Milk of ruminants in ceramic baby bottles from prehistoric child graves.

The study of childhood diet, including breastfeeding and weaning, has important implications for our understanding of infant mortality and fertility in past societies1. Stable isotope analyses of nitrogen from bone collagen and dentine samples of infants have provided information on the timing of weaning2; however, little is known about which foods were consumed by infants in prehistory. The earliest known clay vessels that were possibly used for feeding infants appear in Neolithic Europe, and become more common throughout the Bronze and Iron Ages. However, these vessels-which include a spout through which liquid could be poured-have also been suggested to be feeding vessels for the sick or infirm3,4. Here we report evidence for the foods that were contained in such vessels, based on analyses of the lipid 'fingerprints' and the compound-specific δ13C and Δ13C values of the major fatty acids of residues from three small, spouted vessels that were found in Bronze and Iron Age graves of infants in Bavaria. The results suggest that the vessels were used to feed infants with milk products derived from ruminants. This evidence of the foodstuffs that were used to either feed or wean prehistoric infants confirms the importance of milk from domesticated animals for these early communities, and provides information on the infant-feeding behaviours that were practised by prehistoric human groups.

The effects of simulated gastroesophageal reflux on infant pig oropharyngeal feeding physiology.

The neural connectivity among the oral cavity, pharynx, and esophagus is a critical component of infant feeding physiology. Central integration of oral and pharyngeal afferents alters motor outputs to structures that power swallowing, but the potential effects of esophageal afferents on preesophageal feeding physiology are unclear. These effects may explain the prevalence of oropharyngeal dysphagia in infants suffering from gastroesophageal reflux (GER), though the mechanism underlying this relationship remains unknown. Here we use the validated infant pig model to assess the impacts of simulated GER on preesophageal feeding parameters. We used high-speed videofluoroscopy and electromyography to record bottle-feeding before and following the infusion of a capsaicin-containing solution into the lower esophagus. Sucking parameters were minimally affected by capsaicin exposure, such that genioglossus activity was unchanged and tongue kinematics were largely unaffected. Aspects of the pharyngeal swallow were altered with simulated GER, including increased thyrohyoid muscle activity, increased excursions of the hyoid and thyroid per swallow, decreased swallow frequency, and increased bolus sizes. These results suggest that esophageal afferents can elicit changes in pharyngeal swallowing. In addition, decreased swallowing frequency may be the mechanism by which esophageal pathologies induce oropharyngeal dysphagia. Although recent work indicates that oral or pharyngeal capsaicin may improve dysphagia symptoms, the decreased performance following esophageal capsaicin exposure highlights the importance of designing sensory interventions based upon neurophysiology and the mechanisms underlying disordered feeding. This mechanistic approach requires comprehensive data collection across the entirety of the feeding process, which can be achieved using models such as the infant pig.NEW & NOTEWORTHY Simulated gastroesophageal reflux (GER) in an infant pig model resulted in significant changes in pharyngeal swallowing, which suggests that esophageal afferents are centrally integrated to alter motor outputs to the pharynx. In addition, decreased swallow frequency and increased bolus sizes may be underlying mechanisms by which esophageal pathologies induce oropharyngeal dysphagia. The infant pig model used here allows for a mechanistic approach, which can facilitate the design of intervention strategies based on neurophysiology.

Longitudinal assessment of sleep and fatigue according to baby feeding method in postpartum women: a prospective observational study.

BACKGROUND: Poor subjective sleep quality, depressive symptoms and fatigue occur frequently in postpartum. However, the dynamics of their respective associations from prepartum throughout the maternity period in function of baby feeding method have not been fully elucidated. METHODS: Prospective, longitudinal study using validated questionnaires probing for sleep quality, insomnia, fatigue and depressive symptoms at 35-37 weeks of gestation and at 2, 8 and 12 weeks postpartum in the obstetric departments of two Flemish hospitals. Somers'd ordinal correlation was used for correlations between the results of questionnaires (ratio variables) and the feeding method variable (an ordinal variable); T tests (normal data) or Mann Whitney (non normal data) tests for equality of means; ordinal regression ('Proportional odds model') to investigate the predictive value of parameters at one moment on the feeding method choice at a later moment; logistic regression to investigate the predictive value of parameters on later change of feeding method. RESULTS: 188 women indicating a choice for either bottle or breastfeeding in prepartum (27-35 weeks' gestation) were included. Higher fatigue assessed through the Fatigue Severity Scale within late pregnancy was moderately associated with primary bottle feeding choice. Fatigue decreased at early and late postpartum in bottle feeding (-0.38 ± 1.04; p = .110 and - 0.31 ± 1.01; p = .642 respectively), but remained unchanged from late pregnancy through early and late postpartum in breastfeeding (0.04 ± 1.21; p = .110 and - 0.27 ± 0.96; p = .642 respectively), resulting in similar fatigue in both feeding methods in early through late postpartum. There were no differences in sleep quality or insomnia symptoms at all time points. Presence of postpartum depressive symptoms were associated with early switching to bottle feeding (Somers' d correlation 0.11 (p = .021). CONCLUSIONS: Fatigue and depressive symptoms are inversely associated with breastfeeding initiation or maintenance and influence feeding method dynamics.

Bottle-feeding practice and its associated factors among mothers of children aged 0 to 23 months in sub-Saharan Africa: a multi-level analysis of demographic and health surveys (2015-2022).

BACKGROUND: Avoidance of bottle feeding is recommended as it interferes with optimal suckling behavior, is difficult to keep clean, and is an important route for the transmission of pathogens. However, there is a current shift towards breastfeeding for a short period and the introduction of bottle feeding in both the developed and developing worlds. Bottle-feeding practice and its individual- and community-level determinants are not addressed in sub-Saharan Africa. Therefore, this study aimed to fill this gap and assess the pooled prevalence and associated factors of bottle feeding among mothers of children less than 23 months of age. METHODS: Data from the recent demographic and health surveys of 20 countries in sub-Saharan Africa conducted between 2015 and 2022 were used. A total weighted sample of 86,619 mother-child pairs was included in the current study. Multilevel mixed-effects logistic regression was used to determine the factors associated with the outcome variable. Intra-class correlation coefficient, likelihood ratio test, median odds ratio, and deviance (-2LLR) values were used for model comparison and fitness. Finally, variables with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant. RESULTS: The overall pooled prevalence of bottle feeding among mothers of children aged 0 to 23 months in sub-Saharan Africa was 13.74% (95% CI: 13.51%, 13.97%). Factors like maternal age [AOR = 1.09; 95% CI (1.04, 1.14)], educational status [AOR = 2.83; 95% CI (2.58, 3.10)], marital status [AOR = 1.16; 95% CI (1.09, 1.24)], maternal occupation [AOR = 0.76; 95% CI (0.73, 0.79)], media exposure [AOR = 0.80; 95% CI (0.76, 0.85)], wealth index [AOR = 1.21; 95% CI (1.15, 1.29)], sex of the household head [AOR = 1.17; 95% CI (1.12, 1.24)], family size [AOR = 1.06; 95% CI (1.01, 1.12)], number of under-five children [AOR = 1.11; 95% CI (1.04, 1.19)], place of delivery [AOR = 1.06; 95% CI (1.00, 1.12)], mode of delivery [AOR = 1.41; 95% CI (1.31, 1.52)], counseling on breastfeeding [AOR = 0.88; 95% CI (0.84, 0.92)], age of the child [AOR = 1.65; 95% CI (1.57, 1.75)], and residence [AOR = 1.64; 95% CI (1.56, 1.72)] were significantly associated with bottle-feeding practices. CONCLUSION: Nearly one out of seven children aged 0 to 23 months received bottle feeding in sub-Saharan African countries. Older mothers, higher mothers' educational status, unmarried women, richest families, non-working mothers, exposed to media, female-headed households, large family size, having one under-five children, home delivery, cesarean delivery, children aged 6-11 months, and urban residence were significantly associated with an increased risk of bottle feeding. Breastfeeding promotion programs are advised to target mothers who are older, educated, working, rich, gave birth at home, have a large family size, are delivered by cesarean section, have children aged 6-11 months, and reside in urban areas to achieve a significant decrease in bottle feeding rates in sub-Saharan Africa.

The transition from tube feeding to oral feeding algorithm in preterm infants: case-control study.

BACKGROUND: Oral feeding is a complex sensorimotor process influenced by many variables, making it challenging for healthcare providers to introduce and manage it. Feeding practice guided by tradition or a trial-and-error approach may be inconsistent and potentially delay the progression of oral feeding skills. AIM: To apply a new feeding approach that assesses early oral feeding independence skills of preterm infants in the neonatal intensive care unit (NICU). To prove its effectiveness, compare two approaches of oral feeding progression based on clinical outcomes in preterm infants, the traditional approach used in the NICU of Mansoura University Children Hospital (MUCH) versus the newly applied approach. METHODS: A quasi-experimental, exploratory, and analytical design was employed using two groups, control and intervention groups, with 40 infants for the first group and 41 infants for the second one. The first group (the control) was done first and included observation of the standard practice in the NICU of MUCH for preterm oral feeding, in which oral feeding was dependent on post-menstrual age (PMA) and weight for four months. The second group (the intervention) included early progression to oral feeding depending on early assessment of Oral Feeding Skills (OFS) and early supportive intervention and/or feeding therapy if needed using the newly developed scoring system, the Mansoura Early Feeding Skills Assessment "MEFSA" for the other four months. Infants in both groups were studied from the day of admission till discharge. RESULTS: In addition to age and weight criteria, other indicators for oral feeding readiness and oral motor skills were respected, such as oral feeding readiness cues, feeding practice, feeding maintenance, and feeding techniques. By following this approach, preterm infants achieved earlier start oral feeding (SOF) and full oral feeding (FOF) and were discharged with shorter periods of tube feeding. Infants gained weight without increasing their workload to the NICU team. CONCLUSION: The newly applied approach proved to be a successful bedside scoring system scale for assessing preterm infants' early oral feeding independence skills in the NICU. It offers an early individualized experience of oral feeding without clinical complications.

Feeding modalities, HIV transmission and its predictors among HIV-exposed infants visited Gamo and Gofa zones public health facilities, Southern Ethiopia: a retrospective follow up study.

BACKGROUND: Despite the highest (88%) Prevention of Mother-To-Child Transmission (PMTCT) of HIV coverage in Eastern Africa, 50% of new HIV infections in children aged 0-14 years occur in the region. OBJECTIVE: The aim of this study was to assess the feeding modalities, the rate of HIV transmission and its predictors among HIV exposed infants (HIV-EIs) visited Gamo and Gofa Zones public health facilities, Southern Ethiopia from January 2013 to February 2019. METHOD AND MATERIALS: Institution-based retrospective follow up study was employed among 450 HIV-EIs having DNA/PCR test results. All infant-mother pair records in selected health facilities were reviewed using a standard data extraction tool from March to July 2019. HIV transmission probabilities were assessed by Kaplan-Meier time-to-event analysis method and log-rank tests were used to compare the risk among different groups. The Cox-proportional hazards model, adjusted on infant feeding modalities and other co-variants was used to identify predictors of HIV transmission, and statistical significance was declared at a p-value of < 0.05. RESULTS: In total, 383 complete records were analyzed. In the study, 85.6% (95%CI: 81.6%, 89.1%) of HIV-EIs were exclusively breastfed in the first six months. The 18 months probability of infant HIV transmission was 64 (16.7%) (95%CI: 13.1%-20.8%). The risk of HIV-transmission was higher among infants who were delivered at the hospital than health centers/health posts (AHR = 3.07; 95%CI: 1.19, 7.95); discontinued Cotrimoxazole prophylaxis in at least one visit (AHR = 6.32; 95%CI: 3.35, 11.94); did not exclusively breastfeed (AHR = 3.07; 95%CI: 1.72, 5.47) and came from urban areas (AHR = 5.90; 95%CI: 1.40, 24.85). CONCLUSIONS: The study showed that HIV-EIs had a greater rate of 18 months HIV transmission than the national pooled prevalence. The risk of transmission is higher among infants who do not breastfeed exclusively for the first 6 months, and the risk increases with the number of months spent by breastfeeding. Therefore, strengthening counselling on safer feeding options and Cotrimoxazole prophylaxis use; provision of quality PMTCT service with special focus in hospitals and urban residents were recommended.

Effects of simplified group housing on behavior, welfare, growth performance, and health of preweaned dairy calves on a California dairy.

Most US dairy calves are raised in individual hutches for biocontainment purposes and to facilitate monitoring and handling of calves. However, individual hutches typically restrict calves' activity and social interactions. Previous studies showed that group housing (GH) is beneficial to calf welfare and is associated with social benefits. The adoption of GH on dairies is hindered by several concerns, with the primary concern being the potential for increased transmission of diseases due to heightened calf-to-calf contact. In light of this, our study aimed to compare the behavior, health, and growth outcomes of calves housed in groups of 3 to individually housed (IH) calves during the preweaning period. A total of 42 Holstein heifer calves on a commercial dairy in Northern California were enrolled in groups of 3 to different housing treatments; IH (n = 21) or GH (n = 21) between July and October 2020. Each treatment was composed of 7 groups of 3 calves each. Calves in the GH treatment were housed in groups of 3 from 6 to 10 d until 70 d of age. Individual pens consisted of one polyethylene hutch with a 1.5 m × 1.2 m outside exercise area. Group pens were constructed by assembling 3 polyethylene hutches with a 1.5 m × 3.6 m outside exercise area of wire panel fencing. Calves were weighed and measured for height at birth and weaning. Diarrhea and bovine respiratory disease (BRD) scores were recorded daily throughout the preweaning period. Cumulative incidence and hazard ratios were estimated for BRD and diarrhea for GH and IH. A mixed model with pen as a random effect was specified to evaluate the effect of treatment. Group-housed calves gained 0.64 ± 0.02 kg/d while IH calves gained 0.65 ± 0.02 kg/d. Similarly, there was no evidence for treatment differences in withers height gain in GH calves (0.22 ± 0.01 cm/d) compared with IH calves (0.21 ± 0.01 cm/d). The cumulative incidence of BRD based on the California scoring system in GH calves was 75 ± 9.68% compared with 66.66 ± 10.28% in IH calves. Group-housed calves had a BRD hazard of 1.14 times that of IH calves (95% CI: 1.21-2.40). The cumulative incidence of diarrhea (fecal score 3) in GH calves was 100% in comparison to 95.20% ± 4.66% in IH calves. The mean proportion of scan observations of calves feeding on concentrates was significantly higher in GH (0.145 ± 0.004/h) compared with IH calves (0.076 ± 0.003/h) during the preweaning period. The study results provide evidence that this simplified GH system provides benefits of GH without detrimental short-term effects on calf growth and health during the preweaning period.

Analyzing effects on anterior open bite in twins by PLS-SEM and sobel test.

OBJECTIVE: This study aimed to assess the different pathways between predictor factors such as zygosity, atypical swallowing, mouth breathing, breastfeeding and bottle feeding related to anterior open bite (AOB) in twins. METHODS: The study was conducted in monozygotic (MZ) and dizygotic (DZ) twin children aged 3-15 years. AOB, atypical swallowing, mouth breathing, feeding type, duration of bottle use, and mouth opening status during sleep were recorded during oral examination. Partial least squares structural equation model (PLS-SEM) and sobel tests were performed to assess the total and indirect effects among the variables on AOB. RESULTS: A total of 404 children (29.2% MZ;70.8% DZ) participated in this study. The effect of zygosity on mouth breathing in the PLS-SEM model was statistically significant. Conversely, it was determined that mouth breathing effected that atypical swallowing (p = 0.001). Atypical swallowing triggered AOB (p = 0.001). The atypical swallowing has a mediation effect between AOB and mouth breathing (p = 0.020). Mouth breathing causes atypical swallowing and therefore indirectly increases the likelihood of AOB. While breastfeeding decreases AOB incidence (p = 0.023), bottle feeding increases AOB incidence (p = 0.046). The sobel tests show that the fully mediator variable feature of mouth breathing is statistically significant in the negative relation between zygosity and atypical swallowing. CONCLUSION: The PLS-SEM model showed that mouth breathing triggers atypical swallowing and atypical swallowing triggers AOB. As a result of this chain of relationships, an indirect effect of zygosity on AOB was observed. According to sobel tests, zygosity has an indirect effect on atypical swallowing through mouth breathing, while mouth breathing has a positive indirect effect on AOB through atypical swallowing. CLINICAL RELEVANCE: This study identified the relationships between different factors and the presence of AOB. The findings of this study demonstrate in detail the relationships between AOB and zygosity, atypical swallowing, mouth breathing, breastfeeding and bottle feeding. Brestfeeding has a reducing effect on the frequency of AOB. Among the nutritional forms, breastfeeding ensures the proper development of the stomatognathic system by working the oro-facial muscles.

Trends and associated factors of bottle-feeding in Turkey: dramatic change over the last three decades under the limited implemented code.

The study aimed to examine the trends and associated factors of bottle-feeding among children aged 0-35 months. Data covering 11,205 mother-child pairs, from six recent Turkey Demographic and Health Surveys (TDHSs) were analyzed by using complex sample crosstabs and logistic regression. Bottle-feeding was on an upward trend from 33.0% to 51.5% from 1993 to 2013 and fell slightly 47.9% in 2018. Increasing trends of bottle-feeding were found in children aged 6-35 months, the East region, lower wealth index, maternal education under 5 years, Kurdish mothers, and the low antenatal care attendance. Multivariate analysis using data from TDHS-2018 showed that young maternal age, low birth weight and being 6-23 months of age were associated with higher rates of bottle-feeding. The prolonged bottle-feeding became widespread, and the bottle-feeding was common even in 35-month-old children. Interventions by the Government and stakeholders to minimize low rates of bottle-feeding should focus on high-risk groups.

Exploration of the Association Between Sucking Measures and Ability to Attain Independent Oral Feeds Among Infants Who Are Born Preterm.

IMPORTANCE: Infants who are born preterm often experience difficulty transitioning from full tube to independent oral feeds, which often prolongs their hospital stay. No clinical measures associated with attainment of independent oral feeds are currently available. OBJECTIVE: To identify specific nutritive sucking measures associated with time to attainment of independent oral feeds among infants who are born preterm. DESIGN: An observational cohort pilot study was undertaken. SETTING: A Level 2 to Level 3 neonatal intensive care unit. PARTICIPANTS: Fourteen infants (7 male, 7 female) born at or less than 34 wk gestation were enrolled. OUTCOMES AND MEASURES: The monitored suck measures included average suck strength (millimeters of mercury), average sucking burst duration (seconds), average suck count (number of sucks), and average pause duration (seconds). Time to independent oral feeds (days) and baseline characteristics were also monitored. The nutritive sucking measures were recorded once, during the first 5 min of an oral feed, when infants were taking an average of three to four oral feeds per day using a nipple monitoring device. RESULTS: An inverse relation was found among average suck burst duration (p = .04), gestational age (p = .03), and days to attainment of independent oral feeds. CONCLUSIONS AND RELEVANCE: Study results suggest that average sucking burst duration, during the first 5 min of an oral feed, is associated with time to attain independent oral feeds. Plain-Language Summary: Sucking burst duration is a simple measure that may be used clinically to identify early on infants who may have trouble transitioning from full tube to independent oral feedings. The results of this study suggest that a suck burst duration in the first 5 min of an oral feeding is inversely associated with the length of time to achieve independent oral feeding. The results highlight the importance of considering an infant's nutritive sucking ability when evaluating their potential to achieve independent oral feedings.

Historical Perspectives and Clinical Updates on Preterm Bottle Feeding With Noninvasive Ventilation.

The controversial topic of oral feeding while on noninvasive ventilation remains at the forefront of preterm intensive care management. The intersection of pulmonary, neurologic, and gastrointestinal maturation coalesces at a postmenstrual age that requires changes in practices compared with those used in older infants. Various animal models in the past decades aimed to gain physiological knowledge of noninvasive ventilation effects on the suck-swallow-breathe coordination sequence. However, the preterm infant poses nuanced anatomic challenges. Although concerns for oral feeding while on noninvasive ventilation include aspiration risks and potential inpatient obstacles, there is evidence to support the feasibility, initiation, and progression of oral feedings while an infant is supported on high-flow nasal cannula and continuous positive airway pressure. There is evidence to support that this may accelerate attainment of oral feeding milestones and, thus, eventual hospital discharge. More recent multidisciplinary institutional protocols may provide cautious guidance on evaluation and algorithms to assess infants who may benefit from initiation and advancement of oral feeding versus awaiting further maturation.

Infant Oral Candidiasis and Bottle Cleaning Methods: A Descriptive Study.

As manufacturers produce bottles with additional parts, such as an anticolic straw, cleaning time increases. Increased cleaning time potentially decreases cleaning effectiveness and, thus, increases the chance for thrush. This study explored the relationship between the number of bottle parts and cleaning methods for bottle-fed-only infants (<13 months) presenting with oral candidiasis. After obtaining demographic information on eligible infants (via parental consent) from the chart, caregivers of 60 infants verbally completed a questionnaire. The questionnaire elicited information about the preferred bottle for feeding, number of parts, washing frequency, washing method, drying method, sterilization frequency, and sterilization method. The χ2 test, and Fisher's exact test when necessary, was performed to examine the relationship between each reported cleaning method (washing, drying, and sterilization) compared with the number of bottle parts (≤3 or ≥4). The number of bottle parts showed no association with bottle cleaning methods (p > .05). Although there were no statistically significant relationships, trends did present that warrant investigation. Future studies to confirm recommended practices for cleaning methods and identify those at risk from demographic data could positively affect the health of bottle-fed infants by reducing the occurrence of thrush.

National survey of infant feeding bottles in Germany: Their characteristics and marketing claims.

Bottles and teats are ubiquitously used for feeding infants and young children. Yet there are limited empirical studies on the scope of infant feeding bottles, their attributes, or their marketing claims. We report the first comprehensive survey on infant feeding bottles and teats in Germany. We aimed to explore the extent of bottles and teats available in Germany, describe their physical attributes and analyze their marketing claims. A cross-sectional survey of German bottle and teat manufacturer websites was conducted between June and November 2022. Product attributes are presented with descriptive statistics and photographs. Marketing claims are summarized in a descriptive content analysis. We identified 41 brands encompassing 447 unique products (226 bottles, 221 teats). The majority of bottles were plastic (147, 65%) or glass (64, 28%), and the majority of teats were silicone (188, 85%). Most brands (38, 93%) promoted products using one or more inappropriate marketing claims, including equivalency to breastfeeding (29, 73%), idealization through technical or medical descriptions (23, 58%), claims on disease prevention (31, 78%), references to naturalness (29, 73%), infant autonomy (10, 25%), and endorsements from parents (10, 25%) or health professionals (11, 28%). The majority of bottles and teats available in Germany appear to be marketed inappropriately and hold the potential to undermine public health recommendations on infant and young child feeding. Therefore, we recommend Germany strengthens legislation on the marketing of bottles and teats in accordance with the International Code of Marketing of Breastmilk Substitutes.

Infant and young child feeding practices in refugee settings across 203 population-based surveys from 2013-2019.

Infant and young child feeding (IYCF) plays a crucial role in early childhood growth and development. This study summarizes recent IYCF practices in multiple refugee settings and compares them to those in the host countries. We analyzed 203 surveys conducted among refugees residing in 15 countries and 120 unique sites and assessed eight IYCF indicators available from those surveys. A total of 146 surveys were conducted in Eastern and Southern Africa (ESA) and 50 in Western and Central Africa (WCA) regions. The median prevalence across surveys of all four indicators describing intake of breast milk was relatively high: 96.6% for ever breastfed, 81.2% for initiation of breastfeeding within 1 h of birth, 76.9% for exclusive breastfeeding 0-5 months, and 75.0% for continued breastfeeding 12-23 months. The median prevalence of early initiation and exclusive breastfeeding was markedly higher in ESA than in WCA (85.0% vs. 37.5% and 83.5% vs. 56.1%, respectively). Conversely, the overall median prevalence of timely introduction of solid and semisolid foods and flesh food consumption was low: 51.8% and 16.1%, respectively. Flesh food consumption was higher in WCA than in ESA (27.4% vs. 11.6%). The median prevalence of mixed milk feeding at 0-5 months and bottle feeding was very low: 2.4% and 3.8%, respectively. Indicators describing breast milk intake were generally either similar or higher in refugees than in the host country populations, whereas the other indicators were generally higher in the host populations than in refugees. The low prevalence of timely introduction of solids and of flesh food consumption in refugees is concerning and requires substantial improvement.

Effects of non-nutritive sucking habits on malocclusions: a systematic review.

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.

Turkish adaptation of the Neonatal Eating Assessment Tool-Bottle-Feeding in preterm infants discharged to home.

Background/aim: Preterm infants often continue to have feeding difficulties after hospital discharge. Parental use of assessment tools and collaboration with health professionals are important for the early diagnosis of postdischarge feeding difficulties. This methodological study examined the validity and reliability of the Turkish version of the Neonatal Eating Assessment Tool (NeoEAT)-Bottle-feeding in postdischarge preterm infants in Türkiye. Materials and methods: A Turkish version of the NeoEAT-Bottle-feeding was developed and applied to 321 mothers of preterm infants younger than 7 months of corrected age between August 2021 and December 2022. Cronbach's alpha, exploratory factor, confirmatory factor, item-total correlation, test-retest, and known-groups validity analyses were performed. Results: The Turkish NeoEAT-Bottle-feeding has 60 items in five factors explaining 55.785% of the total variance. Exploratory factor analysis indicated that the item factor loading ranged from 0.320 to 0.792. The known-group validity analysis confirmed that preterm infants with diagnosed feeding problems had higher total and subscale scores than those without (p = 0.001). The Cronbach's alpha (α) of the entire scale was 0.96. The item-total correlation coefficients were between 0.31 and 0.77 (p = 0.001). There was excellent agreement between test values and retest values obtained after a 2-week interval (intraclass correlation coefficient: 0.930-1.000). Conclusion: The Turkish NeoEAT-Bottle-feeding was shown to be a reliable and valid parent-reported assessment tool for oral feeding skills and difficulties after neonatal intensive care unit discharge in bottle-fed preterm infants younger than 7 months of corrected age. Healthcare professionals can use this assessment tool during the initial evaluation of risk factors contributing to problematic feeding and to determine the effectiveness of planned interventions in preterm infants.

Feeding Practices and Dietary Diversity in the First Year of Life: PreventADALL, a Scandinavian Randomized Controlled Trial and Birth Cohort Study.

BACKGROUND: Breastmik is considered the optimal source of nutrition in early infancy. However, recommendations and practices for when and how complementary food should be introduced in the first year of life vary worldwide. Early introduction of allergenic foods may prevent food allergies, but if early food introduction influences infant feeding practices is less known. OBJECTIVES: We sought to assess infant feeding practices in the first year of life and to determine if early interventional food introduction influences breastfeeding and dietary diversity. METHODS: Dietary intake was assessed in infants from the population-based clinical trial Preventing Atopic Dermatitis and ALLergies (PreventADALL) in children study. A total of 2397 infants were cluster-randomized at birth into 4 different groups: 1) control, 2) skin intervention, 3) introduction to 4 allergenic foods between 3 and 4 mo of age: peanut, cow milk, wheat, and egg, as small tastings until 6 mo, and 4) combined skin and food interventions. Dietary data were available from at least one of the 3-, 6-, 9-, and 12-mo questionnaires in 2059 infants. In the present analysis, groups 1 and 2 constitute the No Food Intervention group, whereas groups 3 and 4 constitute the Food Intervention group. We used the log-rank test and Cox regression to assess the impact of food intervention on age of breastfeeding cessation. Mixed effects logistic regression was used to compare dietary diversity, defined as the number of food categories consumed, between intervention groups. RESULTS: At 3, 6, 9, and 12 mo, 95%, 88%, 67%, and 51% were breastfed, respectively, and breastfeeding duration was not affected by the food intervention. In the No Food Intervention group, mean age of complementary food introduction was 18.3 wk (confidence interval [CI]: 18.1, 18.5). In the Food Intervention group, the dietary diversity score was 1.39 units (CI: 1.16, 1.62) higher at 9 mo (P < 0.001) and 0.7 units (CI: 0.5, 0.9) higher at 12 mo (P < 0.001) compared to the No Food Intervention group. CONCLUSIONS: Early food intervention did not affect breastfeeding rates and increased dietary diversity at 9 and 12 mo.

Dual modality feeders: a group of human milk feeders with unique practices and needs.

OBJECTIVE: Dual modality feeding (DMF) - feeding human milk interchangeably from the breast and from a bottle - comes with unique practical, emotional and relational challenges, as well as support needs. Yet, there is little research that explores the experiences of individuals who use DMF in the Canadian context. The aim of this study is to explore the practices, challenges, reasons and enablers of DMF. DESIGN: Repeat, semi-structured one-on-one interviews were conducted at 8 weeks and 22 weeks postpartum. Interview transcripts were thematically analysed using a critical feminist lens. SETTING: Nova Scotia, Canada. PARTICIPANTS: Ten DMF mothers. RESULTS: DMF practices were influenced by a mix of social and material circumstances, including breast-feeding challenges, the involvement of support persons, finances and access to lactation support. Individuals who predominantly fed at the breast expressed milk strategically to mitigate transitory breast-feeding challenges, for convenience under specific circumstances, and to share feeding responsibilities with other caregivers for personal and practical reasons. Individuals who mainly bottle-fed did so due to long-term breast-feeding challenges or a need to return to employment. Enablers of successful DMF were consistent between the two groups and included practical, personal and relational aspects. CONCLUSIONS: DMF is a unique practice compared to feeding human milk solely from the breast or bottle. Despite the potential growing prevalence of DMF, it is currently understudied and inadequately addressed in existing support programmes in Nova Scotia. Tailored programming and public messaging are needed to support DMF families.

Factors influencing infant feeding for Aboriginal and Torres Strait Islander women and their families: a systematic review of qualitative evidence.

BACKGROUND: Breastfeeding provides all the necessary energy and nutrients for an infant and provides many benefits for mothers and babies. The effects of colonisation have contributed to reduced prevalence and duration of breastfeeding among Australian Aboriginal women and widespread use of infant formula as a substitute for breastmilk. This review aimed to synthesise qualitative evidence about the factors that influence breastfeeding and infant feeding practices of Aboriginal and Torres Strait Islander women and their families. METHODS: MEDLINE, CINAHL, Informit and Google Scholar were systematically searched for qualitative studies that included the perspective of Aboriginal and Torres Strait Islander women and their families about the factors influencing infant feeding decisions. Included studies were appraised using an Indigenous quality assessment tool and were synthesised via inductive thematic analysis informed by an ecological framework. RESULTS: The search identified 968 studies with 7 meeting the inclusion criteria. Key factors influencing breastfeeding and infant feeding practices of Aboriginal women included cultural practices, normalisation of bottle feeding, shame associated with breastfeeding in public, access to culturally safe nutrition education, support services and health professionals, family/partner support, knowledge of the benefits of breastfeeding, experiences with previous babies and concern that the baby was not getting enough milk. CONCLUSION: The perspectives of Aboriginal and Torres Strait Islander women must be considered when providing breastfeeding and infant feeding advice. This can be achieved through Aboriginal and Torres Strait Islander people designing, implementing, and leading the delivery of education and information regarding breastfeeding and health infant feeding practices that have been influenced by the priorities of Aboriginal and Torres Strait Islander communities.

Associations between early introduction to complementary foods, subsequent cereal-added bottle feeding and daily macronutrient intake among infants.

Introducing complementary foods early during infancy has been associated with an increased risk of overweight later in life, but the pathway is an understudied topic. Hence the study was conducted with low-income and primarily minority mother-infant dyads to: 1) understand how the introduction of complementary foods prior to 4 months was associated with socio-demographic characteristics and food security status; 2) determine the association between early introduction to complementary foods and breastfeeding and adding cereal into the bottle in later infancy (i.e., at 6 and 9 months), and; 3) examine how adding infant cereal into the bottle was related to daily calorie and macronutrient intake in infancy. We conducted interviews with mothers (n = 201) at 4 months of age and 24-h feeding recalls at age 6 and 9 months. Results indicated that 29% of the infants were fed complementary foods before 4 months of age. Introducing complementary foods early was negatively associated with breastfeeding and positively associated with adding cereal into the bottle at 6-months. This practice was more common among those who experienced marginal to very low levels of food security. Comparing by race/ethnicity, Latinx mothers were significantly less likely to introduce solids early. After controlling for sex, infants fed cereal in the bottle were consuming significantly more calories compared to their counterparts. Specifically, adding cereal into the bottle resulted in approximately 10% additional daily calorie intake among infants. Understanding how these feeding practices affect appetite development and weight status during infancy is warranted.