Prevalence of malocclusion in early childhood and its associated factors in a primary care service in Brazil

ABSTRACT Purpose to evaluate the prevalence of malocclusion and its associated factors of children cared for by a PHC Service in Porto Alegre, Brazil. Methods a cross-sectional study nested in a cohort, carried out in 12 Health Care Practices. Of the 414 children in the cohort examined, 268 were assessed for malocclusion. The presence of anterior open bite, posterior and anterior crossbite was evaluated by the criteria of Foster and Hamilton. Socioeconomic variables, breastfeeding habits and pacifier use information were collected through a standardized questionnaire. Data analysis was performed using a hierarchical approach by Poisson Regression with robust variance. Results out of the total 268 evaluated, 135 (50.4%) were boys, and the average age was 28.6 (± 11.9) months. Out of the 143 (53.4%) cases of malocclusion, 113 were anterior open bite, 16 were anterior crossbite, 27 were posterior crossbite, and 38 had increased overjet. In the final analysis, it was observed that there was a higher prevalence of malocclusion in children who never breastfed (PR = 1.44; 95%CI 1.00-2.08) and who always used a pacifier to sleep (PR = 1.81; 95%CI 1.14-2.86). Conclusion the prevalence of malocclusion in this population was high and was associated with behavioral habits, such as the use of pacifier and not breastfeeding.

Feeding practices and early weaning in the neonatal period: a cohort study

OBJECTIVE To describe feeding practices and the risk factors for the mixed breastfeeding and early weaning in the neonatal period. METHODS Cohort study, which we collected socioeconomic, demographic, health care and feeding data from 415 mother/child binomials born in four public maternity hospitals in Natal/Brazil. They were followed-up at 48 hours, 7 and 28 days after birth. The association was established using Pearson’s Chi-square test and Poisson’s regression, after adjusting it to other variables. RESULTS The prevalence of mixed breastfeeding in the first 2 days was 47,2% and early weaning in 7 and 28 days was 8,4% and 16,2% in that order. The main reasons for mixed breastfeeding and early weaning were: colostrum deficiency (33.8%), difficulty in latching/sucking (23.5%) and “little milk” (70.0%). The use of formula/milk/porridge remained associated with maternal age ≤ 20 years (RR = 0.64; 95%CI: 0.47–0.86), age 20–29 years (RR = 0,70; 95%CI: 0,57–0,87), primiparity (RR = 1.37; 95%CI: 1.11–1.60) and cesarean delivery (RR = 1.20; 95%CI: 1.00–1.45) at 2 days; absence of paternal support (RR = 4.98; 95%CI: 2.54–9.79) and pacifier use (RR = 3.21; 95%CI: 1.63–6.32) at 7 days; and only pacifier use (RR = 2.48; 95%CI: 1.53–4.02) at 28 days. CONCLUSIONS Early weaning was associated with maternal and health care factors, thus suggesting the need to readjust good practices and educational actions to achieve the exclusive offer to the maternal breast in the neonatal period.

357Infant pacifier sanitization and risk of food allergy: the Barwon Infant Study

Background Environmental microbial exposure and human gut microbiota play a role in development of the immune system and susceptibility to food allergy. Pacifier use has been inconsistently associated with allergy, but the association between sanitization and food allergy is unknown. We investigated the association between infant pacifier use, with a consideration of sanitization, and food allergy at age 1 in the Barwon Infant Study (BIS). Methods Questionnaire data were collected prospectively from pregnant mothers from the Barwon region of south-east Australia at baseline and at infant ages 1, 6, and 12 months. Pacifier sanitization was defined as the joint exposure of a pacifier and cleaning methods (antiseptic, mouth, tap water, boiling). Challenge-proven food allergy was determined at age 1. Results Any pacifier use at 6 months was associated with food allergy (aOR, 1.94; 95% CI, 1.04-3.61), but not at other ages. This overall association was driven by the joint exposure pacifier-antiseptic use (aOR, 5.90; 95% CI, 2.18-15.97) compared to no pacifier use. Among pacifier users, pacifier-antiseptic was still associated with food allergy (aOR, 3.88; 95% CI, 1.55-9.72) when compared to pacifier-no antiseptic use. Further, increased use of pacifier-antiseptic at 0, 1 or 2 interviews over the first 6 months was associated with higher food allergy risk (ptrend=0.005). Conclusions Joint exposure to antiseptics and pacifiers at 6 months increased the odds of food allergy, showing a trend with increased use over time. Key messages This is the first report of pacifiers used with antiseptic being positively associated with challenge-proven food allergy.

Sustained Pacifier Use is Associated with Smaller Vocabulary Sizes at 1 and 2 Years of Age.

Pacifier use during childhood has been hypothesised to interfere with language processing.Recent evidence suggests that transient use of an object in the infant’s mouth (a teething toy)impairs speech sound discrimination and that extensive pacifier use translates into slowerprocessing of abstract words at 7-8 years, but to date no studies have revealed detrimentaleffects of prolonged pacifier use on infant vocabulary learning. The present pre-registeredstudy tests the hypothesis that greater accumulated pacifier use is associated with smallervocabulary sizes at 12- (in comprehension and production) and 24-months of age (inproduction).

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.

Effects of Pacifiers on Peripheral Capillary Oxygen Saturation during Wake Time

We studied the variations in peripheral capillary oxygen saturation (SpO2) during wake time in relation to pacifier use and to the following different positions: supine at 0°, supine at 30° (in babies under one year) vs. sitting (in babies between 1 and 3 years of age). We observed 54 patients under the age of three years, weighing over 1.800 g. Peripheral oxygen saturation was recorded for at least 40 min per patient in the following positions: 20 min lying supine at 0° (10 min with a pacifier and 10 min without); 20 min lying supine at 30° inclination or in a sitting position if the baby was older than one year (10 min with a pacifier and 10 min without). Pacifier use improved the peripheral oxygen saturation both in the 0° supine position, and at 30° in a sitting position. No significant differences were observed in the SpO2 levels comparing the different positions. In conclusion a pacifier thus seems to have a positive effect on respiration.

Maintenance of Maternal Breastfeeding up to 6 Months: Predictive Models

Background: There is evidence of the benefits of exclusive breastfeeding (EBF) but maintaining EBF for the minimum recommended time of 6 months is challenging. Aims: This study aimed to determine the prevalence of breastfeeding types in a Spanish setting, explore the influencing factors, and analyze the relationships between the reasons for EBF cessation and the EBF durations achieved. Method: This longitudinal descriptive study included 236 healthy children with standard weight followed up by the public health system. A baseline survey and three telephone interviews (1, 3, and 6 months) were conducted. Results: The prevalence of EBF at 6 months was 19.49%. The mean age of the mothers was 32.3 (±5.3). The variables influencing EBF maintenance were the prior decision to practice EBF (p = 0.03), the belief that EBF is sufficient (p = 0.00), not offering water or fluid to the child (p = 0.04), delaying pacifier use (p < 0.001), a longer gestation time (p = 0.05), and previous experience with practicing EBF for more than 6 months (p = 0.00). The reason for the earliest EBF cessation (mean 52.63 ± 56.98 days) was the mother’s lack of self-efficacy (p = 0.05). Conclusion: Knowing the reasons for EBF cessation among mothers is important for helping mothers and preventing early weaning. A safe environment and support can prevent early weaning.

609 Comparing parental sleep goals for younger versus older toddlers

Introduction This study aimed to assess parental sleep goals, comparing younger (12-23.9-month-olds) and older toddlers (24-35.9-month-olds) in consideration of developmental differences. Methods Parents (98.0% mothers) of 401 toddlers (12–35 mos; M=22.49 mos; 49% male) in the US completed an online survey, including an abbreviated Brief Infant Sleep Questionnaire and a list of 58 desired areas of change (DACs). There were 230 one-year-olds (1yos; M=17.42mos) and 171 two-year-olds (2yos; M=29.30mos), with no difference in parent age between groups (M=34.41 years). Results 25.7% reported a perceived sleep-problem, whereas 94.8% indicated at least one sleep-related DAC. Parents of one- and two-year-olds reported similar rates of DAC for overnight sleep (58% vs. 49%), morning sleep (55% vs. 52%), and naps (70% vs. 64%), p&gt;.05. Parents of 2yos, however, reported bedtime as a DAC at a higher rate (59% vs. 79%), p&lt;.001. Twenty-five percent of specific bedtime DACs (n=8) were endorsed by ≥10% of parents. Parents endorsed falling asleep without an adult (17% of 1yos vs. 22% of 2yos) and falling asleep without nursing (10% vs. 9%) at similar rates, p&gt;.05. Parents of two-year-olds were more likely to endorse: getting through bedtime routine quickly/easily without stalling (10% vs. 30%,), earlier bedtime (10% vs. 24%), falling asleep faster at bedtime (24% vs. 10%), falling asleep without a pacifier (11% vs. 19%), falling asleep faster while alone (8% vs. 16%), and falling asleep without stalling/making requests (3% vs. 18%), p&lt;.05. Conclusion The majority of parents of toddlers endorsed a sleep-related desired area of change, with two-thirds wanting to change something about bedtime and naps, and over half wanting to change something about overnight and morning sleep. Parents of older toddlers (2yos) were more likely to desire changes at bedtime than parents of younger toddlers (1yos), especially related to stalling and discontinuing pacifier use. As toddlers age, bedtime problems are more likely. Health care providers should be aware of developmental changes, such as increased language and assertions of independence, that seem to mostly affect bedtime when addressing sleep issues in toddlers. Support (if any) Johnson & Johnson Consumer Inc., Skillman, NJ, USA.