Effects of oral stimulation with breast milk in preterm infants oral feeding: a randomized clinical trial

Objectives This study was performed to evaluate the effect of oral stimulation with breast milk for preterm infants. Methods A total of 68 subjects form neonatal intensive care unit were randomly assigned into control group (n=20), premature infant oral motor intervention (PIOMI) group (n=25) and premature infant oral motor intervention with breast milk (BM-PIOMI) group (n=23). Results BM-PIOMI group had significant shorter initiation of oral feeding (IOF) time compared to PIOMI group (2.95 days, 95% CI [0.42–5.48]) or control group (9.79 days, 95% CI [7.07–12.51]). BM-PIOMI group had significant sooner transition time from IOF to full oral feeding (FOF) compared to control group (6.68 days, 95% CI [2.2–11.16]), but not to PIOMI group (2.09 days, 95% CI [−2.07 to 6.25]). Length of hospital stay (LOS) did not show statistical different between three groups (control 38.85 ± 14.40 vs. PIOMI 38.48 ± 11.76 vs. BM-PIOMI 38.04 ± 12.2). Growth mixture model identified improvement in non-nutritive sucking (NNS) score in BM-PIOMI group compared to control and PIOMI group (0.8293, p<0.0001, and 0.8296, p<0.0001, respectively). Conclusions Oral stimulation with breast milk can better promotes the oral feeding process of premature infants than the simple oral stimulation, by shorten IOF time and improve early NNS score, but does not shorten transition time from IOF to FOF and LOS. Trial registration The trial identification number is ChiCTR1800019134 (Chinese Clinical Trial Registry http://www.who.int/ictrp/network/chictr2/en/)

The effect of non-nutritive sucking combined with oral motor stimulation and oral support on feeding performance in premature infants: A single-blind randomized–clinical trial

PURPOSE: Feeding problems are common in premature infants (PIs) and may lead to negative consequences such as malnutrition, dehydration, excessive weight loss, as well as developmental and psychological deficits. Moreover, they are associated with increased length of hospital stay/cost. There is not enough evidence on how feeding problems should be treated in PIs. The goal of this study was to investigate the effects of non-nutritive sucking combined with oral motor stimulation and oral support on feeding performance in PIs. METHODS: A single-blind randomized clinical trial was performed on 44 PIs with feeding problems. Patients were randomly categorized into two groups: (1) combined intervention (CI) and (2) non-nutritive sucking (NNS). The CI group received NNS, oral motor stimulation and oral support simultaneously. Infants in both groups received 14 treatment sessions for 14 consecutive days. The Preterm Oral Feeding Readiness Assessment Scale (POFRAS) was used as the primary outcome measure. Weight, volume of milk intake, time to achieve full oral feeding, and length of hospital stay were secondary outcome measures. All measures were assessed before treatment, after the 7th session, after the 14th session, and after 7 days after the end of treatment. RESULTS: Both groups improved in all outcome measures across time (P < 0.001). The improvements in the POFRAS, volume of milk intake, and time to achieve full oral feeding were significantly greater in the CI group than the NNS group (P < 0.001). The improvements attained in weight and length of hospital stay were not significantly different between the CI and NNS groups (P > 0.05). Large effect sizes were found for POFRAS score in both CI (d = 3.98) and NNS (d = 2.19) groups. CONCLUSION: The current study showed that the combined intervention including NNS, oral motor stimulation, and oral support significantly improved the feeding performance in PIs.

Knowledge of Non-nutritive Digit Sucking Among Mothers of Under-Five Children in Ilorin, Nigeria

Background: The sucking habits of infants can be nutritive and non-nutritive sucking. Digit-sucking is normal in babies and young children, but sometimes it may persist into early childhood. Objective: To determine the burden, knowledge and belief of mothers/caregivers concerning digit sucking among under-five children. Methods: A cross-sectional study involving children under the age of 5 years attending the University of Ilorin Teaching Hospital, Ilorin, Nigeria, was conducted. The mothers of selected children were surveyed using an interviewer-administered questionnaire. Results: The prevalence of non-nutritive digit sucking was 45.8%. While 68 (43.9%) of these children sucked their digits, 3 (1.9%) sucked pacifiers. The thumb and two digits were the preferred digits (52.9%). Sucking was done while awake in 36 (52.9%) children while 32 (47.1%) sucked whether awake or sleeping. Most (60.3%) mothers have the wrong perception of digit sucking and had attempted to discourage it. Conclusions: The prevalence of non-nutritive and digit sucking was high in the population studied. Sucking occurs while awake and asleep, both day and night. Most mothers have the wrong perception of digit sucking and had attempted its stoppage.

Prevalence of Malocclusion and Associated Variables in Preschool Children of Tbilisi, Georgia

Background: Primary dentition is a determinant for future permanent occlusion. Objective: This aimed to evaluate the prevalence of malocclusion and associated variables in the primary dentition among preschoolers in the city of Tbilisi, Georgia. Methods: A cross-sectional survey was conducted among kindergarten children aged 3–5 years. Orthodontic characteristics were assessed by one calibrated clinician (E.G). Questionnaires were given to parents to record associated variables like general health problems, functional changes, and the presence of non-nutritive sucking habits. Results: A total of 396 participants aged 3-5 were included in the study. The prevalence of malocclusion was 49.8%, without significant differences among genders. The prevalence of Class II malocclusion was 21.2%(±4.091), followed by a deep overbite, i.e, 10.7% (±3.14), crossbite, i.e, 7% (±2.561), anterior open bite, i.e, 6.9%, and Class III malocclusion, i.e, 1.6% (±1.513). A total of 41.5% of children with breathing problems had Class II and 13% had crossbite. Speech disorder in 46.8% of cases was associated with anterior open bite. Pacifier users had Class II in 22.5%, deep overbite in 12.2%, and open bite in 9.2% of cases. There was a high prevalence of anterior open bite (25.2%) in children with a thumb-sucking habit (RR=4.90). These data sets are statistically reliable (p < 0.05). Conclusion: Almost half of the evaluated preschoolers had malocclusion. The most frequent disorder was Class II. Malocclusion is associated with non-nutritive sucking habits and mouth breathing.

The effectiveness of early intervention on malocclusion and its impact on craniofacial growth: A systematic review

This review aims to assess the available evidence related to the effectiveness of early interventions on malocclusion and its impact on the craniofacial structure among children under six years of age. Furthermore, we aimed to evaluate the correlation between nutritive sucking behavior mechanisms on the oral facial components. We searched Medline, Embase, Cochrane Library, Scopus, and the LILACS from inception to December 10, 2020, to identify published randomized and non-randomized controlled trials that investigated the broad spectrum of early interventions for the treatment of malocclusions among pediatric patients under six years old. We have also included studies that evaluated the impact or the relationship between feeding alternatives, malocclusion, and craniofacial growth. Reviewers working in pairs investigators independently performed title and abstract screening, full-text screening, data extraction, risk of bias assessment using ROBINS-I tool, and rated the certainty of evidence using GRADE. Seven studies were included (783 patients), with an overall risk of bias classified as critical. Early treatment was shown to improve facial asymmetry, particularly in the lower part of the face, along with an increase of palatal volume and palatal surface. Early treatment showed important reduction of mandibular protrusion and length, leading to favorable sagittal growth of the maxilla. Furthermore, the early intervention significantly enhanced the average bite force magnitude (from 318.20 N to 382.79 N) and increased the general thickness of facial muscles. Our findings suggest that the benefits generated by early orthodontic interventions are related to the improvement of craniofacial symmetry/bone structure, and refinement of masticatory ability and performance. Notwithstanding, there is still a need for further studies appraising patient-important outcomes, such as quality of life and nutritional features.

Effect of Oromotor Stimulation on Sucking and Feeding Performance of Preterm Neonates Admitted in Neonatal Care Unit of Selected Hospital, West Bengal

Feeding problem remains a common problem among preterm neonates. An experimental study was undertaken to assess the effect of oromotor stimulation on feeding and sucking performance of preterm neonates admitted in selected hospital, west Bengal. Quasi experimental time series design was adopted. From the population of preterm neonates 60 samples (30 in experimental group and 30 in control group) were selected by non-probability purposive sampling. After selection, initially the baseline data was collected using a record analysis proforma. On the 1st day sucking and feeding performance scoring was done before giving the oromotor stimulation to ascertain the homogeneity of the experimental and control group. After that in two consecutive feeding, oromotor stimulation was given to the neonates in experimental group before 15 minutes of the feeding. The intervention was given to the neonates in experimental group for the next two days, twice only in two consecutive feeding. Neonates in control group received routine care. Sucking and feeding performance scoring was done in both groups using a standardized non-nutritive sucking scoring scale and a validated and reliable early feeding performance scale. The result showed that there is significant difference in sucking performance (t=3.60, p<0.05) and feeding performance (t=3.78, p<0.05) among experimental and control group in final observation. It can be concluded that oromotor stimulation is effective to improve the feeding and sucking abilities of preterm neonates. In the neonatal care units, nurses can provide oromotor stimulation to improve feeding and sucking abilities of the preterm neonates. Keywords: Feeding, Sucking, Performance, Preterm, Oromotor stimulation, Neonates, Preterm neonates.

AWARENESS OF MOTHER WITH BABY PACIFIER

Introduction: Pacifiers consist of a latex or silicone nipple with a firm plastic shield and handle and are available in different forms and sizes. This is used in infant for colling and calming effect on infant however, it is related to many disadvantage and side effect on teeth of the infants. In this study we aimed to a Assess the interrelation between different on-nutritive sucking habits, pacifier use and thumb/digit sucking. Besides, Investigate the relationships between various non-nutritive sucking habits and occlusion in the primary dentition. Methodology: Following a comprehensive literature review, the questionnaire was designed and used for data collection. Then, a cross‐sectional survey was distributed throughout the internet for two months (October - November 2019) to 200 mothers in Riyadh, Saudi Arabia. The mothers answered 16 questions, where 5 of them were self-administered, while the others followed the pacifier and their effect on Breastfeeding and teeth. Initially, the participants have answered inquiries about the demographic information. Results: The results of our study include 202 mothers in which 55.9 % were between 18 -30 years old while 88.6 % of married while 6.4 % were widowed and the rest were divorced. Moreover, 67.3 % of mothers in this study started breast feeding but stopped it, while 15.3 % still breast feeding partially, 12.9 % still breasting feeding exclusively and 4.5 % never breast fed during the process of the survey. 58.9 % of mothers agree about the use of pacifier with their infants where younger mothers were more intended to agree about using of pacifier. Considering the reason behind using of pacifier, mothers reported that 74.3 % of mothers using pacifier because of its comfort or soothing effect. Moreover, 47.1 % of the sample thought that best time to start using pacifiers is from first week of birth and 49 % of mothers in this study thought that pacifier should be used for 4 hours per day. Finally, most of mother thought that the ideal time of pacifier cessation before the first year (45%). Conclusion: As with all infant care practices, there may be multiple factors influencing the parental decision to use or not use a pacifier for the infant. Some of these factors (e.g., concerns about nipple confusion, dental concerns) may be the result of misinformation. As pacifier use has been associated with a reduced risk for SIDS, it is important for health care providers to understand and be able to address the concerns that parents may have about pacifier use. In the hospital setting, providers should be aware that parents may have strong preferences about getting educated regarding pacifier use and its consequences.