BACKGROUND: In Western countries during the 1960s and 1970s, sore nipples and insufficient milk were common problems that made it hard for mothers to maintain breastfeeding for long. This study investigated the relationship of breastfeeding problems to nursing behavior and pacifier use. METHODS: Fifty-two healthy mother-infant pairs with breastfeeding problems were referred for observation of nursing behavior to a breastfeeding clinic at the Department of Pediatrics of Malmö General Hospital, Malmö, Sweden, from August 1987 to July 1989. The infants ranged in age from 1 to 17 weeks. A faulty nursing pattern was corrected as necessary. Forty mother-infant pairs with no breastfeeding problems provided a control group. RESULTS: In most cases the nursing problems were related to incorrect sucking technique. The difference in technique of the study group compared with the control group was significant (p = 0.0001). The continuation of breastfeeding was poorer if the infant already had become used to bottle-feeding. Pacifier use was more common in conjunction with breastfeeding problems and in cases with a faulty superficial nipple-sucking technique. CONCLUSION: Breastfeeding problems may be prevented by the adoption of hospital routines that do not interfere with the start of breastfeeding and by the avoidance of extensive use of pacifiers.
Active digit-sucking results in 1) reduced vertical growth of the frontal parts of alveolar process which creates an anterior open bite; 2) proclination of the upper incisors as a result of the horizontal force created by the digit; 3) anterior displacement of the maxilla for the same reason; 4) anterior rotation of the maxilla, resulting in an increased prevalence of posterior crossbite in the deciduous dentition; and 6) proclination or retroclination of the lower incisors which seems to be due to the strength of the tightness of the lower lip and tongue activity during sucking. When the sucking habit stops, the anterior open bite will correct itself spontaneously, due to increased growth of the alveolar processes, provided that the patient is still growing. If the lip activity and the lip/teeth relationship is normal, the upper incisors will upright themselves, and sometimes, due to the anterior displacement of maxilla, become somewhat retroclined. The skeletal effect of the sucking habit will remain. Improper use of a pacifier can create quite disastrous effects on the occlusion, if, for instance, the child has the shield. Otherwise, the effect of the pacifier is limited to the vertical and the transversal plane. The anterior open bite is normally more obvious and visible earlier in pacifier-suckers than in digit-suckers. As in digit-suckers, the open bite is associated with tongue-thrust during swallowing. Also in pacifier-suckers, the open bite will correct itself spontaneously when the habit stops despite the tongue-thrust. Sucking a pacifier is more clearly related to a posterior crossbite in the deciduous dentition than is digit-sucking. When the pacifier is in the child's mouth, the teat occupies the upper part of the anterior and middle part of the mouth thus forcing the tongue to a lower position. In the upper jaw, the teeth in the canine area lack palatal support from the tongue during the sucking activity of the cheeks. This reduces the arch width and increases the risk of a transversal malrelation between the upper and lower arches. The low tongue position widens the lower jaw in the same area thus enhancing the probability of the development of a posterior cross-bite.
OBJECTIVES, DESIGN AND SUBJECTS: Earlier results on the effect of breastfeeding on the one hand, and non-nutritive sucking habits (pacifier and/or digit sucking) on the other, on the orofacial development of infants are inconclusive. Thus we studied the prevalence of malocclusions and their relationship to the duration of breastfeeding and to non-nutritive sucking habits in a group of randomly selected 3-year-old children (n = 148).
Posterior crossbite was detected in 13%, anterior open bite in 18% and large overjet (> 3 mm) in 26% of the children. The proportion of children with anterior vertical open bite was significantly larger among children with non-nutritive sucking habits than among the other children (P
Breast milk has been shown to contribute significantly to positive neurodevelopmental and medical outcomes in the extremely low birth weight (ELBW) infant population. It is crucial that ELBW infants receive their mother's colostrum as a first feeding, followed by expressed breast milk for as long as possible. Evidence-based literature supports the difficult challenges both mothers and ELBW infants face if they are to succeed at breast pumping and breastfeeding. Influencing factors include the medical fragility of the infant, limited frequency and duration of kangaroo care between mother and infant, lack of an adequate volume of breast milk, as well as inconsistent or incorrect information surrounding the use of breast milk and breastfeeding. A feeding care map as described in this article can help the bedside nurse assist the mother-ELBW infant dyad in optimizing breast milk volumes, laying the groundwork for breastfeeding. Displaying supportive practices and preterm infant developmental milestones, the map categorizes infant, maternal, and dyad feeding issues along a progressive time line from admission to discharge.
BACKGROUND: This study was designed to test the hypothesis that incorrect sucking technique and pacifier use are factors contributing to breastfeeding failure. METHOD: The nursing patterns of 82 exclusively breastfeeding mother-infant pairs were observed 4 to 5 days postpartum on the maternity ward at University Hospital in Malmö, Sweden. The breastfeeding outcome and pacifier use was assessed by regular telephone contacts during a 4-month follow-up. RESULTS: The breastfeeding rate at 4 months was 91 percent in the nonpacifier group and 44 percent in the pacifier group (p = 0.03). An incorrect superficial nipple-sucking technique at the breast from the start combined with pacifier use resulted in early weaning in most cases. CONCLUSION: To promote successful breastfeeding and to reduce nursing problems, an incorrect sucking technique should be prevented or corrected, and the use of pacifiers should be avoided or restricted.
In a prospective study of 13 preterm twins still in the hospital, 85% were breast-fed, of which 46% were breast-fed exclusively. Most mothers preferred simultaneous breast-feeding, using the football hold. Observations and maternal descriptions showed differences between the twins in their development of breast-feeding behavior, especially in sucking. The mothers' suggestions regarding special support for the breast-feeding mothers of preterm twins involved synchronizing feeding with the twins' behavioral states; twin cobedding; appropriate armchairs and breast-feeding pillows; experimenting with breast-feeding positions; information about breast milk production; nurses' spontaneous practical assistance, encouragement, and emotional support; the provision of privacy; the availability of parent rooms; and opportunities for fathers' presence in the hospital.
Exclusive breastfeeding was studied among 506 infants in Uppsala, Sweden, based on daily recordings during the first 6 mo. The mothers had previously breastfed at least one infant for at least 4 mo. Most of the mothers considered that they breastfed on demand. Wide variations in breastfeeding frequency and suckling duration were found both between different infants and in the individual infant over time. At 2 wk, the mean frequency of daytime feeds (based on one 13-d record) between different infants ranged from 2.9 to 10.8 and night-time feeds from 1.0 to 5.1. The daytime suckling duration (based on one 24-h record) ranged from 20 min to 4h 35 min and night-time duration from 0 to 2h 8 min. At any given age, a maximum of only 2% of the infants were not breastfed during the night. At 4 mo, 95% of the infants were breastfeeding and 40% were exclusively breastfed at this age. Longer breastfeeding duration and longer duration of exclusive breastfeeding were both associated with higher frequency of breastfeeds, longer breastfeeding of the previous child and higher education. No gender differences were found. Maternal smoking was associated with shorter duration of exclusive breastfeeding, and pacifier use was associated with shorter duration of both exclusive breastfeeding and total breastfeeding. This study confirms that every mother-infant pair needs to be understood as a unique dyad throughout lactation. These data demonstrate a wide range of patterns among women who are exclusively breastfeeding and indicate that it would be inappropriate to put pressure on individual families to adopt preconceived patterns of infant feeding.
Department of Women's and Children's Health, Section for International Maternal and Child Health, Uppsala University, Uppsala, Sweden. clara.aarts@ich.uu.se
OBJECTIVES: To analyze the influence of thumb sucking and pacifier use on breastfeeding patterns in exclusively breastfed infants, on the duration of exclusive breastfeeding, and on the total breastfeeding duration. STUDY DESIGN: Descriptive, longitudinal, prospective study. SETTING: The subjects were recruited from a population of 15 189 infants born in the maternity ward at the University Hospital, Uppsala, Sweden between May 1989 and December 1992. STUDY POPULATION: 506 mother-infant pairs. METHODS: Daily recordings by the mothers on infant feeding from the first week after delivery through the duration of the study. Fortnightly home visits with structured interviews by a research assistant. RESULTS: Pacifier use was associated with fewer feeds and shorter suckling duration per 24 hours, shorter duration of exclusive breastfeeding, and shorter total breastfeeding duration compared with no pacifier use. These associations were not found for thumb sucking. The possible negative effects of pacifiers on breastfeeding seemed to be related to the frequency of their use. Maternal age and education only slightly modified the association between pacifier use and breastfeeding duration. CONCLUSIONS: More frequent use of a pacifier was associated with shorter breastfeeding duration, even among a group of mothers who were highly motivated to breastfeed. breastfeeding duration, breastfeeding pattern, exclusive breastfeeding, pacifier use, thumb sucking.
OBJECTIVES: The aim of this study was to describe oral development and morphology in 18-month-old children with Down syndrome (DS) treated with palatal plates in combination with structured communication and speech training. The aim is further to describe the design of the palatal plates, compliance in their use and to give a brief report of their effect on oral motor function and speech. SAMPLE AND METHODS: Forty-two children with DS were followed from
The purpose of this study was to describe the dietary habits of infants and toddlers living in Sweden with special reference to caries prevalence at 2 and 3 years of age and to immigrant status. The study was designed as a prospective, longitudinal study starting with 671 children aged 1 year. At 3 years, all children were invited to a further examination. A total of 298 individuals, randomly selected from the original group, were also examined at 2 years. The accompanying parent was interviewed about the child's dietary habits. Children with caries at 2 and 3 years of age and immigrant children had, when they were 1 year old, consumed caries-risk products and been given nocturnal meals and sweetened liquid in a feeding bottle more often than caries-free 2- and 3-year-olds and non-immigrant children. Although a great variation in dietary habits was found in infants and toddlers, the use of sugar-containing products is widespread in Sweden even in early childhood.
