Association between breast-feeding practices and sucking habits: a cross-sectional study of children in their first year of life

Co-Sleeping as a Protector against Malocclusion in the Primary Dentition: A Cross-Sectional Study

Mothers practice co-sleeping and breastfeeding simultaneously, for convenience and to strengthen bonding. Due to the scarcity of studies analyzing the impact of co-sleeping on primary dentition, this study aimed to analyze the possible effects of co-sleeping on children’s occlusion. In this cross-sectional study, mothers of 221 children aged 2−5 years who had been breastfed for less than 6 months completed a questionnaire about non-nutritive sucking habits. The WHO (World Health Organization) and IOTN-AC indices (the Aesthetic Component of the Index of Orthodontic Treatment Need) were used to assess malocclusion. The type of sagittal (dental and skeletal), transverse and vertical malocclusion was recorded. The non-co-sleeping group showed significantly higher pacifier use (p < 0.05), digital sucking (p < 0.05) and atypical swallowing (p < 0.05) habits. The non-co-sleeping group showed significantly higher mean scores on the IOTN-AC (p < 0.05) and WHO (p < 0.01), a significantly higher presence of canine class II (p < 0.05), anterior open bite (p < 0.05), posterior crossbite (p < 0.05), overbite (p < 0.05), skeletal class II (p < 0.01) and protrusion (p < 0.05). In conclusion, children who practice co-sleeping appear to have a lower frequency and duration of non-nutritive sucking habits. Co-sleeping may contribute to a lower development of malocclusions in children who are weaned early (before six months of age).

Exclusive breast-feeding is associated with reduced pacifier sucking in children: Breast-feeding and pacifier-sucking habit

BACKGROUND

Studies suggest that when children do not achieve the emotional satiety and adequate stimulus provided by breast-feeding, they exhibit sucking behaviors. This study aimed to estimate the association from 4 through 6 months of exclusive breast-feeding (EB) postpartum and pacifier-sucking behavior at 12 months of life.

METHODS

A cohort study was conducted with 1,037 infants, born alive and monitored up to 12 months. At 4 and 6 months after birth, the children were classified according to the type of breast-feeding they had received: exclusive, predominant, complementary, or none. The prevalence of pacifier-sucking behavior was calculated, and the association between the 2 events was estimated. Mothers' socioeconomic-demographic characteristics, delivery features, and prenatal care, as well as the biological characteristics of the children, were determined. Relative risk (RR) and 95% confidence intervals (95% CI) were calculated.

RESULTS

In comparison with EB infants, the RR of pacifier-sucking behavior at 12 months of life was higher in children receiving complementary breast-feeding or no breast-feeding for both 4 months (RR_adjusted, 1.68 [95% CI, 1.39 to 2.02] and RR_adjusted, 2.67 [95% CI, 2.24 to 3.17], respectively) and 6 months (RR_adjusted, 1.43 [95% CI, 1.03 to 2.00] and RR_adjusted, 3.30 [95% CI, 2.40 to 4.54], respectively).

CONCLUSIONS AND PRACTICAL IMPLICATIONS

EB for 6 months postpartum is associated with reduced pacifier-sucking behavior, adjusted for maternal color, number of prenatal consultations, and family income. Promotion of EB may reduce the use of pacifiers and their potential deleterious effects on oral health. Dental health care professionals should consider discussing the importance of breast-feeding with their patients with regard to the possible development of sucking habits in their children.

Duration of Breastfeeding, Bottle-Feeding, and Parafunctional Oral Habits in Relation to Anxiety Disorders Among Children

OBJECTIVE

The aim of the present study is to investigate the duration of breastfeeding in relation to various parafunctional oral habits in children with anxiety disorders.

MATERIALS AND METHODS

The study includes 195 children and adolescents with anxiety disorders and age- and gender-matched 255 healthy control subjects. Diagnoses were made with semistructured interview (K-SADS). Information about breastfeeding and parafunctional oral habits was investigated via a questionnaire prepared for the study.

RESULTS

The mean age was 11.50 ± 2.50 years for clinical group and 11.27 ± 2.33 years for controls. Fifty-four percent of the clinical group and 56% of the control group were female subjects. Duration of exclusive (4.72 ± 2.86, 5.55 ± 2.36; p = 0.002) and total breastfeeding (12.38 ± 10.32, 15.89 ± 9.09; p < 0.001) was significantly lower and duration of bottle-feeding (22.30 ± 19.54, 16.64 ± 12.79; p = 0.005) was higher than controls in the clinical group. Duration of exclusive breastfeeding was significantly correlated with duration of bottle-feeding (r = -0.263, p < 0.001) and duration of pacifier use (r = -0.249, p = 0.001). Multiple regression analysis showed that duration of exclusive breastfeeding (β = 0.88, p = 0.006) and bottle-feeding (β = 1.02, p = 0.005), as well as various oral habits, was associated with diagnosis of an anxiety disorder.

CONCLUSION

Nutrition methods in early years of life may result in long-term consequences regarding anxiety disorders for children. Clinicians should encourage parents for a shorter duration of bottle-feeding and a longer duration of exclusive breastfeeding.

The association between nutritive, non-nutritive sucking habits and primary dental occlusion

Background

The development of primary dentition can be affected by oral sucking habits. Therefore, this study aims to investigate the association of nutritive and non-nutritive sucking habits with primary dentition development.

Methods

One thousand one hundred and fourteen children aged 2 to 5 years old in Hong Kong were recruited in a cross-sectional study. Information on their nutritive (e.g. breastfeeding and bottle feeding) and non-nutritive sucking habits (e.g. pacifier use and thumb/digit sucking) was collected via questionnaires. The children’s primary occlusions were examined in three dimensions.

Results

Children who were breastfed for more than 6 months had a lower proportion of daily pacifier use (p < 0.05). Children who used pacifiers daily had a higher proportion of thumb/digit sucking (p < 0.05). Children who used pacifiers daily for more than one year had higher chances of developing an anterior open bite (p < 0.05) and a reduced overbite (p < 0.05). Those exhibiting daily thumb/digit sucking for more than one year had higher chances of developing Class II incisor and Class II canine relationships, an increased overjet and anterior open bite (p < 0.05).

Conclusion

Pure breastfeeding for more than 6 months is inversely associated with daily pacifier use and daily pacifier use is positively associated with daily thumb/digit sucking. Children with more than one year of daily pacifier use and thumb/digit sucking have higher chances of developing abnormal dental relationships in the sagittal (i.e. Class II incisor and Class II canine relationships and increased overjet) and vertical (i.e. anterior open bite) dimensions, respectively.

Association of Breastfeeding Duration, Nonnutritive Sucking Habits, and Malocclusion

AIM

This study aimed to investigate the associations between breastfeeding, nonnutritive sucking habits (NNSHs), and malocclusion in deciduous, mixed, and permanent dentition.

MATERIALS AND METHODS

A sample of 50 children between 3 and 12 years, enrolled in a pediatric dentistry dental care program, underwent orthodontic examination for detection of occlusal patterns and malocclusion. In addition, data regarding breastfeeding duration and NNSH acquisition were obtained from standardized questionnaires responded by the children's parents or legal guardians.

RESULTS

Regardless of a long period of breastfeeding, a high incidence of NNSH in the evaluated sample was observed. Nevertheless, the presence of NNSHs was not significantly associated with malocclusion.

CONCLUSION

The findings could not indicate a statistically significant association between breastfeeding duration, acquisition of NNSHs, and malocclusion. Longitudinal studies with larger samples are still needed to better support clinical decisions.How to cite this article: Roscoe MG, da Silva Bonifacio SV, da Silva TB, Pingueiro JMS, Lemos MM, Feres MFN. Association of Breastfeeding Duration, Nonnutritive Sucking Habits, and Malocclusion. Int J Clin Pediatr Dent 2018;11(1):18-22.

Infant pacifiers for reduction in risk of sudden infant death syndrome

BACKGROUND

Sudden infant death syndrome (SIDS) has been most recently defined as the sudden unexpected death of an infant less than one year of age, with onset of the fatal episode apparently occurring during sleep, that remains unexplained after a thorough investigation, including the performance of a complete autopsy and a review of the circumstances of death and clinical history. Despite the success of several prevention campaigns, SIDS remains a leading cause of infant mortality. In 1994, a 'triple risk model' for SIDS was proposed that described SIDS as an event that results from the intersection of three factors: a vulnerable infant; a critical development period in homeostatic control (age related); and an exogenous stressor. The association between pacifier (dummy) use and reduced incidence of SIDS has been shown in epidemiological studies since the early 1990s. Pacifier use, given its low cost, might be a cost-effective intervention for SIDS prevention if it is confirmed effective in randomised controlled trials.

OBJECTIVES

To determine whether the use of pacifiers during sleep versus no pacifier during sleep reduces the risk of SIDS.

SEARCH METHODS

We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 2), MEDLINE via PubMed, Embase, and CINAHL to 16 March 2016. We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials.

SELECTION CRITERIA

Published and unpublished controlled trials using random and quasi-random allocations of infants born at term and at preterm (less than 37 weeks' gestation) or with low birth weight (< 2500 g). Infants must have been randomised by one month' postmenstrual age. We planned to include studies reported only by abstracts, and cluster and cross-over randomised trials.

DATA COLLECTION AND ANALYSIS

Two review authors independently reviewed studies from searches. We found no eligible studies.

MAIN RESULTS

We identified no randomised controlled trials examining infant pacifiers for reduction in risk of SIDS.

AUTHORS' CONCLUSIONS

We found no randomised control trial evidence on which to support or refute the use of pacifiers for the prevention of SIDS.

Agentes comunitários de saúde e o aleitamento materno: desafios relacionados ao conhecimento e à prática

RESUMO Objetivo: identificar o conhecimento de Agentes Comunitários de Saúde sobre as práticas e a promoção do aleitamento materno. Métodos: estudo transversal, descritivo, inquérito, quanti-qualitativo realizado com amostra de 148 agentes. A coleta de dados foi realizada por meio da aplicação de um questionário semiestruturado, com questões abertas e fechadas. Foram analisadas as variáveis: sociodemográficas, capacidade para orientação sobre o aleitamento, participação em treinamentos/cursos, conhecimentos sobre vantagens do aleitamento para mãe e bebê. Realizou-se análise estatística descritiva, foram empregados os testes Qui-quadrado, Exato de Fisher e G, ao nível de significância 5%. As questões abertas foram analisadas segundo a técnica de pesquisa qualitativa. Resultados: aproximadamente, 45,95% dos agentes não foram capacitados para realizar orientação prática das nutrizes sobre o aleitamento e 63,30% nunca participaram de cursos sobre amamentação. A maioria citou vantagens do aleitamento relacionadas, somente, ao bebê, emergindo as categorias: nutrição do bebê, imunológica, desenvolvimento/saúde do bebê, dentição/ossos. Houve associação estatisticamente significante entre capacidade de orientar as mães na amamentação e participação em treinamentos (p<0,001). Conclusão: os agentes não haviam participado de cursos de capacitação para acompanhar as nutrizes, apresentaram conhecimento limitado sobre a prática e a promoção do aleitamento, e as visitas domiciliares realizadas pós-parto ocorreram tardiamente.

Clarifying nipple confusion

Nipple confusion, an infant's difficulty with or preference for one feeding mechanism over another after exposure to artificial nipple(s), has been widely debated. This is in part due to conflicting statements, one by the American Academy of Pediatrics in 2005 suggesting that infants should be given a pacifier to protect against Sudden Infant Death Syndrome, and the other by the World Health Organization in 2009 stating that breastfeeding infants should never be given artificial nipples. Despite the limited and inconsistent evidence, nipple confusion is widely believed by practitioners. Therefore, there is a unique opportunity to examine the evidence surrounding nipple confusion by assessing the research that supports/refutes that bottle feeding/pacifier use impedes breastfeeding efficacy/success/duration. This review examined 14 articles supporting and refuting nipple confusion. These articles were reviewed using the Johns Hopkins Nursing Evidence-Based Practice Rating Scale. Based on our review, we have found emerging evidence to suggest the presence of nipple confusion only as it relates to bottle usage and found very little evidence to support nipple confusion with regards to pacifier use. The primary difficulty in conclusively studying nipple confusion is establishing causality, namely determining whether bottles'/pacifiers' nipples are causing infants to refuse the breast or whether they are simply markers of other maternal/infant characteristics. Future research should focus on prospectively examining the causality of nipple confusion.

Association of breastfeeding and three-dimensional dental arch relationships in primary dentition

BACKGROUND

The benefits of breastfeeding on oral health are still inconclusive, especially the association on occlusion. This study aimed to investigate the association of breastfeeding and the development of primary dentition.

METHODS

A cross-sectional study was conducted with 851 Asian children aged 2-5 years old in Hong Kong. Questionnaires were completed by the parents to collect information on breastfeeding and the non-nutritive sucking habits. The children's dental arch relationships were examined in the sagittal, vertical, and transverse dimensions by an experienced examiner.

RESULTS

Children who experienced pure breastfeeding for more than 6 months had a lower chance of developing a class II incisal relationship (P < 0.05) or an increased overjet (P < 0.05), and had wider intercanine (P < 0.05) and intermolar widths (P < 0.05). Vertically, no association on the extent of overbite or openbite was found (P > 0.05).

CONCLUSIONS

Pure breastfeeding for more than 6 months is positively associated with primary dental arch development in the anterior sagittal dental segment and on the horizontal arch width in primary dentition. Therefore, pure breastfeeding for more than 6 months is recommended, as it is associated with lower chance of the development of abnormal dental relationships. The results will be valuable for education and promotion of maternal breastfeeding.

Prevalence of Non-Nutritive Sucking Habits and Potential Influencing Factors among Children in Urban Communities in Nigeria

BACKGROUND

The use of non-nutritive sucking materials like pacifiers and fingers poses health challenges to children in resource-limited settings, where hygiene practices and provision of clean water are poor. This study was designed to determine the prevalence of non-nutritive sucking habits and its association with acute diarrhea in children aged 6-23 months in urban communities of Nigeria.

METHODS

In this cross-sectional study, 12 communities from 4 out of 12 geopolitical wards in Ibadan North Local Government Area and 427 mothers of children aged 6-24 months were randomly selected. A pre-tested, interviewer-administered questionnaire was used to obtain information on socio-demographic characteristics, recent history of diarrhea (3 months prior to visit) and use of non-nutritive sucking materials. Descriptive statistics, Chi-square, and logistic regression were used for data analysis at p = 0.05.

RESULTS

Mean age of the children was 13.9 ± 5.3 months and 50.6% were males. Prevalence of non-nutritive sucking was 45.2%. Prevalence of non-nutritive sucking was not significantly different between males (45.8%) and females (44.5%). The odds ratio of engaging in non-nutritive sucking increases by 6.0% with increasing age (OR = 1.06; 1.02; 1.10). More children who were not exclusively breastfed (53.5%) than exclusively breastfed (26.2%) were likely to engage in non-nutritive sucking (OR = 3.25; 95% CI = 2.07, 5.12). Acute diarrhea was more frequently reported in non-nutritive sucking group than the other (OR = 1.51; 95% CI = 1.03, 2.22).

CONCLUSION

Non-nutritive sucking was linked with failure to practice exclusive breastfeeding, worse with increasing age, and predisposes to acute diarrhea. Further studies are necessary to verify the nature of these associations.

Longitudinal study of habits leading to malocclusion development in childhood

BACKGROUND

The increased prevalence of malocclusions represents a secular trend attributed to the interaction of genetic and environmental factors. The analysis of factors related to the causes of these changes is essential for planning public health policies aimed at preventing and clinically intercepting malocclusion. This study investigated the sucking habits, nocturnal mouth breathing, as well as the relation of these factors with malocclusion.

METHODS

This is a longitudinal study in which 80 mother-child pairs were monitored from the beginning of pregnancy to the 30th month after childbirth. Home visits for interviews with the mothers were made on the 12th, 18th and 30th months of age. Finger sucking, pacifier sucking, bottle feeding, breastfeeding and nocturnal mouth breathing, were the variables studies. On the 30th month, clinical examinations were performed for overjet, overbite and posterior crossbite. A previously calibrated single examiner (Kappa coefficient = 0.92) was responsible for all examinations. Data were analyzed using the chi-squared or Fisher's exact tests, at a significance level of 5%.

RESULTS

Bottle feeding was the most prevalent habit at 12, 18 and 30 months (87.5%; 90% and 96.25%, respectively). Breastfeeding was 40%, 25% and 12.50% at 12, 18 and 30 months, respectively. Nearly 70% of the children in this study had some sort of malocclusion. Pacifier sucking habit at 12, 18 and 30 months of age was associated with overjet and open bite; and at 30 months, an association with overbite was also observed. Finger sucking habit and breastfeeding at 12, 18 and 30 months were also associated with overjet and open bite. The posterior crossbite was associated with bottle feeding at 12 and 30 months, and nocturnal mouth breathers at 12 and 18 months.

CONCLUSIONS

Sucking habits, low rates of breastfeeding, and nocturnal mouth breathing were risk factors for malocclusion.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

BACKGROUND

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

RESULTS

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

CONCLUSION

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

Breastfeeding and parafunctional oral habits in children with and without attention-deficit/hyperactivity disorder

INTRODUCTION

Although children with attention-deficit/hyperactivity disorder (ADHD) were reported to have insufficient breastfeeding, consequences and oropharyngeal implications of this finding have not been studied. In this case-control study, we aimed to investigate early feeding practices and parafunctional oral habits in children with ADHD.

SUBJECTS AND METHODS

The study group consisted of 200 children and adolescents, 7-17 years old, diagnosed as having ADHD at Marmara University Child Psychiatry Clinics in Istanbul, Turkey. The Conners Parent and Teacher Rating Scales were used to assess behavioral disturbances. A questionnaire was developed consisting of items pertaining to breastfeeding period, early feeding history, and parafunctional oral habits. The study data were compared with those for 175 healthy schoolchildren after exclusion of possible ADHD cases.

RESULTS

The children with ADHD were found to have insufficient exclusive breastfeeding (less than 6 months) (p=0.0001). The children with insufficient exclusive breastfeeding were more likely to have a history of bottle feeding, longer duration of bottle feeding, and early introduction of bottle feeding (p=0.01). Overall, significant differences were detected on the domains of duration of bottle feeding, introduction of bottle feeding, introduction of pacifier use, variables of nail and toenail biting, as well as pencil biting, bruxism, and snoring between the ADHD group and the control group.

CONCLUSIONS

The present results indicate that early in life, children with ADHD are subject to insufficient exclusive breastfeeding, different feeding practices, and elevated parafunctional oral habits more often than typically developing children. For all professionals who provide healthcare to children, increased awareness and attention to these factors are suggested.

Electromyographic analysis of masseter muscle in newborns during suction in breast, bottle or cup feeding

Background

When breastfeeding is difficult or impossible during the neonatal period, an analysis of muscle activity can help determine the best method for substituting it to promote the child’s development. The aim of this study was to analyze the electrical activity of the masseter muscle using surface electromyography during suction in term newborns by comparing breastfeeding, bottle and cup feeding.

Methods

An observational, cross-sectional analytical study was carried out on healthy, clinically stable term infants, assigned to receive either breast, or bottle or cup feeding. Setting was a Baby Friendly accredited hospital. Muscle activity was analyzed when each infant showed interest in sucking using surface electromyography. Root mean square averages (RMS) recorded in microvolts were transformed into percentages (normalization) of the reference value. The three groups were compared by ANOVA; the “stepwise” method of the multiple linear regression analysis tested the model which best defined the activity of the masseter muscle in the sample at a significance level of 5%.

Results

Participants were 81 full term newborns (27 per group), from 2 to 28 days of life. RMS values were lower for bottle (mean 44.2%, SD 14.1) than breast feeding (mean 58.3%, SD 12.7) (P = 0.003, ANOVA); cup feeding (52.5%, SD 18.2%) was not significantly different (P > 0.05). For every gram of weight increase, RMS increased by 0.010 units.

Conclusions

Masseter activity was significantly higher in breastfed newborns than in bottle-fed newborns, who presented the lowest RMS values. Levels of masseter activity during cup-feeding were between those of breast and bottle feeding, and did not significantly differ from either group. This study in healthy full term neonates endorses cup rather than bottle feeding as a temporary substitute for breastfeeding.

Infant Oral Health Knowledge and Awareness: Disparity among Pregnant Women and Mothers visiting a Government Health Care Organization

OBJECTIVES

The present study is designed to assess the knowledge, attitude and practices of pregnant women and mothers about feeding habits and infant oral health.

MATERIALS AND METHODS

A total of 230 study subjects were divided into two groups: Group A included pregnant women and group B were mothers of child up to 1 year of age. Each group comprised of 170 subjects. A self-administered questionnaire comprising of total 23 questions on infant feeding practices, nocturnal bottle feeding, correct age of eruption of first teeth and first dental visit. Two separate questionnaires were framed for both the groups.

RESULTS

There was a lack of knowledge among both the groups about infant feeding and weaning. Nocturnal bottle feeding was more prevalent.

CONCLUSION

The present study reflects a need for maternal counseling on infant oral health. How to cite this article: Nagaraj A, Pareek S. Infant Oral Health Knowledge and Awareness: Disparity among Pregnant Women and Mothers visiting a Government Health Care Organization. Int J Clin Pediatr Dent 2012;5(3):167-172.

Maternal breastfeeding, parafunctional oral habits and malocclusion in adolescents: a multivariate analysis

OBJECTIVE

Malocclusion may result in esthetic impairment and functional disorders such as bad chewing, speech and swallowing, with a negative impact on quality of life. There is uncertainty regarding the effects of breastfeeding on dentofacial malocclusions. The purpose of the study was to evaluate the relationship between maternal breastfeeding and dental malocclusions and facial characteristics in adolescents with permanent dentition.

METHODS

Probabilistic sampling of 2060 12- to 15-year-old students in a cross-sectional study was used. Malocclusion, as defined by Angle, and facial characteristics were the dependent variables. The duration of breastfeeding was the main independent variable. Other covariates were tested as effect modifiers or confounders. The associations were estimated using the odds ratio (OR) in multinomial logistic regression analysis (α=5%).

RESULTS

There was an association between a short duration of breastfeeding (less than 6 months) and Angle class II (OR=3.14; 95% CI: 1.28-7.66) and class III (OR=2.78; 95% CI: 1.21-6.36) malocclusion only in students with a prolonged history of bruxism. A higher occurrence of severe convex profile (OR=3.4; 95% CI: 0.63-18.26) and a lower occurrence of cancave profile (OR=0.43; 95% CI: 0.21-0.88) were also observed only among adolescents who had been breastfed for a short period and exposed to a long periods of mouth breathing.

CONCLUSIONS

These findings support the hypothesis that breastfeeding alone seems not to be directly associated with malocclusions, but it may have a synergetic effect with parafunctional oral habits on the development of occlusofacial problems. It is recommended that deleterious oral habits be avoided, especially by children who were breast-fed for less than 6 months.

Breastfeeding and non-nutritive sucking patterns related to the prevalence of anterior open bite in primary dentition

OBJECTIVE

Nutritional, immunological and psychological benefits of exclusive breastfeeding for the first 6 months of life are unequivocally recognized. However, mothers should also be aware of the importance of breastfeeding for promoting adequate oral development. This study evaluated the association between breastfeeding and non-nutritive sucking patterns and the prevalence of anterior open bite in primary dentition.

MATERIAL AND METHODS

Infant feeding and non-nutritive sucking were investigated in a 3-6 year-old sample of 1,377 children, from São Paulo city, Brazil. Children were grouped according to breastfeeding duration: G1--non-breastfed, G2--shorter than 6 months, G3--interruption between 6 and 12 months, and G4--longer than 12 months. Three calibrated dentists performed clinical examinations and classified overbite into 3 categories: normal, anterior open bite and deep bite. Chi-square tests (p<0.05) with odds ratio (OR) calculation were used for intergroup comparisons. The impact of breastfeeding and non-nutritive sucking on the prevalence of anterior open bite was analyzed using binary logistic regression.

RESULTS

The prevalence estimates of anterior open bite were: 31.9% (G1), 26.1% (G2), 22.1% (G3), and 6.2% (G4). G1 would have significantly more chances of having anterior open bite compared with G4; in the total sample (OR=7.1) and in the subgroup without history of non-nutritive sucking (OR=9.3). Prolonging breastfeeding for 12 months was associated with a 3.7 times lower chance of having anterior open bite. In each year of persistence with non-nutritive sucking habits, the chance of developing this malocclusion increased in 2.38 times.

CONCLUSIONS

Breastfeeding and non-nutritive sucking durations demonstrated opposite effects on the prediction of anterior open bite. Non-breastfed children presented significantly greater chances of having anterior open bite compared with those who were breastfed for periods longer than 12 months, demonstrating the beneficial influence of breastfeeding on dental occlusion.

Repercussões das estratégias de retirada dos hábitos orais deletérios de sucção nas crianças do Programa de Saúde da Família em Olinda - PE

OBJETIVO: verificar as respostas às estratégias de retirada dos hábitos orais deletérios de sucção nas crianças do Programa de Saúde da Família (PSF) em Olinda, PE. Em acréscimo, identificar a frequência e os principais tipos de hábitos orais deletérios presentes. MÉTODOS: estudo longitudinal, com cortes transversais, intervencional e descritivo, com 90 crianças na faixa etária entre 2 aos 11 anos, acompanhadas pela equipe de Fonoaudiologia da Funeso, no PSF de Jardim Fragoso, em Olinda, durante o ano de 2007 e que apresentavam hábitos orais deletérios. Os instrumentos e etapas contempladas nesta pesquisa abrangeram a abordagem lúdica para a conscientaização sobre os malefícios originados pela utilização prolongada desses hábitos, a aplicação de questionário direcionado aos pais ou cuidadores e às crianças e a avaliação clínica, com controle da remoção dos hábitos nas crianças, em um período de 30 dias. RESULTADOS: das crianças avaliadas, 53,3% eram do sexo masculino e 46,7% do sexo feminino. Todos os entrevistados apresentavam hábitos orais deletérios; em que 48,9% possuíam apenas um tipo de hábito; e 46,7% e 4,4%, respectivamente, dois e três tipos de hábitos associados. Hábitos nocivos de sucção foram os mais prevalentes, com 52,2% para o uso de chupetas; 50% para o uso de mamadeiras e 22,2% para a sucção digital. Trinta dias após a intervenção, 26 crianças ou 28,9% da amostra haviam removido esses hábitos. CONCLUSÃO: as estratégias empregadas alcançaram a remoção de todos os tipos de hábitos apresentados, na distribuição estabelecida, necessitando-se de controle por um tempo maior nesse sentido.

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%) and G4 (19.4%). Many children discontinued pacifier use and bottle-feeding at 3-4 years of age (24.9% and 40.1%, 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.