DESIGN This 2-year cohort study evaluated a random sample of preschool children (2-5 years of age) from Southern Brazil. Caregivers answered a questionnaire addressing socio-economic and behavioural characteristics. Anterior open bite was recorded following the criteria recommended by Foster and Hamilton. Structural equation model was performed to assess the direct and indirect pathways among variables at baseline (T1) to predict the AOB at follow-up (T2). RESULTS Regarding the AOB, 407 children were evaluated at T1 and 187 at T2. The prevalence of AOB was 32.9% at baseline and 16.0% at follow-up. The presence of AOB at follow-up was directly affected by the change in pacifier sucking habit from T1 to T2. Considering the indirect paths, the AOB at T1 influenced the AOB in T2 via a change of pacifier sucking habit. CONCLUSION These findings suggest that the non-habit of sucking pacifiers is a fundamental strategy for the prevention of AOB as well as the promotion of health in childhood.
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Affiliation(s)
- Renita Baldo Moraes
- Department of Health Sciences, University of Santa Cruz do Sul, Santa Cruz, Brazil
| | - Jessica Klöckner Knorst
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Fabiana Vargas-Ferreira
- Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Thiago Machado Ardenghi
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
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MacMillan KK, Lewis AJ, Watson SJ, Power J, Galbally M. Maternal psychosocial predictors of pacifier use in a mother-infant interaction task: An observational study from the MPEWS pregnancy cohort. Infant Behav Dev 2020; 61:101505. [PMID: 33197785 DOI: 10.1016/j.infbeh.2020.101505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 10/19/2020] [Accepted: 11/01/2020] [Indexed: 10/23/2022]
Abstract
The prevalence of pacifier use is high but when it occurs outside of the recommended sleep context, it becomes more controversial. Using 211 mother-infant dyads recorded as part of the Mercy Pregnancy and Emotional Wellbeing Study, we examined the maternal psychosocial predictors of pacifier use within an interaction task (i.e., ten minutes face-to-face followed by 30-minutes unstructured play). Predictors included maternal emotional availability measured with the Emotional Availability Scales; depression measured by the Structured Clinical Interview for the DSM-IV-TR Clinician Version; and maternal history of childhood trauma measured by the Childhood Trauma Questionnaire. An unadjusted odds ratio demonstrated that women classified as non-emotionally available to their infants were three-and-a-half-times more likely to use a pacifier. Multivariate logistic regression including all maternal psychosocial predictors demonstrated that even when adjusting for cessation of breastfeeding, maternal emotional availability remained the only significant predictor of pacifier use. This is the first time that predictors of pacifier use have been examined with a sample of clinically depressed women, as well as women with childhood trauma history. The results provide preliminary evidence that women who are not emotionally available might be more likely to rely on a pacifier during mother-infant interaction.
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Affiliation(s)
| | | | - Stuart J Watson
- Psychology, Murdoch University, Perth, Australia; School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Josephine Power
- School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Megan Galbally
- Psychology, Murdoch University, Perth, Australia; School of Medicine, University of Notre Dame, Fremantle, Australia; Women's Health, Genetics and Mental Health Directorate, King Edward Memorial Hospital for Women, Subiaco, Australia; Faculty of Health and Medicine Sciences, University of Western Australia, Perth, Australia
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Braga VS, Vítolo MR, Kramer PF, Feldens EG, Feldens CA. Breastfeeding in the First Hours of Life Protects Against Pacifier Use: A Birth Cohort Study. Breastfeed Med 2020; 15:516-521. [PMID: 32589452 DOI: 10.1089/bfm.2020.0054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: To investigate risk factors for pacifier use in the first year of life. Materials and Methods: A prospective cohort study was conducted with children enrolled at birth in Porto Alegre, Southern Brazil, whose mothers underwent prenatal care at primary care units. Soon after the birth of the children, data were collected on anthropometrics, type of childbirth, and time until breastfeeding on the first day of life. At 6 and 12 months of age, data were collected on breastfeeding practices and whether the child had used a pacifier in the previous 6 months. Statistical analysis involved the use of Poisson regression with robust variance. Results: The incidence of pacifier use in the first year of life was 60% (317/532). The multivariable analysis showed that pacifier use in the first year of life was 33% higher when the mother was younger than 18 years of age (relative risk [RR] = 1.33; confidence interval [95% CI]: 1.01-1.76). Infants who breastfed in the first 30 minutes after birth had a 25% lower risk of pacifier use in the first year of life (RR = 0.75; 95% CI: 0.60-0.94), and those who breastfed between 30 minutes and 6 hours after birth had an 18% lower risk (RR = 0.82; 95% CI: 0.69-0.97) compared to those who took longer to begin breastfeeding or did not breastfeed. Conclusions for Practice: Breastfeeding soon after being born protected against pacifier use in the first year of life. This finding suggests pathways to improve child health, especially in the prenatal period and with an emphasis on pregnant adolescents.
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Affiliation(s)
- Vanessa Simas Braga
- Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil
| | - Márcia Regina Vítolo
- Department of Nutrition, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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Batista CLC, Rodrigues VP, Ribeiro VS, Nascimento MDSB. Nutritive and non-nutritive sucking patterns associated with pacifier use and bottle-feeding in full-term infants. Early Hum Dev 2019; 132:18-23. [PMID: 30928831 DOI: 10.1016/j.earlhumdev.2019.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 03/15/2019] [Accepted: 03/19/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND The current literature does not provide accurate information about the association between use of artificial nipples and sucking patterns in infants. AIMS We aimed to investigate whether pacifier use and/or bottle-feeding were associated with nutritive sucking (NS) and non-nutritive sucking (NNS) patterns. STUDY DESIGN Cross-sectional study. SUBJECTS 429 full-term infants/mothers. OUTCOME MEASURES Data were collected through a questionnaire and observations of NS during breastfeeding and NNS (finger sucking). Multivariate logistic regression was used to analyze the adjusted associations between artificial nipple use and between NS and NNS changes. RESULTS There were higher frequencies of changes in the NNS and NS patterns in the group that used artificial nipples. Regarding the type of artificial nipple, pacifier use had a greater influence on changes in the NNS pattern whereas the use of a baby bottle presented a greater number of associations with changes in the NS pattern. CONCLUSION The findings suggest that the use of artificial nipples may be associated with changes in the sucking patterns of infants, demonstrating the possible existence of nipple confusion and its effect on breastfeeding.
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Affiliation(s)
| | - Vandilson P Rodrigues
- Department of Morphology, Federal University of Maranhão, São Luís, MA 65080-805, Brazil
| | - Valdinar S Ribeiro
- Department of Medicine, Federal University of Maranhão, São Luís, MA 65020-270, Brazil
| | - Maria D S B Nascimento
- Department of Pathology, Graduate Program in Adult Health, Federal University of Maranhão, São Luís, MA 65080-805, Brazil
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Involvement of maternal grandmother and teenage mother in intervention to reduce pacifier use: a randomized clinical trial. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2018.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Giugliani ERJ, Nunes LM, Issler RMS, Santo LCDE, Oliveira LDD. Involvement of maternal grandmother and teenage mother in intervention to reduce pacifier use: a randomized clinical trial. J Pediatr (Rio J) 2019; 95:166-172. [PMID: 29447832 DOI: 10.1016/j.jped.2017.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 12/03/2017] [Accepted: 12/20/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To assess the impact of an intervention for teenage mothers with the involvement of maternal grandmothers on the prevalence of pacifier use in the first six months of life. METHODS This randomized clinical trial involved 323 teenage mothers, allocated to four groups: intervention with teenagers only, intervention with teenagers and their mothers, and respective controls. Six breastfeeding counseling sessions, including the recommendation to avoid the use of a pacifier, were delivered at the maternity ward and subsequently at the teenagers' homes, at seven, 15, 30, 60, and 120 days postpartum. Data on infant feeding and pacifier use were collected monthly by interviewers blinded to group allocation. The impact of the intervention was measured by comparing survival curves for pacifier use in the first six months of life and mean time to pacifier introduction. RESULTS The intervention had a significant impact on reducing pacifier use only in the group in which grandmothers were involved. In this group, the intervention delayed by 64 days the introduction of a pacifier (21-85 days), compared to 25 days in the group without the participation of grandmothers (65-90 days). CONCLUSIONS The intervention reduced pacifier use in the first six months of life and delayed its introduction until beyond the first month when grandmothers were involved. The intervention did not have a significant impact when only teenage mothers were involved.
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Affiliation(s)
- Elsa Regina Justo Giugliani
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Departamento de Pediatria, Porto Alegre, RS, Brazil
| | - Leandro Meirelles Nunes
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Departamento de Pediatria, Porto Alegre, RS, Brazil.
| | - Roberto Mário Silveira Issler
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Departamento de Pediatria, Porto Alegre, RS, Brazil
| | - Lilian Cordova do Espírito Santo
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Departamento de Enfermagem Materno Infantil, Porto Alegre, RS, Brazil
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Buccini G, Pérez-Escamilla R, D’Aquino Benicio MH, Justo Giugliani ER, Isoyama Venancio S. Exclusive breastfeeding changes in Brazil attributable to pacifier use. PLoS One 2018; 13:e0208261. [PMID: 30566449 PMCID: PMC6300199 DOI: 10.1371/journal.pone.0208261] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 11/13/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Identifying key interventions to increase exclusive breastfeeding duration has been a challenge. Pacifier use has been associated with exclusive breastfeeding discontinuation in Brazil. However, the proportion of the improvement in exclusive breastfeeding duration attributable to pacifier use remains unknown. RESEARCH AIM Quantify the proportion of increases in exclusive breastfeeding prevalence that can be attributed to reduced pacifier use over time. METHODS Secondary data analyses of two nationally representative cross-sectional surveys conducted in States' capitals in 1999 and in 2008 (N = 42,395 Brazilian infants under 6 months of age). We estimated the fraction of exclusive breastfeeding prevalence improvements that could be attributed to pacifier use based on multilevel regression analysis. RESULTS From 1999 to 2008, there was an increase of 15.2 percentage points in exclusive breastfeeding prevalence and a decrease of approximately 17 percentage points in the prevalence of pacifier use among infants under 6 months. Reduction in pacifier use explained an increase in 5.5 percentage points' exclusive breastfeeding rates. If pacifier use were to decrease from 41.6% (prevalence in 2008) to 14% (as found in New Zealand), there would be an expected additional increase in exclusive breastfeeding of approximately 12 percentage points. CONCLUSIONS About one-third of the improvements in EBF prevalence observed in Brazil over a decade can be attributed to the corresponding decline in pacifier use.
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Affiliation(s)
- Gabriela Buccini
- Departament of Nutrition, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Departament of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Rafael Pérez-Escamilla
- Departament of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
| | | | | | - Sonia Isoyama Venancio
- Departament of Nutrition, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Department of Director, Instituto de Saúde, São Paulo, São Paulo, Brazil
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Carcavalli L, Martins CC, Rocha IA, Parlato EM, Serra-Negra JM. Preterm Birth, Pacifier use and Breastfeeding: is there a Relationship? Braz Dent J 2018; 29:388-394. [DOI: 10.1590/0103-6440201801962] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/18/2018] [Indexed: 11/21/2022] Open
Abstract
Abstract 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.
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Carneiro NCR, Monteiro LR, Pordeus IA, Borges-Oliveira AC. Oral sucking habits among children with Down syndrome and cerebral palsy. SPECIAL CARE IN DENTISTRY 2017; 37:176-180. [DOI: 10.1111/scd.12231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Natália Cristina Ruy Carneiro
- Faculty of Dentistry, Department of Pediatric Dentistry and Orthodontics; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Luisa Ribeiro Monteiro
- Faculty of Dentistry, Department of Social and Preventive Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Isabela Almeida Pordeus
- Faculty of Dentistry, Department of Pediatric Dentistry and Orthodontics; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Ana Cristina Borges-Oliveira
- Faculty of Dentistry, Department of Social and Preventive Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
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Buccini GDS, Pérez‐Escamilla R, Paulino LM, Araújo CL, Venancio SI. Pacifier use and interruption of exclusive breastfeeding: Systematic review and meta-analysis. MATERNAL & CHILD NUTRITION 2017; 13:e12384. [PMID: 27863027 PMCID: PMC6866034 DOI: 10.1111/mcn.12384] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/11/2016] [Accepted: 08/23/2016] [Indexed: 01/25/2023]
Abstract
Identifying modifiable risk factor for exclusive breastfeeding (EBF) interruption is key for improving child health globally. There is no consensus about the effect of pacifier use on EBF interruption. Thus, the aim of this systematic review was to investigate the association between pacifier use and EBF interruption during the first six month. A search of CINAHL, Scopus, Web of Science, LILACS and Medline; from inception through 30 December 2014 without restriction of language yielded 1,866 publications (PROSPERO protocol CRD42014014527). Predetermined inclusion/exclusion criteria peer reviewed yielded 46 studies: two clinical trials, 20 longitudinal, and 24 cross-sectional studies. Meta-analysis was performed and meta-regression explored heterogeneity across studies. The pooled effect of the association between pacifier use and EBF interruption was 2.48 OR (95% CI = 2.16-2.85). Heterogeneity was explained by the study design (40.2%), followed by differences in the measurement and categorization of pacifier use, the methodological quality of the studies and the socio-economic context. Two RCT's with very limited external validity found a null association, but 44 observational studies, including 20 prospective cohort studies, did find a consistent association between pacifier use and risk of EBF interruption (OR = 2.28; 95% CI = 1.78-2.93). Our findings support the current WHO recommendation on pacifier use as it focuses on the risk of poor breastfeeding outcomes as a result of pacifier use. Future studies that take into account the risks and benefits of pacifier use are needed to clarify this recommendation.
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Jaafar SH, Ho JJ, Jahanfar S, Angolkar M. Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev 2016; 2016:CD007202. [PMID: 27572944 PMCID: PMC8520760 DOI: 10.1002/14651858.cd007202.pub4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
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.
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Affiliation(s)
- Sharifah Halimah Jaafar
- Regency Specialist HospitalDepartment of Obstetrics and GynaecologyNo 1 Jalan Suria,Bandar Seri AlamJohor BahruJohorMalaysia81750
| | - Jacqueline J Ho
- Penang Medical CollegeDepartment of Paediatrics4 Sepoy LinesPenangMalaysia10450
| | - Shayesteh Jahanfar
- University of British ColumbiaDepartment of Public Health, School of Population and Public Health2206 East MallVancouverBCCanadaVT6 1Z3
| | - Mubashir Angolkar
- JN Medical CollegeWomen's and Children's Health ResearchNehru NagarBelgaumKarnatakaIndia590010
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Buccini GDS, Pérez-Escamilla R, Venancio SI. Pacifier Use and Exclusive Breastfeeding in Brazil. J Hum Lact 2016; 32:NP52-60. [PMID: 26446096 DOI: 10.1177/0890334415609611] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/08/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Exclusive breastfeeding (EBF) rates for infants younger than 6 months have increased in Brazil, although at the current pace of improvement it would take 6 years to reach an EBF rate of 50%. Thus, it is important to identify relevant modifiable key risk factors for the premature interruption of EBF. OBJECTIVE This study aimed to find out if pacifier use is an independent risk factor for the interruption of EBF among Brazilian infants. METHODS We conducted secondary cross-sectional data analyses of 2 waves of infant feeding surveys conducted in 1999 and in 2008 in the Brazilian state capitals and Federal District (N = 42 395 children < 6 months). Multivariate logistic regression was used to test the association between pacifier use and the risk of interruption of EBF in a pooled sample and within each survey wave, adjusting for socioeconomic, demographic, and biomedical confounders. RESULTS In the pooled sample, a third of the infants were exclusively breastfed (32.7%) and almost 50% had used a pacifier. Whereas EBF prevalence among infants increased from 25.1% in 1999 to 40.3% in 2008, pacifier use prevalence decreased from 58.5% to 41.6% in the same time period. Pacifier use was strongly associated with the risk of interruption of EBF in 1999 (adjusted odds ratio [AOR] = 2.65; 95% confidence interval [CI], 2.38-2.94), in 2008 (AOR = 3.18; 95% CI, 2.81-3.60), and in the pooled sample (AOR = 2.77; 95% CI, 2.63-2.91) after adjusting for key confounders. CONCLUSION Pacifier use was the strongest risk factor for EBF interruption. Effective strategies to reduce pacifier use among infants younger than 6 months may further improve EBF rates in Brazil.
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Kramer PF, Feldens EG, Bruch CM, Ferreira SH, Feldens CA. Clarifying the effect of behavioral and clinical factors on traumatic dental injuries in childhood: a hierarchical approach. Dent Traumatol 2015; 31:177-83. [DOI: 10.1111/edt.12167] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2015] [Indexed: 12/27/2022]
Affiliation(s)
| | | | - Cristina Montini Bruch
- Department of Pediatric Dentistry; Universidade Regional Integrada do Alto Uruguai e das Missões; Erechim Brazil
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Ferreira HR, Rosa EF, Antunes JLF, Duarte DA, Imparato JCP, Pannuti CM, Mendes FM. Prolonged pacifier use during infancy and smoking initiation in adolescence: evidence from a historical cohort study. Eur Addict Res 2015; 21:33-8. [PMID: 25358513 DOI: 10.1159/000365351] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 06/19/2014] [Indexed: 11/19/2022]
Abstract
AIM To investigate the association between prolonged pacifier use during childhood and smoking in adolescence and early adulthood. METHODS A historical cohort study including patients from a dental private office was designed. Dental records were used, which contained complete data about sucking habits from 314 children (2-10 years of age) who had attended a private dental office from 1988 to 1994 in Ibiá, Brazil. Then, we collected data about the smoking habits from 261 subjects who were successfully contacted again from 2004 to 2006. Our outcome variable was smoking, and subjects who had smoked more than 100 cigarettes during their lifetime were classified as smokers. Poisson regression analysis matched the association between oral habits and smoking. Incidence rate ratios (IRR) and 95% confidence intervals (95% CI) were calculated. The level of significance was set at 5%. RESULTS We observed a statistically significant association between prolonged pacifier use (more than 24 months) and smoking (IRR = 4.48; 95% CI 2.32-8.65). Breastfeeding, in contrast, was a protective factor (IRR = 0.64; 95% CI 0.42-0.96). CONCLUSIONS Prolonged pacifier use during childhood is positively associated with smoking initiation in adolescence and early adulthood.
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Affiliation(s)
- Helenice R Ferreira
- Division of Pediatric Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
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NIHI VSC, MACIEL SM, JARRUS ME, NIHI FM, SALLES CLFD, PASCOTTO RC, FUJIMAKI M. Pacifier-sucking habit duration and frequency on occlusal and myofunctional alterations in preschool children. Braz Oral Res 2015; 29:1-7. [DOI: 10.1590/1807-3107bor-2015.vol29.0013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 08/13/2014] [Indexed: 11/21/2022] Open
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Feldens CA, Kramer PF, Feldens EG, Pacheco LM, Vítolo MR. Socioeconomic, behavioral, and anthropometric risk factors for traumatic dental injuries in childhood: a cohort study. Int J Paediatr Dent 2014; 24:234-43. [PMID: 24102653 DOI: 10.1111/ipd.12066] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To investigate risk factors for the occurrence of traumatic dental injuries (TDI) at 4 years of age. DESIGN Prospective cohort study. METHODS A birth cohort (n = 500) was recruited from the public healthcare system in São Leopoldo, Brazil. Demographic, socioeconomic, anthropometric, and behavioral variables were collected at 6 months, 1 year, and 4 years of age. Clinical examinations at 4 years of age were carried out by a single examiner using the Andreasen classification. Poisson regression was used to determine risk factors for the occurrence of TDI at 4 years of age. RESULTS A total of 23.7% of the children (80/337) exhibited TDI at 4 years of age. The risk of TDI was 35% lower among children who had been breastfeed for ≥6 months relative risk (RR 0.65; 95% CI 0.43-0.97) and more than twofold higher among those who were bottle fed ≥ three times a day (RR 2.37; 95% CI 1.10-5.11) at 12 months of age. Higher household income in the first year of life and greater height at 4 years of age were significantly associated with the outcome. CONCLUSIONS The identification of behavioral, socioeconomic, and anthropometric risk factors for TDI in early childhood can contribute to the elaboration of prevention strategies.
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