Effect of breast- and bottle-feeding duration on the age of pacifier use persistence

Association between oral habits, mouth breathing and malocclusion

The ratio of bad habits, mouth breathing and malocclusion is an important issue in view of prevention and early treatment of disorders of the craniofacial growth. While bad habits can interfere with the position of the teeth and normal pattern of skeletal growth, on the other hand obstruction of the upper airway, resulting in mouth breathing, changes the pattern of craniofacial growth causing malocclusion. Our crosssectional study, carried out on 3017 children using the ROMA index, was developed to verify if there was a significant correlation between bad habits/mouth breathing and malocclusion. The results showed that an increase in the degree of the index increases the prevalence of bad habits and mouth breathing, meaning that these factors are associated with more severe malocclusions. Moreover, we found a significant association of bad habits with increased overjet and openbite, while no association was found with crossbite. Additionally, we found that mouth breathing is closely related to increased overjet, reduced overjet, anterior or posterior crossbite, openbite and displacement of contact points. Therefore, it is necessary to intervene early on these aetiological factors of malocclusion to prevent its development or worsening and, if already developed, correct it by early orthodontic treatment to promote eugnatic skeletal growth.

Surface electromyography in premature infants: a series of case reports and their methodological aspects

OBJECTIVES

To analyze the development of a method for using Surface Electromyography (sEMG) to evaluate the suckling of premature infants and describe five case reports.

METHODS

The five premature infants who took part in the study were submitted to sEMG evaluation of the masseter and buccinator muscles during different feeding methods.

RESULTS

Higher masseter muscle activity was observed in the infants that breastfed or used a cup; masseter muscle activity was reduced and buccinator muscle activity was increased in infants who were fed artificially using only a bottle.

CONCLUSIONS

Masseter action was reduced in bottle-fed infants, and there were similarities in masseter activity during breastfeeding and cup-feeding.

Factors associated with prolonged non-nutritive sucking habits in two cohorts of Brazilian children

BACKGROUND

Non-nutritive sucking habits (NNSH) are very common during childhood. However, if these habits were maintained for 36 months of age or more, they are considered to be prolonged (PNNSH) and can cause occlusal, physiological and esthetic changes. There is controversy about their prevalence and whether perinatal, social, demographic and health characteristics influence their onset and duration. So, the objectives of this study are to estimate the prevalence of PNNSH and to evaluate perinatal, early life and school age factors associated with their occurrence in children.

METHODS

A sample of 1,463 children aged 7-11 years born in Ribeirão Preto (RP-1994) and São Luís (SL-1997/98), Brazil, was reevaluated at school age in 2004/05. Birth weight, gestational age and perinatal variables were obtained at birth. Type of feeding, occurrence and duration of finger and pacifier sucking were recorded retrospectively at school age. PNNSH were defined when persisted for 36 months of age or more. Crude and adjusted prevalence ratios (PR) were estimated by Poisson regression (alpha = 5%).

RESULTS

Prevalence of PNNSH was higher in RP (47.6%) than in SL (20.2%) - (p < 0.001). Perinatal variables were not associated to PNNSH, whilst female sex (PR = 1.27 in RP; PR = 1.47 in SL) and bottle feeding for 24 months or more (PR = 2.24 in RP; PR = 2.49 in SL) were risk factors in both locations. Breast feeding for 12 months or more (PR = 0.53 in RP; PR = 0.31 in SL) was associated with lower prevalence of PNNSH in both places. In SL, children whose mothers lived in consensual union (PR = 1.62) and worked outside the home (PR = 1.51) showed higher prevalence of PNNSH compared to their counterparts.

CONCLUSIONS

Prevalence of PNNSH was high especially in RP and was not associated with perinatal variables. In both cities there was an association between female sex, shorter breast-feeding duration, longer bottle feeding duration and higher prevalence of PNNSH.

Breastfeeding and sucking habits in children enrolled in a mother-child health program

BACKGROUND

Early weaning can cause changes in posture and strength of the phonoarticulatory organs, favoring the installation of undesirable oral habits. The objective of the research was to evaluate the relationship between the practice of exclusive breastfeeding and its influence on the development of deleterious oral habits in children. This was a cross sectional observational study with 252 children of both sexes, between 30 and 48 months of age, attending a program of dental care for mothers and newborns. As an instrument of data collection was a questionnaire semistructured mothers of children with questions about the form and duration of breastfeeding and non-nutritive oral habits in children.

RESULTS

In this sample, 48.4% of the children were exclusively breastfed for six months; 20.2% exhibited sucking habits involving the use of a pacifier, which was more frequent among the girls. As factors associated with the decreasing of the occurrence of non-nutritive sucking habits, are a longer exclusive breastfeeding, predominant breastfeeding and breastfeeding. Children who were breastfed for six months until twelve months in an exclusive way decreased by 69.0% chances of coming to have non-nutritive sucking habits when compared with those who were breastfed up to one month.

CONCLUSION

The longer the duration of breastfeeding, that is, exclusive, predominant or breastfeeding, the lower are the chances of children develop non-nutritive sucking habits.

Suckling and non-nutritive sucking habit: what should we know?

Correct breast feeding can be considered a tool for the post-natal prophylaxis of craniofacial abnormalities, or at least a way of reducing their extent.

Inadequate bottle feeding forces the tongue and cheek muscles to develop a compensating and atypical function, in order to obtain the milk. As a result, there can be an adaptation change of the dental and bone structures, leading to malocclusions.

Finger-sucking is normal in the first two-three years of life. It gives the child a feeling of relaxation; that is why it is usually practiced before sleeping. The effects of non-nutritive sucking on the developing dentition are minor in the child under 3 years of age and are usually limited to changes in the incisor position. Some upper or lower incisors (depend on how the finger has been sucked) become spontaneously tipped toward the lips, and/or others are prevented from erupting. Normally children abandon this habit between 2 and 4 years of age. If it persists after this age, it will be the cause for some dental-maxillary anomalies: open-bite, narrow maxilla with upper protrusion, cross-bite; all these could be accompanied by retrognathic mandible.

Persistência de hábitos de sucção não nutritiva: prevalência e fatores associados

OBJETIVOS: identificar a prevalência de hábitos de sucção não nutritiva em pré-escolares e verificar fatores associados a sua persistência. MÉTODOS: estudo transversal e analítico realizado por meio de questionário com responsáveis de 524 crianças em 17 centros educacionais públicos de Recife/PE. Variáveis dependentes (sucção digital e de chupeta) e independentes, relacionadas à criança (sexo, idade, aleitamento materno, uso de mamadeira, enurese noturna, turnos na unidade educacional, cuidador, ordem de nascimento, visita ao dentista) e a sua mãe (escolaridade, idade, renda familiar, trabalho fora do domicilio, turnos de trabalho, coabitação, orientação sobre hábitos), foram associadas, usando os testes estatísticos qui-quadrado de Pearson, Exato de Fisher e regressão Poisson. RESULTADOS: prevalência de hábitos de sucção não nutritiva de 57%: 47,5% apenas sucção de chupeta. Após análise multivariada, as variáveis: tempo de aleitamento materno e uso de mamadeira continuaram associadas ao uso de chupeta, enquanto que as variáveis: escolaridade materna, uso de mamadeira, idade e sexo da criança encontraram-se fortemente associadas à sucção digital. CONCLUSÕES: alta prevalência de hábitos de sucção não nutritiva, sendo a chupeta mais frequente. Aspectos associados ao padrão de aleitamento foram apontados como principais fatores explicativos à persistência destes hábitos em pré-escolares e os aspectos psicossociais tiveram poder de associação relevante.

Advising mothers about breastfeeding and weaning reduced pacifier use in the first year of life: a randomized trial

OBJECTIVE

To assess the effectiveness of home visits for advising mothers about breastfeeding and weaning on pacifier use in the first year of life.

METHOD

A randomized field trial was conducted on mothers who gave birth within the public health system in the Brazilian city of Sao Leopoldo (intervention group = 200; controls = 300). The intervention group received the advice 10 days after the child's birth, monthly up to 6 months, at 8, 10, and 12 months, based on the 'Ten Steps for Healthy Feeding', a Brazilian national health policy for primary care, which follows WHO guidelines. Relative risk (RR) was used to estimate the effects of the intervention on the risk of using a pacifier.

RESULTS

55.4% of the children in the intervention group and 66.1% of the controls used a pacifier in the first year of life. The risk of using a pacifier was 16% lower for the intervention group (RR = 0.84; 95% CI, 0.71-0.99). A multivariable Poisson regression model showed higher adjusted risk of using a pacifier for children who had breastfeeding interrupted in the first month of life (RR = 1.43; 95% CI, 1.21-1.69) and whose mothers presented higher level of depression (RR = 1.40; 95% CI, 1.17-1.66).

CONCLUSIONS

Pacifier use is highly prevalent in the population studied. The home visits for dietary advice appear to help in reducing pacifier use in infants. These findings suggest the need for public health strategies that address early advice on pacifier use to promote child oral and general health.

Prevalência dos hábitos de sucção não nutritiva e sua relação com a idade, gênero e tipo de aleitamento em pré-escolares da cidade de Araraquara

OBJETIVO: avaliar a prevalência dos hábitos de sucção não nutritiva presentes em crianças pré-escolares do município de Araraquara-SP, buscando conhecer melhor suas características, distribuição e relação com o aleitamento materno. MÉTODO: aplicação de um questionário enviado aos pais ou responsáveis. A amostra foi composta por 1371 crianças com idades entre seis meses e cinco anos, na qual 702 crianças (51,2%) apresentavam hábitos deletérios, num total de 812 hábitos relatados. RESULTADOS: de acordo com os resultados, os hábitos foram mais prevalentes no gênero feminino (55%) e na faixa etária entre seis meses e dois anos. O hábito mais comumente encontrado foi o de sucção chupeta (30%), seguido pela sucção de mamadeira (18,4%) e sucção digital (7,6%), não havendo associação entre o tipo de hábito e condição sócio-econômica. Das crianças participantes, 1.239 (90,4%) receberam aleitamento materno, sendo que o tempo de maior prevalência de amamentação foi entre seis meses e 12 meses (43%), não necessariamente de forma exclusiva, mas por um período igual ou superior ao preconizado pela OMS. CONCLUSÃO: houve associação entre o tempo de amamentação com a presença e o tipo de hábito, visto que as crianças que receberam o aleitamento natural por um período superior a 12 meses tenderam a não desenvolver hábitos deletérios. Os resultados comprovam que quanto maior é o tempo de amamentação, menor é a prevalência de hábitos.