Complementary Feeding and Overweight in European Preschoolers: The ToyBox-Study.

Complementary feeding (CF) should start between 4-6 months of age to ensure infants' growth but is also linked to childhood obesity. This study aimed to investigate the association of the timing of CF, breastfeeding and overweight in preschool children. Infant-feeding practices were self-reported in 2012 via a validated questionnaire by >7500 parents from six European countries participating in the ToyBox-study. The proportion of children who received breast milk and CF at 4-6 months was 51.2%. There was a positive association between timing of solid food (SF) introduction and duration of breastfeeding, as well as socioeconomic status and a negative association with smoking throughout pregnancy (p < 0.005). No significant risk to become overweight was observed among preschoolers who were introduced to SF at 1-3 months of age compared to those introduced at 4-6 months regardless of the type of milk feeding. Similarly, no significant association was observed between the early introduction of SF and risk for overweight in preschoolers who were breastfed for ≥4 months or were formula-fed. The study did not identify any significant association between the timing of introducing SF and obesity in childhood. It is likely that other factors than timing of SF introduction may have impact on childhood obesity.

Influence of various environmental factors on the growth of children and adolescents in Jeddah, Kingdom of Saudi Arabia.

OBJECTIVES: To evaluate the association between various environmental factors and the anthropometric measurements of children and adolescents. METHODS: This retrospective studywasperformed from September 2017 to April 2018 and included 393 children aged 2-18 years. Data were extracted through patient and/or parentinterviews and from medical records of endocrine ambulatory clinics. RESULTS: Among underweight children,the proportion of mixed-fed children was the highest, and among normal weight children, most were either bottle-fed or mixed-fed. Most overweight children were mixed-fed, and most obese children were breastfed. Underweight status was noted most commonly in children playing videogames for <2 hours/day, followed by those playing>4 and 2-4 hours/day. Normal weight was noted most commonly in those playing for >4 hours/day, followed by those playing <2 and 2-4 hours/day. Overweight status was noted most commonly in those playing videogames for >4 hours/day, followed by those playing 2-4 and <2 hours/day. Most children playing videogames for <2 hours/day were obese. Mean BMIs were the highest in those who exercised 1-2 times/week. P-values for the association between passive smoking indoors and BMI, weight, and height were 0.045, 0.150, and 0.854, respectively. Regarding socioeconomic status, log BMI values were 1.22, 1.23, and 1.26 in low-, medium-, and high-income families, respectively (P-value, 0.001). CONCLUSION: Children who were bottle-fed in their first year of life, played video games >2 hours/day, did not exercise regularly, were exposed to indoor passive smoking, and had a high socioeconomic status had a higher BMI and weight than their counterparts. (www.actabiomedica.it).

Fatores associados aos padrões alimentares no segundo semestre de vida / Factors associated with dietary patterns in the second half of life

Resumo O objetivo deste artigo é identificar padrões alimentares de crianças com 6, 9 e 12 meses e sua associação com variáveis socioeconômicas, comportamentais, de nascimento e nutrição. Estudo transversal com crianças de uma coorte em Viçosa-MG, sendo 112 crianças com 6 meses, 149 com 9 meses e 117 com 12 meses. O consumo alimentar foi avaliado por um recordatório de 24 horas e os padrões extraídos por análise de agrupamentos. O leite materno foi identificado em pelo menos um padrão alimentar em todos os meses. Houve baixa participação de alimentos ultraprocessados nos padrões alimentares identificados. No 6º mês, crianças com menor renda familiar tiveram menos chance de pertencer ao padrão alimentar composto por fórmulas lácteas. Já o sobrepeso/obesidade foi 3,69 vezes maior em crianças que compunham o padrão 2 (fórmulas lácteas, verduras, legumes, carne bovina e pera). Aos 12 meses o déficit de estatura (RP = 3,28) e o uso de mamadeira (RP = 4,51) estiveram associados ao padrão alimentar composto por fórmulas lácteas e leite de vaca. Os padrões alimentares identificados refletiram a importante participação do leite materno na alimentação das crianças. Padrões alimentares com a presença de outros tipos de leite, foram associados a desvios nutricionais e uso de mamadeiras.

Abstract The aim of this paper is to identify eating patterns of children aged 6, 9 and 12 months and their association with socioeconomic, behavioral, birth and nutrition variables. Cross-sectional study with children from a cohort in Viçosa-MG, with 112 children at 6 months, 149 at 9 months and 117 at 12 months. Food intake was assessed by a 24-hour recall and patterns extracted by cluster analysis. Breast milk was identified in at least one dietary pattern every month. There was a low participation of ultra-processed foods in the identified dietary patterns. At month 6, children with lower family income were less likely to belong to the dietary pattern composed of milk formulas. Already overweight/obesity was 3.69 times higher in children who made up the pattern 2 (dairy formulas, vegetables, vegetables, beef and pear). At 12 months height deficit (PR = 3.28) and bottle use (PR = 4.51) were associated with the dietary pattern composed of milk formulas and cow's milk. The dietary patterns identified reflected the important participation of breast milk in children's diets. Dietary patterns with the presence of other types of milk were associated with nutritional deviations and bottle feeding.

Impact of Maternal Smoking on the Onset of Breastfeeding versus Formula Feeding: A Cross-Sectional Study.

This study sought to estimate the prevalence of maternal smoking and its association with exclusive breastfeeding vs. formula feeding. A cross-sectional study was performed on postpartum women at a public hospital in Spain, between January and August 2018. The main variables studied were their age, level of study, smoking habits, and chosen mode of infant feeding. In total, 948 postpartum women were included. Of these, 12.45% were smokers who smoked a mean of 7.23 cigarettes/day. Among the group of smokers, the probability of feeding the newborns with formula milk was multiplied by 2.32 ([95%CI 1.50-3.58] p < 0.001). When stratifying tobacco use into mild, moderate and severe, we found a statistically significant dose-response pattern. These associations and their statistical significance were maintained when adjusting by age and level of study. In conclusion, in the group of postpartum mothers who smoked, the probability of feeding the newborns with formula milk doubled. Our data highlight the need to improve health education programs in women of childbearing age, especially during pregnancy.

Avaliação do aleitamento materno em crianças até dois anos assistidas na atenção básica do Recife, Pernambuco, Brasil / Breastfeeding assessment in children up to 2 years of age assisted in primary health care of Recife in the state of Pernambuco, Brazil

Resumo O presente estudo teve por objetivo avaliar o aleitamento materno exclusivo (AME) e total em crianças até 2 anos de idade atendidas em Unidades Básicas de Saúde (UBS) do Recife-PE. Estudo descritivo transversal, realizado nas Unidades Básicas de Saúde da Mustardinha, Jardim Uchôa, Fernandes Figueira e Upinha Novo Prado. A população foi composta por crianças de 0 a 24 meses de idade. Foram avaliadas 141 crianças, das quais 54,6% eram do sexo feminino, 22% tinham idade ≤ 6 meses, 21,3% entre 7 a 12 meses e 56,7% entre 13 e 24 meses. Ao analisar a prevalência de aleitamento materno exclusivo e total, verificou-se a mediana de 60,84 e 182,52 dias, respectivamente. Crianças do sexo masculino, uso de chupeta e mamadeira foram associados ao menor tempo de aleitamento materno exclusivo.

Abstract The scope of this study was to evaluate exclusive and total breastfeeding in children up to 2 years of age treated in Basic Health Units (BHU) of Recife in the state of Pernambuco. A cross-sectional descriptive study was conducted in the Basic Health Units of Mustardinha, Jardim Uchôa, Fernandes Figueira and Upinha Novo Prado. The study population consisted of children of 0 to 24 months of age. One hundred and forty-one children from 0 to 24 months of age were evaluated, of which 56.4% were female, 22% were ≤ 6 months old, 21.3% were between 7 and 12 months of age and 56.7% were between 13 and 24 months of age. Analysis of the prevalence of exclusive and total breastfeeding revealed an average of 60.84 and 182.52 days, respectively. Male children, the use of pacifiers and bottle-feeding was associated with shorter exclusive breastfeeding duration.

Determinants of early initiation of breastfeeding in Ethiopia: a population-based study using the 2016 demographic and health survey data.

BACKGROUND: Timely breastfeeding initiation is a simple but important measure that has protective effects on infants and mothers. This study aims to determine the predictors of early breastfeeding initiation among mothers residing in Ethiopia. METHODS: This study employed the 2016 Ethiopian Demographic and Health Survey data. A total of 5546 children born during the last 24 months at the time of survey were included for analysis from nine regional states and two city administration areas. Socio-demographic and socio-economic factors including individual, household and community-level factors were examined of their significance against the outcome variable of early initiation of breastfeeding using a mixed-effect logistic regression model. RESULTS: The proportion of infants who had timely initiation of breastfeeding was 74.3% (n = 3064). In the multivariate logistic regression analysis, mothers who delivered with assistance of one or more health professionals had 68% (AOR 1.68; 95% CI: 1.23, 2.29) higher odds of initiating timely breastfeeding. In addition, mothers delivering by a caesarean section had 86% reduced odds of early breastfeeding initiation (AOR 0.14; 95% CI: 0.09, 0.22) when compared to mothers who had vaginal delivery. In terms of socio-demographic factors, the odds of early breastfeeding initiation were more than two and half times higher particularly for mothers residing particularly in Oromiya (AOR 2.58; 95% CI: 1.84, 3.63) and Southern Nations Nationalities and Peoples (SNNP) (AOR 2.75; 95% CI: 1.86, 4.05). In addition, timely breastfeeding initiation was also significantly associated with wealth index with wealthier mothers having 43% higher odds compared to mothers of poorest households (AOR 1.43; 95% CI: 1.07, 1.92). Other factors such as age, gender and birth order of the infant also had significant associations with early breastfeeding initiation. CONCLUSION: Early breastfeeding initiation in Ethiopia is inextricably associated with various socio-demographic, biomedical, and socio-economic factors. The study findings can potentially inform mothers and the wider community on the benefits of timely breastfeeding initiation and policymakers and community leaders to target health promotional interventions and resources where needed.

Evaluating effects of prenatal web-based breastfeeding education for pregnant mothers in their third trimester of pregnancy: Prospective randomized control trial.

BACKGROUND: Education is the cornerstone supporting breastfeeding practices. However, the traditional oral education method cannot always satisfy the learning needs of mothers. OBJECTIVE: to measure the effectiveness of prenatal web-based breastfeeding education program for Jordanian pregnant mothers in their third trimester of pregnancy on enhancing knowledge, attitude, and self-efficacy of breastfeeding after giving birth. METHODS: prospective randomized control trial design was used with sample consisted of 112 pregnant mothers who were recruited from one antenatal clinic in Irbid Governorate. Data collection instruments were the infant feeding knowledge and attitudes (IIFAS) and Breastfeeding Self-Efficacy Scale (BSES) were used to measure self efficacy, knowledge and attitudes regarding breastfeeding. RESULTS: Participants of the experimental group were at moderate level of BSES in pre and post intervention with increasing the number of mothers in the same level post intervention. Participants were at a neutral level of IIFAS in both groups generally, they were neither positive to breastfeeding nor to bottle feeding. There was no significant difference between the experimental and control groups on post- intervention scores on BSES and IIFAS. CONCLUSION: This study is considered the first trial to use new teaching methodologies as internet and website in teaching mothers about breastfeeding. Despite that there were not differences between intervention and control groups, web-based breastfeeding education program may contribute in improving breastfeeding self efficacy. IMPLICATIONS: Inclusion prenatal web-based breastfeeding education in antenatal clinics at MCHC centers of Ministry of Health. Further research is needed to replicate this study in other Jordanian health settings.

Human milk as a protective factor for bronchopulmonary dysplasia: a systematic review and meta-analysis.

OBJECTIVE: To summarise current evidence evaluating the effects of human milk on the risk of bronchopulmonary dysplasia (BPD) in preterm infants. DESIGN: We searched for studies on human milk and BPD in English and Chinese databases on 26 July 2017. Furthermore, the references of included studies were also screened. The inclusion criteria in this meta-analysis were the following: (1) preterm infants (<37 weeks); (2) human milk; (3) comparing with formula feeding; (4) the outcome included BPD; and (5) the type of study was randomised controlled trial (RCT) or cohort study. RESULT: A total of 17 cohort studies and 5 RCTs involving 8661 preterm infants met our inclusion criteria. The ORs and 95% CIs of six groups were as follows: 0.78 (0.68 to 0.88) for exclusive human milk versus exclusive formula group, 0.77 (0.68 to 0.87) for exclusive human milk versus mainly formula group, 0.76 (0.68 to 0.87) for exclusive human milk versus any formula group, 0.78 (0.68 to 0.88) for mainly human milk versus exclusive formula group, 0.83 (0.69 to 0.99) for mainly human milk versus mainly formula group and 0.82 (0.73 to 0.93) for any human milk versus exclusive formula group. Notably, subgroup of RCT alone showed a trend towards protective effect of human milk on BPD but no statistical significance. CONCLUSION: Both exclusive human milk feeding and partial human milk feeding appear to be associated with lower risk of BPD in preterm infants. The quality of evidence is low. Therefore, more RCTs of this topic are needed.

Association between pacifier use and bottle-feeding and unfavorable behaviors during breastfeeding / Associação entre uso de chupeta e mamadeira e comportamentos desfavoráveis à amamentação durante as mamadas

Abstract Objective: To investigate the association between pacifier use and bottle-feeding and unfavorable behaviors during breastfeeding. Method: A cross-sectional study was conducted with 427 babies/mothers. Socio-demographic, perinatal data, and information about the use of artificial nipples (pacifier and/or bottle) were collected through a questionnaire. The breastfeeding aspects regarding position, affectivity, sucking behavior, baby responses, and breast anatomy were evaluated through observation during breastfeeding. The chi-squared test and the multiple linear regression analysis were used to investigate the association between the variables. Results: The aspects of breastfeeding that showed higher percentages of the category "poor" were sucking behavior (22.5%) and position (22.2%). The group of infants who used pacifiers and/or bottle showed higher percentages in the poor and fair categories when compared with the good category for all five breastfeeding aspects evaluated (p < 0.001). The linear regression analysis revealed that the increase in the number of unfavorable behaviors regarding position, affectivity, sucking behavior, and baby responses were independently associated with both pacifier and bottle use (β positive, p < 0.05), while breast anatomy was independently associated only with bottle use. Conclusion: The findings suggest that the use of pacifiers and/or bottle-feeding may be associated with unfavorable behaviors during breastfeeding, especially the use of bottle-feeding.

Resumo Objetivo: Investigar a associação entre uso de chupeta e mamadeira e comportamentos desfavoráveis à amamentação durante as mamadas. Métodos: Um estudo transversal foi conduzido com 427 bebês/mães. Foram coletados dados sociodemográficos, perinatais e sobre o uso de bicos artificiais (chupeta e/ou mamadeira) através de questionário. Os aspectos de amamentação referentes à posição, afetividade, adequação da sucção, respostas do bebê e anatomia das mamas foram avaliados através da observação durante a mamada. O teste qui-quadrado e a análise de regressão linear múltipla foram usados para investigar associação entre as variáveis. Resultados: Os aspectos de amamentação que apresentaram percentuais mais elevados da categoria ruim foram a adequação da sucção (22,5%) e posição (22,2%). O grupo de bebês que usavam chupeta e/ou mamadeira apresentou percentuais mais elevados nas categorias ruim e regular quando comparados com a categoria bom para todos os cinco aspectos da amamentação avaliados (p < 0,001). A análise de regressão linear revelou que o incremento do número de comportamentos desfavoráveis referentes à posição, afetividade, adequação da sucção e respostas do bebê estavam associados de forma independente tanto ao uso de chupeta quanto ao uso de mamadeira (β positivo, p < 0,05), enquanto que anatomia das mamas estava associado de forma independente apenas com o uso de mamadeira. Conclusão: Os achados sugerem que o uso de chupeta e/ou mamadeira pode estar associado a comportamentos desfavoráveis durante amamentação, em especial o uso de mamadeira.

Weaning practices of mothers in eastern Turkey / Práticas maternas de desmame no leste da Turquia

Abstract Objective: The study aimed to determine the practices used by breastfeeding mothers to wean their children from the breast. Method: This qualitative-quantitative research was conducted with mothers whose children were registered the pediatric clinics of a state hospital between June and September 2016. In accordance with a purposeful sampling method, 232 mothers of children between the ages of 2 and 5 years were included in the study. Data were collected through face-to-face interviews using a questionnaire with demographic characteristics of mothers as well as their weaning practices. The data obtained were analyzed with a computer-assisted program using number and percentage distributions. Results: The mean breastfeeding duration was 19.00 ± 7.11 months. It was determined that the majority of mothers (56.5%) used traditional methods for weaning their children. These included applying substances with a bad taste (58.1%) to their breasts, covering their breasts with various materials (26.2%) to make the child not want to nurse anymore, and using a pacifier or feeding bottle (9.2%) to substitute for the mother's breast. Conclusions: It was observed that more than half of the mothers were used some traditional practices that could cause trauma in their children, instead of natural weaning.

Resumo Objetivo: O estudo visou determinar as práticas utilizadas por mães em amamentação para desmamar seus filhos do peito. Método: Essa pesquisa qualitativa-quantitativa foi realizada com mães cujos filhos foram registrados em clínicas pediátricas de um hospital estadual entre junho-setembro de 2016. De acordo com o método de amostragem proposital, 232 mães de crianças com idades entre 2 e 5 anos foram incluídas no estudo. Os dados foram coletados por meio de entrevistas presenciais que utilizam um questionário com características demográficas das mães, bem como suas práticas de desmame. Os dados obtidos foram analisados com um programa de computador que utiliza distribuições numéricas e percentuais. Resultados: A duração média de amamentação foi de 19 ± 7,11 meses. Foi determinado que a maior parte das mães (56,5%) utilizou métodos tradicionais para desmamar seus filhos. Esses métodos incluíram aplicar substâncias com gosto ruim (58,1%) em seus seios, cobrir seus seios com materiais diversos (26,2%) para fazer com que seu filho deixe de querer mamar e utilizar chupeta ou mamadeira (9,2%) para substituir o peito da mãe. Conclusões: Foi observado que mais da metade das mães estavam utilizando algumas práticas tradicionais que podem causar trauma em seus filhos, em vez do desmame natural.

Long-term efficacy of a tongue tie service in improving breast feeding rates: A prospective study.

BACKGROUND: Breast feeding rates in England at 3months of age are approximately 17% for exclusive breast-feeding and 55% for breast-feeds supplemented with formula. Tongue-tie (TT) in infants is cited as a significant cause of difficulty with maintaining breast-feeding. Early treatment and support can improve breast-feeding and allow infants to benefit from the many long-term benefits of breast-feeding. Our aim was to determine BF rates in infants 3months after attending our tongue-tie clinic (TTC). METHODS: Institutional ethical approval and study approval were obtained. Patients attending the TTC from May to July 2016 were included. Telephone contact was made 3months postprocedure to establish current behaviour. Symptom resolution was recorded as complete resolution (CR), moderate resolution (MoR), or minimal resolution (MiR). Feeding pattern was either exclusively BF or combined breast and formula feeds or exclusively formula fed. RESULTS: 100 infants were included with complete follow-up data on 87 (87% response rate). Median age at release of TT was 17 (2-88) days without any recurrence. Status at 3months was CR (n=70, 80%); MoR (n=13, 15%), and MiR (n=4, 5%). 43 (49%) were exclusively BF, 36 (41%) were supplementing BF with some formula (2/3 by choice and 1/3 owing to insufficient milk production), and 8 (10%) were using only formula milk (7 by choice and 2 owing to ongoing feeding difficulties). Of the 17 mothers still experiencing symptoms, 5 were exclusively breast-feeding, and 8 were persisting with combined feeds. CONCLUSION: Infants attending our tongue-tie clinic achieved both higher exclusive breastfeeding and combined breast and bottle-feeding when compared to national breast-feeding data at 3months of age. This can facilitate the achievement of long-term breastfeeding, exposing infants and mothers to many of the associated benefits. LEVEL OF EVIDENCE: 4.

Infant and young child feeding patterns in Kuwait: results of a cross-sectional survey.

OBJECTIVE: The beneficial role of breast-feeding for maternal and child health is now well established. Its possible role in helping to prevent diabetes and obesity in children in later life means that more attention must be given to understanding how patterns of infant feeding are changing. The present study describes breast-feeding profiles and associated factors in Kuwait. Design/Setting/Subjects Interviews with 1484 recent mothers were undertaken at immunisation clinics across Kuwait. Descriptive analysis and binary logistic regression of results were performed. RESULTS: Rates of breast-feeding initiation in Kuwait were high (98·1 %) but by the time of discharge from hospital, only 36·5 % of mothers were fully breast-feeding, 37·0 % were partially breast-feeding and 26·5 % were already fully formula-feeding. Multiple social and health reasons were given for weaning the child, with 87·6 % of mothers who had stopped breast-feeding completely doing so within 3 months postpartum. Nationality (P<0·001), employment status 6 months prior to delivery (P<0·001), mode of delivery (P=0·01), sex of the child (P=0·026) and breast-feeding information given by nurses (P=0·026) were all found to be significantly associated with breast-feeding. Few women (5·6 %) got information on infant nutrition and feeding from nursing staff, but those who did were 2·54 times more likely to be still breast-feeding at discharge from hospital. Over 70 % of mothers had enjoyed breast-feeding and 74 % said they would be very likely to breast-feed again. CONCLUSIONS: In Kuwait where the prevalence of both obesity and type 2 diabetes is growing rapidly, the public health role of breast-feeding must be recognised and acted upon more than it has in the past.

Pumping Milk Without Ever Feeding at the Breast in the Moms2Moms Study.

BACKGROUND: More than 85% of contemporary lactating women in the United States express their milk at least sometimes. Some produce milk exclusively through pumping. We characterized women who pumped but never fed at the breast and compared their infant feeding practices with those of women who fed at the breast with or without pumping. SUBJECTS AND METHODS: Study participants were those delivered at Ohio State University Wexner Medical Center in 2011 and completed a questionnaire at 12 months postpartum (n = 478). We used bivariate and multivariate approaches (survival analysis) to compare women who pumped but never fed at the breast with women who fed at the breast with or without pumping. RESULTS: Women (n = 33, 6.9%) who pumped but never fed at the breast comprised a diverse group but were more likely to have delivered preterm and were of lower socioeconomic status on average. They initiated pumping and formula feeding earlier (median = day 1 after delivery) and were more likely to report difficulty making enough milk compared with women who fed at the breast with or without pumping. They had much shorter total duration of milk production (adjusted hazard ratio = 3.3, 95% confidence interval: 2.1, 5.2) after controlling for clinical and sociodemographic confounders. CONCLUSIONS: Pumping without feeding at the breast is associated with shorter milk feeding duration and earlier introduction of formula compared with feeding at the breast with or without pumping. Establishing feeding at the breast, rather than exclusive pumping, may be important for achieving human milk feeding goals.

Associação entre hábitos orais deletérios e as estruturas e funções do sistema estomatognático: percepção dos responsáveis / Association between harmful oral habits and the structures and functions of the stomatognathic system: perception of parents/guardians

RESUMO Objetivo Verificar a ocorrência e associar a presença dos hábitos orais deletérios com as estruturas e funções do Sistema Estomatognático, quanto aos aspectos de fala, oclusão e respiração, na percepção dos responsáveis. Método Estudo transversal, de caráter exploratório. A amostra, não probabilística, foi composta por 289 crianças de zero a 12 anos atendidas em uma unidade de estratégia de saúde da família. Os dados foram obtidos através de um questionário de identificação de hábitos deletérios aplicado com os responsáveis pelas crianças. Os resultados foram considerados a um nível de significância de 5% e as análises foram realizadas utilizando o programa SPSS versão 19.0 e o teste Quiquadrado de associação para análise das variáveis categóricas. Resultados O índice de aleitamento materno foi de 85%, entretanto, apenas 32,4% foram amamentados exclusivamente até os seis meses. Os hábitos mais prevalentes e mantidos atualmente foram a mamadeira (28,62%) e a chupeta (23,18%) convencional. Houve associação significativa (p=0,001) entre o fato de a criança permanecer com a boca aberta e respirar de modo oral e oronasal. A presença de hábitos como a mamadeira (p=0,016) e a chupeta (p=0,001) ortodôntica estava relacionada ao modo respiratório relatado. O tempo de manutenção dos hábitos estava associado à percepção da presença de alterações na fala (p=0,046); e oclusais (p=0,014). Conclusão A presença e a manutenção de hábitos orais deletérios mostraram-se associadas à percepção da presença de alterações nas estruturas e funções do Sistema Estomatognático de alterações de oclusão, respiração e fala, representando parcela importante da demanda por reabilitação.

ABSTRACT Purpose To verify the occurrence and associate the presence and duration of harmful oral habits with the structures and functions of the stomatognathic system. Methods This is a cross-sectional, exploratory study. Participants’ participation was formalized by the signing of an Informed Consent Form. The non-probabilistic sample comprised 289 children aged one to 12 years assisted at a Family Health Strategy unit. The data were obtained through a questionnaire to identify harmful oral habits applied to the children’s parents and/or guardians. The results were considered at 5% level of significance. The statistical analyses were performed using the SPSS 19.0 software and the chi-squared association test was employed to investigate the categorical variables. Results The breastfeeding rate found was 85%; however, only 32.4% of the children were exclusively breastfed until six months of age. The most prevalent habits and those currently maintained were use of conventional bottle (28.62%) and conventional pacifier (23.18%). Significant correlation (p=0.001) was found between keeping the mouth open and oral and oronasal breathing. The presence of habits such as using orthodontic bottle (p=0.016) and orthodontic pacifier (p=0.001) was associated with the breathing mode reported. Habit duration was associated with the perception of changes in speech (p=0.046) and with malocclusion (p=0.014). Conclusion The presence and duration of harmful oral habits were associated with the perception of changes in the structures and functions of the stomatognathic system regarding occlusion, breathing, and speech, accounting for a significant portion of the demand for rehabilitation.

Independent effect of type of breastfeeding on overweight and obesity in children aged 12-24 months. / Efeito independente do tipo de aleitamento no risco de excesso de peso e obesidade em crianças entre 12-24 meses de idade.

This study aimed to analyze the effect of type of breastfeeding on the nutritional status of children between 12-24 months of age. This cohort study included 435 children born in 2012 in a public hospital in Joinville, Santa Catarina State, Brazil. Two years after delivery the mothers and their children were contacted in their homes for a new investigation of demographic, economic, nutritional, and anthropometric data. In the unadjusted analysis, children who were not exclusively breastfed were more likely to be overweight (including obesity) at 2 years of age (OR = 1.6; p = 0.049) than exclusively breastfed children. After adjusting for several covariates, children who were not exclusively breastfed had a 12% higher risk of overweight including obesity compared to unadjusted analysis (OR = 2.6 vs. OR = 1.8; p = 0.043). In addition, birthweight was also an independent determinant of overweight including obesity (OR = 2.5; p = 0.002). The practice of exclusive breastfeeding can reduce the risk of overweight in children from developing countries such as Brazil.

[Effects of breast-feeding duration, bottle-feeding duration and oral habits on the occlusal characteristics of primary dentition].

OBJECTIVE: To assess the effects of breast-feeding duration, bottle-feeding duration and oral habits on the occlusal characteristics of primary dentition in 3-6-year-old children in Beijing. METHODS: This cross sectional study was conducted via an examination of the occlusal characteristics of 734 children combined with a questionnaire completed by their parents/guardians. The examination was performed by a single, previously calibrated examiner and the following variables were evaluated: presence or absence of deep overbite, open bite, anterior cross bite, posterior cross bite, deep overjet, terminal plane relationship of the second primary molar, primary canine relationship, crowding and spacing. Univariate analysis and multiple Logistic regressions were applied to analyze the associations. RESULTS: It was found that a short duration of breast-feeding (never or ≤6 months) was directly associated with posterior cross bite (OR=3.13, 95%CI=1.11-8.82, P=0.031) and no maxillary space (OR=1.63, 95%CI=1.23-2.98, P=0.038). In children breast-fed for ≤6 months, the probability of developing pacifier-sucking habits was 4 times that for those breast-fed for >6 months (OR=4.21, 95%CI=1.85-9.60, P=0.000 2). The children who were bottle-fed for over 18 months had a 1.45-fold higher risk of nonmesial step occlusion and a 1.43-fold higher risk of class II canine relationship compared with those who were bottle-fed for 6-18 months. Non-nutritive sucking habits were also found to affect occlusion: a prolonged digit-sucking habit increased the probability of an anterior open bite, while a pacifier-sucking habit was associated with excessive overjet and absence of lower arch developmental space. Tongue-thrust habit was associated with anterior open bite (OR=4.21, 95%CI=1.85-9.60, P=0.000 2) and posterior cross bite (OR=7.24, 95%CI=1.30-40.13, P=0.024). Lower lip sucking habit was associated with deep overjet and had a negative association with class III canine relationship. Unilateral chewing was associated with spacing in mandibular (OR=1.57, 95%CI=1.03-2.41, P=0.037). Mouth breathing was associated with chronic rhinitis and adenoidal hypertrophy and had an association with spacing in maxillary. The chi-square test did not indicate a statistically significant association between upper lip sucking habit and any occlusal characteristics. CONCLUSION: Breast-feeding duration was shown to be associated with the prevalence of posterior crossbite, or no maxillary space in the deciduous dentition and development of a pacifier-sucking habit. Children who had a longer duration of bottle-feeding were more likely to develop class II canine relationship. Children who had an oral habit were more likely to develop abnormal occlusal characteristics.

Evaluation of Possible Associated Factors for Early Childhood Caries and Severe Early Childhood Caries: A Multicenter Cross-Sectional Survey.

OBJECTIVES: The present study evaluated associated factors for developing early childhood caries (ECC) and Severe-ECC (S-ECC) in a group of children aged 24-71 months. Potential positive effects of early dental visit on formation of ECC is investigated as well. STUDY DESIGN: This was a multicenter, cross-sectional study conducted at three governmental and university pediatric dentistry clinics in 408 preschool children who were randomly selected from a total of 4116 children. The questionnaires administered to the mothers by interview and intraoral examination performed by calibrated pediatric dentists. The children were evaluated in three groups according to their caries experience as who had caries free, ECC and S-ECC. RESULTS: The following factors were significantly associated with caries formation: 1. Prolonged (i.e., >18 months) breastfeeding in preterm babies (OR=2.4) 2. Prolonged breastfeeding in children who started tooth brushing after 1.5 years of age (OR=3.7), 3. Sugar (p<0.001) and fruit-juice consumption (p<0.0001), and 4. Lack of periodic dental examination (p<0.05). Parental smoking habit does not significantly affect ECC development. Nocturnal bottle feeding and nocturnal feeding also affected S-ECC formation significantly (p=0.043 and p=0.005, respectively). CONCLUSIONS: There is a significant difference between the children with caries and caries-free associated with the brushing initiation age started before or after 18 months. If a child is under the risk of multiple caries factors, it is very difficult to evaluate which habits affect the caries formation or increase the severity of the caries lesions.

Impact of providing free preventive dental products without health workers' counselling on infants' tooth-brushing and bottle-feeding termination practices: a randomised controlled trial.

OBJECTIVE: To investigate the impact of an integrated oral health promotion intervention, within the Syrian national immunisation programme, which provided free preventive dental health products, without health workers' counselling, on one-year-old infants' tooth-brushing and bottle-feeding termination practices. RESEARCH DESIGN: a randomised controlled parallel-group trial. SETTING: A maternal and child health centre in Sweida city, Syria. PARTICIPANTS: 92 mothers of one-year-old infants, attending an infant vaccination clinic, were allocated into three groups: Test, Control One and Control Two. INTERVENTIONS: The Test group received an oral health promotion package including an infant oral health pamphlet, a baby toothbrush, fluoride toothpaste (1,000 mg/L) and a trainer cup, without health workers' counselling. Control One received only the pamphlet, whilst Control Two received no intervention. MAIN OUTCOME MEASURES: after one month, the presence of old plaque on infants' primary teeth was checked, to assess tooth-brushing behaviour. Also, a mothers' self-completed questionnaire was administered to assess bottle-feeding use. RESULTS: The response rate was 100% and the attrition rate was zero. There were differences in tooth-brushing and bottle-feeding termination practices between the three groups (P⟩0.001). Infants in the Test group were less likely to have old plaque and more likely to stop bottle-feeding than their counterparts in the two control groups. There were no differences in the abovementioned outcomes between the two control groups. CONCLUSIONS: Providing free preventive dental health products, without health worker's counselling, in an integrated oral health promotion intervention, was an effective measure to promote infants' tooth-brushing and bottle-feeding termination practices. These findings should be supported by long-term follow up studies.

Efeito independente do tipo de aleitamento no risco de excesso de peso e obesidade em crianças entre 12-24 meses de idade / Efecto independiente del tipo de lactancia en el riesgo de exceso de peso y obesity en niños entre 12-24 meses de edad / Independent effect of type of breastfeeding on overweight and obesity in children aged 12-24 months

Resumo: Este estudo teve como objetivo avaliar a importância do tipo de aleitamento no risco de excesso de peso de crianças entre 12-24 meses de idade. Trata-se de um estudo de coorte que incluiu 435 crianças nascidas em 2012 em uma maternidade pública de Joinville, Santa Catarina, Brasil. Dois anos após o parto, as mães e seus filhos foram contatados nas residências para uma nova coleta de dados. Na análise não ajustada, crianças que não receberam aleitamento materno exclusivo apresentaram maior risco de desenvolver excesso de peso aos dois anos de idade (OR = 1,6; p = 0,049), quando comparadas às crianças amamentadas exclusivamente. Mesmo após o ajuste para diversas covariáveis, o risco das crianças não amamentadas exclusivamente apresentarem excesso de peso aumentou 12% em relação à análise não ajustada (OR = 2,6 vs. OR = 1,8; p = 0,043). Adicionalmente, o peso ao nascer também mostrou ser um determinante independente do risco de excesso de peso (OR = 2,5; p = 0,002). A prática do aleitamento materno exclusivo pode reduzir o risco de excesso de peso em crianças de países em desenvolvimento como o Brasil.

Resumen: Este estudio tuvo como objetivo evaluar la importancia del tipo de lactancia en el riesgo de exceso de peso de niños entre 12-24 meses de edad. Se trata de un estudio de cohorte que incluyó a 435 niños nacidos en 2012, en una maternidad pública de Joinville, Santa Catarina, Brasil. Tras dos años después del parto, se contactó con las madres y sus hijos en sus residencias para una nueva recogida de datos. En el análisis no ajustado, los niños que no recibieron exclusivamente el pecho materno presentaron mayor riesgo de desarrollar exceso de peso a los dos años de edad (OR = 1,6; p = 0,049), cuando se comparan con los niños amamantados exclusivamente. Incluso tras el ajuste para diversas covariables, el riesgo de que los niños no amamantados exclusivamente presentaran exceso de peso aumentó un 12%, en relación con el análisis no ajustado (OR = 2,6 vs. OR = 1,8; p = 0,043). Asimismo, el peso al nacer también mostró ser un determinante independiente del riesgo de exceso de peso (OR = 2,5; p = 0,002). La práctica de dar exclusivamente el pecho puede reducir el riesgo de exceso de peso en niños de países en desarrollo como Brasil.

Abstract: This study aimed to analyze the effect of type of breastfeeding on the nutritional status of children between 12-24 months of age. This cohort study included 435 children born in 2012 in a public hospital in Joinville, Santa Catarina State, Brazil. Two years after delivery the mothers and their children were contacted in their homes for a new investigation of demographic, economic, nutritional, and anthropometric data. In the unadjusted analysis, children who were not exclusively breastfed were more likely to be overweight (including obesity) at 2 years of age (OR = 1.6; p = 0.049) than exclusively breastfed children. After adjusting for several covariates, children who were not exclusively breastfed had a 12% higher risk of overweight including obesity compared to unadjusted analysis (OR = 2.6 vs. OR = 1.8; p = 0.043). In addition, birthweight was also an independent determinant of overweight including obesity (OR = 2.5; p = 0.002). The practice of exclusive breastfeeding can reduce the risk of overweight in children from developing countries such as Brazil.