Analgesic effects of breast- and formula feeding during routine childhood immunizations up to 1 year of age.

BACKGROUND: Data on analgesic effects of breast/formula milk sucking while receiving routine childhood immunizations are available only in early infancy, have rarely been compared in the same study, and are not accompanied by information on mothers' satisfaction/acceptance. Here we aimed to compare the analgesic effect of both methods vs. held-only controls up to 1 year of age, and verify mothers' satisfaction. METHODS: Two to 12 months children subjected to vaccine were allocated into three groups: breastfed, formula-fed, and held-only controls. A video recording was performed to analyze pain parameters: crying latency/duration and specific scales [FLACC (Face, Legs, Activity, Cry, and Consolability), NIPS (Neonatal Infant Pain Scale)]. After the procedure, mothers filled in a satisfaction questionnaire. RESULTS: One-hundred and sixty-two children were recruited: 54 breastfed, 35 formula fed, and 73 controls. Breastfed showed the longest crying latency, and together with formula fed, had the shortest duration and lowest pain scores. Most mothers appreciated not only the respective feeding-mediated pain mitigation method used, but also the simply-holding procedure. In all cases, they felt reassured, with an unexpected frequent underestimation of their child's pain during the shot. CONCLUSIONS: The analgesic effect of breastfeeding during vaccination extends also to children >6 months old, and is obtained by formula too. Embracing the child may help to reassure mothers. IMPACT: We confirmed the analgesic effect of breastfeeding during the vaccination procedures in early infancy. We show for the first time that this effect is extended also to children up to 1 year of age, and it may be obtained by formula feeding as well. Most mothers appreciated pain mitigation not only through feeding, but also the simply-holding procedure. In all cases, mothers felt reassured, with an unexpected frequent underestimation of their child' pain during the shot. The promotion of these easily feasible and well-accepted strategies should be further encouraged within health professionals during vaccination procedures.

Determinants of weight gain in children from 7 to 10 years.

BACKGROUND AND AIM: To determine the influence of the family risk factors (parental weight, socioeconomic status and cultural level) on the distribution of overweight or obesity in prepubertal children and the dynamics of their weight gain. METHODS AND RESULTS: Three hundred forty-one children (183 boys) attending the second grade of primary school (age 7.4+/-0.5 years) were enrolled in a longitudinal study in Southern Italy. Overweight and obesity status were defined by a body mass index (BMI) above the percentile having respectively the value of 25 and 30 kg/m(2) at 18 years, according to national reference data; overweight extent was expressed as BMI standard deviation score (BMI-SDS). Information about BMI and socioeconomic conditions (occupation and educational level) of parents were collected. Distribution of overweight and obese schoolchildren and variations of BMI-SDS were evaluated over a 3-year period; relationships with family risk factors were also sought. The distribution of overweight/obese children at baseline was high (40%). Tracking rates of overweight and obesity were 73% and 80%, respectively. The higher the BMI-SDS at 7 years, the higher the BMI-SDS at 10 years (r 0.86, P=0.0001). The highest BMI value and the highest distribution of overweight/obese children were observed in subjects with the highest amount of family risk factors. Children exhibiting accelerated weight gain (delta BM I>1/year) showed higher male/female ratio, higher baseline BMI values, higher maternal BMI values, lower maternal educational level and a dramatic increase in the percentage of overweight/obese children than children with normal weight gain. CONCLUSIONS: Children who are overweight/obese at 7 years tend to maintain this condition during prepubertal age. Paediatricians should be alerted when dealing with a child showing a BMI increase above than 1U/year during primary school. Targeted intervention should be directed at young children with overweight parents and low socio-cultural level.