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.

Uso de chupeta em pré-escolares do sul do Brasil: prevalência e fatores associados / Pacifier use in preschoolers from southern Brazil: prevalence and associated factors

Objetivo: investigar a prevalência e os fatores associados ao uso de chupeta em pré-escolares. Sujeitos e método: estudo transversal foi realizado com 1.316 crianças de 0 até 5 anos de idade no município de Canoas, no Rio Grande do Sul. O instrumento de pesquisa foi um questionário semiestruturado respondido pelos responsáveis sobre características sociodemográficas (sexo, cor da pele, idade da criança e materna, escolaridade materna, estrutura e renda familiar) e comportamentais (uso da mamadeira e aleitamento materno). O desfecho foi presença/ausência de uso de chupeta. A análise estatística compreendeu regressão de Poisson com variância robusta bruta e ajustada. Resultados: a prevalência de uso de chupeta em algum momento da vida foi de 68,1%. A análise multivariável ajustada mostrou que crianças que usaram mamadeira tiveram três vezes maior prevalência do desfecho (RP: 3,21; IC95% 2,25-4,59; p<0,001) se comparadas àquelas que nunca usaram mamadeira. Além disso, a análise adicional encontrou que crianças mais novas ainda usam a chupeta quando comparadas às mais velhas. Conclusão: conclui-se que a prevalência do uso de chupeta é alta e está associada com hábitos de nutrição. Assim, entender a associação de aspectos biopsicossociais e sua rede de causalidade torna-se essencial para o estabelecimento de estratégias de promoção de saúde na primeira infância. (AU)

Objective: to investigate the prevalence and the factors associated with pacifier use by preschoolers. Subjects and method: cross-sectional study performed with 1316 children from zero to five years of age, in the city of Canoas, RS, Brazil. The research instrument was a semi- -structured questionnaire answered by the responsible persons on sociodemographic (sex, skin color, child and maternal age, maternal level of education, and family structure and income) and behavioral (bottle-feeding and breastfeeding) characteristics. The outcome was the presence/absence of pacifier use. The statistical analysis included Poisson regression with crude and adjusted robust variance. Results: the prevalence of pacifier use at some point in life was 68.1%. The adjusted multivariate analysis showed that bottle-fed children presented a threefold higher prevalence of the outcome (PR: 3.21, 95%CI 2.25-4.59, p<0.001) compared to those who had never used the bottle. Moreover, an additional analysis found that younger children still use the pacifier compared to older ones. Conclusion: it is concluded that the prevalence of pacifier use is high and it is associated with nutrition habits. Thus, understanding the association of biopsychosocial aspects and their causality network becomes essential for establishing health promotion strategies in early childhood. (AU)

Influence of head and linear growth on the development of malocclusion at six years of age: a cohort study

Abstract The aim of this article was to evaluate the influence of biological and sociobehavioral factors on the development of malocclusions in children. This is a cross-sectional study nested in a cohort of 350 children who participated in a community intervention study. After six years, an active search identified 290 children with occlusal abnormalities. Socioeconomic status, linear growth, and nutritional status of the child at birth and at the time of measurement, as well as dietary and sucking habits, were investigated. Malocclusions were evaluated across three spatial planes - anteroposterior, vertical, and transverse. The prevalence of these anomalies was 64.5%, primarily in the anteroposterior plane. The logistic regression analysis revealed that pacifier use for 60 months or more, stunting as measured at age six, and reduced gain in head circumference from birth to six years of age, were significantly associated with the development of malocclusion in childhood. Head circumference and linear growth are associated with occlusal anomalies in infants, independent of pacifier sucking.

Factors Associated with Early Weaning According to the Report of Mothers in a Child Friendly Hospital Initiative

Objective: To determine the prevalence and factors associated with early weaning according to the report of mothers in a Child Friendly Hospital Initiative. Material and Methods: This is an observational, cross-sectional study with a sample of 252 mother/child binomials, participants in a maternal and childcare program, in a Child Friendly Hospital Initiative in Teresina, Brazil. A semi-structured questionnaire was used as the data collection instrument, administered to the mothers in individual interviews, with questions about socioeconomic conditions, breastfeeding, period, reason and way of weaning; and non-nutritive sucking habits. Early weaning was considered when the supply of breast milk was interrupted before the six months of life. For data analysis, descriptive and bivariate analyses were performed (Pearson's Chi-Square Test and Fisher's Exact Test), with a level of significance of 5%. Results: The prevalence of early weaning was 11.9%. The reasons given for interrupting breastfeeding by the mothers were: 23,% attributions of the mother; 46.% attributions of the infant; 23.3 % organic deficiency of the mother; 6.7% influence of others; and 4.8% of the mothers were still breastfeeding. The finger and/or pacifier sucking habits (p=0.002), and the use of a bottle (p=0.003) were associated with early weaning. A significant association between the total weaning period and the socioeconomic variables was not observed (p>0.05). Conclusion: The prevalence of early weaning was low. The main factors were related to "infant attributions", associated to children with non-nutritive sucking habits, bottle use, first tooth erupted with less than 6 months and whose mothers had formal employment.

Hábitos de alimentação e sucção de bebês assistidos em Hospital Amigo Da Criança, Campina Grande/PB, Brasil / Feeding and sucking habits of infants treated at a 'Friend of Children Hospital' in Campina Grande, PB, Brazil

Objetivo: Verificar a prevalência e a associação de hábitos de alimentação e de sucção de bebês, na faixa etária de zero a 24 meses, atendidos no Instituto de Saúde Elpídio de Almeida (ISEA), em Campina Grande, PB, Brasil. Método: Para tanto, uma amostra probabilística de 800 mães responderam a uma entrevista estruturada, avaliando questões relativas ao padrão alimentar (amamentação e alimentação complementar) e aos hábitos de sucção (uso de chupeta e mamadeira). A análise dos dados incluiu a estatística descritiva e inferencial (teste de Qui-quadrado de Pearson, nível de significância de 5%) por meio do Programa SPSS (Statistical Package for the Social Sciences), v.13.0. Resultados: O percentual de desmame precoce foi considerado baixo (13,5%) e de amamentação exclusiva, elevado (61,9%). Uma parcela expressiva das crianças fazia uso de mamadeira (35,4%) e de chupeta (38,0%). O leite em pó foi a alimentação complementar mais usada pelas mães do estudo (63,9%). Houve associação entre desmame precoce e uso de mamadeiras, bem como aleitamento artificial ou misto e hábito de sucção de chupeta (p menor que 0,05). Conclusão: Os percentuais de desmame precoce foi baixo e de amamentação exclusiva foi elevado e houve associação entre padrão alimentar e hábitos de sucção do bebê. Há, portanto, necessidade da manutenção de políticas de incentivo ao aleitamento materno, corroborando com o aumento da qualidade de vida da população infantil do município estudado.

Objective: To determine the prevalence and association of feeding and sucking habits of infants aged 0-24 months treated at the Institute of Health Elpidio de Almeida (ISEA) in the city of Campina Grande, PB, Brazil. Method: A probabilistic sample of 800 mothers answered to a structured interview to evaluate issues relative to feeding pattern (breast-feeding and complementary feeding) and sucking habits (use of pacifier and feeding bottle). Data analysis included descriptive and inferential statistics (Pearson's chi-square test at a significance level of 5%) using the SPSS (Statistical Package for the Social Sciences) software, v.13.0. Results: The percentages of early weaning and exclusive breastfeeding, respectively, were considered low (13.5%) and high (61.9%). A significant portion of the children was bottle-fed (35.4%) and used pacifiers (38.0%). Powdered milk was the most commonly used complementary feeding by the mothers in the study (63.9%). A statistically significant association was found between early weaning and bottle-feeding, as well as between artificial or mixed nursing with pacifier sucking habit (p<0.05). Conclusion: A low percentage of early weaning and high percentage of exclusive breastfeeding were observed, and there was an association between the infant's feeding pattern and the sucking habits. There is, hence, the need to maintain policies that encourage breastfeeding in order to increase the quality of life of the infant population in the evaluated city.

Comportamento materno versus temperamento da criança: influência no padrão de saúde bucal / Maternal behavior versus child temper: influence on the oral health pattern

Objetivo: Verificar a relação entre cárie dentária, alterações faciais, comportamento materno e temperamento das crianças participantes do programa Clínica de bebês do município de Maringá/PR. Método: Foram examinadas 102 pares de mães e crianças na faixa etária entre 2 e 7 anos. Um questionário analisou os dados socioeconômicos da mãe, padrão de aleitamento, hábitos de sucção não nutritiva e por meio do exame clínico avaliaram-se a quantidade de biofilme presente (IHB), o índice de cárie (ceo-s) e alterações faciais. Avaliou-se, também, o temperamento da criança frente ao atendimento odontológico e o comportamento materno junto à criança. Os dados foram processados e analisados pelo software Statistic R, com nível de significância de 0,05%. Para a comparação das duas amostras foi utilizado o Teste de Mann-Whitney e a associação foi verificada pelo Teste Exato de Fisher. Resultados: Das crianças, 58,8% são do gênero masculino, 88 (86,2%) "livres de cárie" e ceo-s de 0,55 (±1,64). Quanto à presença de hábitos nocivos, 46 (45,1%) possui algum hábito e 21,5% possuíam alterações faciais. Houve diferença estatística para o IHB médio entre as crianças livres de cárie (0,8±0,86) e crianças com cárie (1,46±1,00) (p=0,010; Teste de Mann- Whitney). Quando comparado tempo do hábito nocivo e presença de alteração facial, as crianças que ainda possuíam hábito nocivo tiveram maior percentual de alteração facial. Para o temperamento da criança, a cárie mostrou-se mais presente para o definitivamente negativo (p=0,0499). Em relação ao hábito nocivo, este se mostrou mais presente para o definitivamente negativo (p=0,0434). Quando analisado o comportamento da mãe, 57,14% das crianças com cárie possuem mães consideradas "insensíveis" (p=0,0013). Conclusão: Programas que promovam o vínculo entre o profissional, à criança e a família, desde a idade precoce, com reforço educativo nas consultas...

Objective: To verify the relationship between dental caries, facial alterations, maternal behavior and temper of children attending the Baby Clinic Program of the city of Maringá/PR. Method: One hundred and two pairs of mothers and 2-7-yearold children. A questionnaire was used to evaluate the mothers socioeconomic data, nursing pattern and non-nutritive sucking habits. A clinical exam was done to evaluate the amount of biofilm (Oral Hygiene Index- OHI), the caries index (dfm-t) and the presence of facial alterations. The children's temper regarding the dental treatment and the mothers behavior with he children were also evaluated. The data were processed and analyzed using the Statistic R soft ware with significance level of 5%. The Mann-Whitney test was used for comparison of the two samples and the association between them was verified by the Fisher's Exact Test. Results: Among the children, 58.8% were male, 88 (86.2%) were "caries free" and the dmf-t was 0.55 (±1.64). Forty-six (45.1%) children had some kind of deleterious habits and 21.5% presented facial alterations. There was statistically significant difference for the mean OHI between the caries-free children (0.8±0.86) and children with caries (1.46±1.00) (p=0.010; Mann- Whitney test). When the duration of the deleterious habit and the presence of facial alterations were compared, the children that still presented the deleterious habit had higher percentage of facial alterations. Regarding the children's temper, caries disease was more prevalent for the definitively negative temper (p=0.0499). The prevalence of deleterious habits was also greater for the definitively negative temper (p=0.0434). Regarding the mothers behavior, 57.14% of the children with caries had mothers considered as "insensitive" (p=0.0013). Conclusion: Programs that promote a link between the dental professional, the family and the children since an early age, with educative reinforcement...

Association between sociodemographic factors and nutritive and non-nutritive sucking habits among Iranian girls

Prolonged duration offinger-and pacifier-sucking may be a risk factor for maldevelopment of orofacial structures and dental occlusion. This study assessed the prevalence of nutritive and non-nutritive sucking habits and their association with some contributing factors among 7-year-old girls in Mashhad, Islamic Republic of Iran. Based on a questionnaire to the parents of 436 schoolgirls, the rate of current or previous pacifier-sucking was 26.6% and of finger-sucking was 10.6%. Child's birth rank and number of siblings and parents' educational level were significantly related to ever pacifier-sucking but not to finger-sucking. The highest prevalence of ever pacifier-sucking was among children who had been breast- and bottle-fed but finger-sucking was more common among exclusively breastfed children

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

This study evaluated the effect of breast- and bottle-feeding duration on the age of pacifier use persistence. Questionnaires (n = 723) with information on nutritive and nonnutritive sucking habits of children aged 3-6 years were assessed. The sample was divided according to breastfeeding duration: G1 - non-breastfed, G2 - up to 3 months, G3 - discontinued between 4 and 6 months, G4 - discontinued between 7 and 12 months, and G5 - longer than 12 months. The children were also assigned to 4 groups by age of pacifier use persistence, as well as by age of bottle-feeding persistence: no habits, up to 2 years, 3-4 years and 5-6 years. Associations between nutritive sucking habits and pacifier use were analyzed using logistic regression. The larger breastfeeding groups were G2 (37.9 percent) and G4 (19.4 percent). Many children discontinued pacifier use and bottle-feeding at 3-4 years of age (24.9 percent and 40.1 percent, respectively). Chances of non-breastfed children (G1) with prolonged pacifier-sucking habits, in the three age ranges, were progressively higher in comparison with group G4 (OR: 4.0-7.5, p < 0.01). When comparing bottle-fed with non bottle-fed children, the age range at which bottle-feeding had been discontinued was significantly associated with that of pacifier use cessation: up to 2 years (OR = 6.2), 3-4 years (OR = 7.6) and 5-6 years (OR = 27.0), p < 0.01. It may be suggested that breastfeeding duration has an inversely proportional effect on the age of pacifier use persistence. Bottle-fed children who use pacifiers tend to discontinue these habits at the same period.

Efeitos da sucção não-nutritiva e da estimulação oral nas taxas de amamentação em recém-nascidos pré-termo de muito baixo peso ao nascer: um ensaio clínico randomizado / Effects of non-nutritive sucking and oral stimulation on breastfeeding rates for preterm, low birth weight infants: a randomized clinical trial

OBJETIVO: Determinar a influência da sucção não-nutritiva e da estimulação oral nas taxas de amamentação na alta hospitalar, aos 3 meses e 6 meses de idade corrigida em recém-nascidos pré-termo de muito baixo peso ao nascer. MÉTODOS: Foram randomizados 98 recém-nascidos pré-termo de muito baixo peso ao nascer, e 96 permaneceram no estudo até o 6º mês de idade corrigida. Os recém-nascidos foram randomizados em grupo experimental e grupo controle. O grupo experimental recebeu um programa de estimulação (sucção não-nutritiva associado à estimulação sensório-motora-oral), e o grupo controle, um procedimento simulado a partir do momento em que atingiam alimentação plena até a alimentação oral completa. RESULTADOS: Observou-se que 59 (61,5 por cento) recém-nascidos estavam em amamentação na alta, 31 (32,6 por cento) aos 3 meses e apenas 18 (18,75 por cento) aos 6 meses de idade corrigida. Na alta, 47 por cento dos recém-nascidos do grupo controle e 76 por cento do grupo estimulado estavam em amamentação. Aos 3 meses, 18 por cento do grupo controle e 47 por cento do grupo estimulado continuavam em amamentação, e aos 6 meses, 10 por cento do grupo controle e 27 por cento do grupo estimulado. Houve diferença estatística nos três períodos estudados, favorecendo o grupo estimulado (p < 0,05). CONCLUSÃO: O presente estudo demonstra que a sucção não-nutritiva, associada à estimulação oral, pode contribuir para a melhoria das taxas de amamentação em pré-termos de muito baixo peso ao nascer.

OBJECTIVE: To determine the influence of non-nutritive sucking and oral stimulation programs on breastfeeding rates at discharge, at 3 and at 6 months of corrected age in preterm infants with very low birth weight. METHODS: Preterm infants were randomized into experimental and control groups. Ninety-eight preterm infants were randomized and 96 remained in the study until reaching the corrected age of 6 months. The experimental group received sensory-motor-oral stimulation and non-nutritive sucking, while infants in the control group received a sham stimulation program. Both were administered from reaching enteral feeding (100 kcal/kg/day) until the beginning of oral feeding. RESULTS: Fifty-nine infants (61.5 percent) were breastfeeding at the time of hospital discharge, 31 (36.9 percent) at 3 months, and only 18 (20.5 percent) at 6 months of corrected age. At discharge, 46.9 percent of the control group and 76.5 percent of the experimental group were breastfeeding. There were statistically significant differences between rates of breastfeeding at discharge (47 vs. 76 percent), 3 months (18 vs. 47 percent) and 6 months after discharge (10 vs. 27 percent). The experimental group showed significantly higher rates of breastfeeding (p < 0.05). CONCLUSION: Non-nutritive sucking, associated with oral stimulation programs, can contribute to the improvement of breastfeeding rates among preterm infants with very low birth weight.

O aleitamento materno exclusivo nos primeiros três meses de vida / Exclusive breastfeedinbg on three first months of life

Objetivo: avaliar a prevalência do aleitamento materno exclusivo nos primeiros três meses de vida e fatores intervenientes: socioeconômicos, da mãe e da criança. Métodos: foi realizado estudo transversal que selecionou 86 crianças com idade até três meses , da população carente de três unidades básicas...

Objective: to assess the prevalence of exclusive breastfeeding prevalence on three first months of life according to maternal characteristics and sucking habits of the infants. Methods: a cross-sectional survey selected 86 babies under 3 months age, from...

O que os pais sabem sobre a chupeta de seus filhos? Uma análise qualitativa da questão, vista sob a ótica odontopediátrica / What parents know about their children's dummy? A qualitative analysis, from an odontopediatric perspective

Este trabalho buscou verificar a informação que os pais possuem a respeito da chupeta de seus filhos. Foi feita uma análise qualitativa, através de um questionário introduzido em 2 grupos distintos. Estes grupos diferiram entre si quanto ao grau de instrução dos pais e ao nível sócio-econômico da família. Pelos resultados obtidos foi possível concluir que, independentemente da escolaridade e do nível sócio-econômico, os pais não sabem muito sobre a chupeta e nem tão pouco como usá-la beneficamente. Desta forma, procurou-se também esclarecer dúvidas sobre a utilização da mesma

Normas técnico-administrativas, programa de salud integral de la mujer / Tecnical-administratives norms, health integral program of the woman

Describe el establecimiento de las normas para ayudar a elevar el nivel de salud biosicosocial de la población femenina, mediante acciones de promoción, prevención, atención y recuperación de la salud que conllevan al desarrollo integral de la mujer, la madre y el recien nacido