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Background: As a result of the dental alterations pacifiers can cause, several designs have been described, differing in the shape and size of the teat. The aim of this review was to compare the influence of the physiological pacifier on the development of malocclusions in children with other types of pacifier. The research question was: does the use of physiological pacifiers cause less dentomaxillary alterations than other designs? Methods: A scoping review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using PubMed, Embase, and Scopus. The ROBINS-I risk of bias tool was used for the methodology assessment of the included studies. Results: Of the 122 articles identified in the initial search, 5 articles met all the inclusion criteria. In all of them, in general, the use of the pacifier caused malocclusions such as an anterior open bite, a posterior crossbite, an increased overjet, and an involvement of the overbite. Children who began using the physiological pacifier very early, between 0 and 3 months, were less likely to develop finger sucking/thumb sucking compared to children who started after 3 months. In the prevalence of open anterior bite and overjet, there was a significant difference between the use of conventional pacifiers and anatomical pacifiers compared to the use of physiological pacifiers. Conclusions: the physiological pacifier can cause fewer oral alterations and could be the best option as a pacifier, however, more well-designed and high-quality randomised clinical trials are required. [ABSTRACT FROM AUTHOR]

Acute bronchiolitis affects around 30 % of infants each winter in France. Breastfeeding (BF) is described as being protective against acute lower respiratory infections in developing countries, but this effect is more difficult to demonstrate in industrialized countries. Moreover, the effect of using a pacifier in the occurrence of bronchiolitis is not clearly established. In this context, the aim of the study was to investigate the link between BF and the use of a pacifier in the occurrence of bronchiolitis in children under 1 year of age who presented to five pediatric emergency centers in Pays de la Loire, France. A questionnaire collecting data on diet, sociodemographic characteristics, and the reason for presentation was provided at the admission to pediatric emergency centers in five hospitals in Pays de Loire, France, between 2018 and 2020. Children with bronchiolitis were included in group 1, and children consulting for other reasons (except gastrointestinal infections or otitis) were included in group 2. Breastfeeding was classified as exclusive breastfeeding (EBF) and partial breastfeeding (PBF). Pacifier use was classified as frequent and during sleep or not used. The study included 671 children under 1 year of age, including 174 (25.8 %) who were admitted with bronchiolitis. In univariate analysis, a significantly smaller number of children in group 1 s were breastfed (EBF and PBF) at admission compared with children in group 2:21.8 % versus 32.8 %, respectively, (OR=0.57, 95 % CI: 0.38–0.86, p = 0.006); furthermore, children in group 1 used a pacifier more often than those in group 2: 84.5 % versus 75.8 % (OR=1.74, 95 % CI: 1.10–2.76, p = 0.017). In multivariate analysis, after adjusting for age, ongoing BF or EBF beyond 9 and 12 months of age remained a protective factor; however, the protective effect of BF disappeared with the introduction of a pacifier, and pacifier use was significantly associated with bronchiolitis. The protective effect of BF against bronchiolitis was demonstrated independently of pacifier use. However, due to the strong association between pacifier use and bronchiolitis, the effect of BF weakened. The advice to be given to parents for BF and pacifier use is discussed. [ABSTRACT FROM AUTHOR]

La tétine, communément appelée sucette ou suce, est au cœur de vives controverses. On la juge responsable d'augmenter le risque d'otites moyennes et de troubles dentaires chez l'enfant, de nuire à l'allaitement et au développement du langage. Pour autant, elle est aussi associée à un moindre risque de mort inattendue du nourrisson et a un effet analgésique précieux dans le cas d'interventions douloureuses sur le nouveau-né. Quels sont les méfaits réellement identifiés par la science et pour quel type d'usage ? Quels sont, au contraire, les atouts de la tétine documentés par les recherches ? L'objectif de cet article est de faire le point sur les données scientifiques disponibles à son sujet pour permettre au professionnel, et à la famille, de faire un choix éclairé pour un usage adapté. C'est également l'occasion de se pencher sur l'une des fonctions premières de la tétine, celle de faire cesser les pleurs des bébés ; une fonction discutable qui vient interroger le regard ambivalent que l'on porte sur les pleurs des petits. If there's one childcare item that's long been the subject of passionate debate, it's the pacifier. They are thought to increase the risk of otitis media and dental problems in children, and to interfere with breastfeeding and language development. However, it is also associated with a lower risk of unexpected infant death syndrome, and has a valuable analgesic effect in the case of painful operations on newborns. But what harm has science actually identified, and for what type of use? What, on the contrary, are the advantages of pacifiers documented by research? The aim of this article is to take stock of the scientific data available on the subject, to enable professionals and families to make an informed choice for appropriate use. It's also an opportunity to look at one of the pacifier's primary functions: to stop babies crying. A questionable function that calls into question the ambivalent way in which we look at babies' crying. [ABSTRACT FROM AUTHOR]

Infant breastfeeding diagnostics remain subjective due to the absence of instrumentation to objectively measure and understand infant oral motor skills and suckling characteristics. Qualitative diagnostic exams, such as the digital suck assessment which relies upon a clinician's gloved finger inserted into the infant's mouth, produce a diversity of diagnoses and intervention pathways due to their subjective nature. In this paper, we report on the design of a non-nutritive suckling (NNS) system which quantifies and analyzes quantitative intraoral vacuum and sucking patterns of full-term neonates in real time. In our study, we evaluate thirty neonate suckling profiles to demonstrate the technical and clinical feasibility of the system. We successfully extract the mean suck vacuum, maximum suck vacuum, frequency, burst duration, number of sucks per burst, number of sucks per minute, and number of bursts per minute. In addition, we highlight the discovery of three intraoral vacuum profile shapes that are found to be correlated to different levels of suckling characteristics. These results establish a framework for future studies to evaluate oromotor dysfunction that affect the appearance of these signals based on established normal profiles. Ultimately, with the ability to easily and quickly capture intraoral vacuum data, clinicians can more accurately perform suckling assessments to provide timely intervention and assist mothers and infants towards successful breastfeeding outcomes.

Background: As a result of the dental alterations pacifiers can cause, several designs have been described, differing in the shape and size of the teat. The aim of this review was to compare the influence of the physiological pacifier on the development of malocclusions in children with other types of pacifier. The research question was: does the use of physiological pacifiers cause less dentomaxillary alterations than other designs? Methods: A scoping review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using PubMed, Embase, and Scopus. The ROBINS-I risk of bias tool was used for the methodology assessment of the included studies. Results: Of the 122 articles identified in the initial search, 5 articles met all the inclusion criteria. In all of them, in general, the use of the pacifier caused malocclusions such as an anterior open bite, a posterior crossbite, an increased overjet, and an involvement of the overbite. Children who began using the physiological pacifier very early, between 0 and 3 months, were less likely to develop finger sucking/thumb sucking compared to children who started after 3 months. In the prevalence of open anterior bite and overjet, there was a significant difference between the use of conventional pacifiers and anatomical pacifiers compared to the use of physiological pacifiers. Conclusions: the physiological pacifier can cause fewer oral alterations and could be the best option as a pacifier, however, more well-designed and high-quality randomised clinical trials are required.

Pacifiers are a common soothing tool used by parents to calm and comfort infants and toddlers. While pacifiers can provide temporary relief, there is growing concern about the potential long-term effects of prolonged pacifier use on language and cognitive development. Previous studies have suggested that prolonged use of pacifiers may have negative consequences on language outcomes in infants and toddlers, especially during the first few years of life known to be a critical period for language development. Previous studies have shown that children who use pacifiers extensively have smaller vocabulary sizes at 1 and 2 years of age which can have subsequent effects on socioemotional. In addition, significant association between greater frequency of daytime pacifier use and worsening of cognitive outcomes was shown. Furthermore, research has shown a strong dose--response association between intense pacifier use up to 4 years of age and lower IQ at 6 years. Recently, the importance of oral motor movements and sensorimotor production for speech perception in infants as young as 6 months has been highlighted, raising important questions on the effect of oral motor movement restrictions at an early age. Together, these findings raise concern about the potential long-term effects of prolonged pacifier use on language and cognitive development at a critical time in child development. However, it is still debatable within the scientific field the potential relationship between pacifier use and language development in early life most likely due to the complexity of studying child development. This mini review aims to provide valuable insights for parents, caregivers, and healthcare professionals in making informed decisions and understand regarding pacifier use for infants and toddlers. [ABSTRACT FROM AUTHOR]

Craniofacial growth and development have been shown to be influenced by various environmental factors that impact child development. This study aims to analyze the different patterns of feeding during early childhood, starting from birth, and assess the variability of nutrition during the first stage of childhood, along with the habits developed, to study their impact on jaw development. The study was conducted on a sample of twenty-five patients aged 3 to 5, following approval from the ethics committee of the Catholic University of Valencia. Informed consent was obtained from the fathers, mothers, and/or legal guardians, who were administered surveys on habits and diet. Cephalometric measurements within the parameters of ideal occlusion were subsequently taken. While previous studies examined this subject, the findings are challenging to evaluate. However, this study identified significant associations (p = 0.001) between clinical measurements and children's eating habits. The growth and development of the craniofacial cavity are influenced by multiple factors, including a child's diet and habits. Nonetheless, further research is required to determine whether diet can be considered a determining factor in proper jaw growth. [ABSTRACT FROM AUTHOR]

Increased dental overjet in adolescence is a clinically relevant outcome associated with the complexity and high cost of treatment, indicating the need for prevention strategies. We investigated the long-term impact of breastfeeding and pacifier use on increased overjet (IOVJ) in permanent dentition. A prospective cohort nested in a randomized controlled trial was conducted from birth to 12 years of age (n = 214). Breastfeeding and pacifier use were recorded monthly until 12 months. Overjet was assessed at age 12 years. We employed a causal mediation analysis using parametric regression models assuming no interaction between breastfeeding and pacifier usage. We found a total protective effect of breastfeeding on IOVJ (OR 0.49; 95% CI 0.28–0.96), where 63.1% were mediated by pacifier use (OR 0.61; 95% CI 0.44–0.87). Breastfeeding directly decreased the odds of IOVJ by 20%; however, the confidence interval included the null estimate (OR 0.81; 95% CI 0.41–1.60). In conclusion, breastfeeding protects by half of the IOVJ in adolescence through reducing pacifier use. Oral and general health professionals should collaborate to support WHO breastfeeding guidelines during individual patient counseling. Guidelines for practice, policy or public information require messages that include a common risk approach to oral and general health. [ABSTRACT FROM AUTHOR]

Infant breastfeeding diagnostics remain subjective due to the absence of instrumentation to objectively measure and understand infant oral motor skills and suckling characteristics. Qualitative diagnostic exams, such as the digital suck assessment which relies upon a clinician’s gloved finger inserted into the infant’s mouth, produce a diversity of diagnoses and intervention pathways due to their subjective nature. In this paper, we report on the design of a non-nutritive suckling (NNS) system which quantifies and analyzes quantitative intraoral vacuum and sucking patterns of full-term neonates in real time. In our study, we evaluate thirty neonate suckling profiles to demonstrate the technical and clinical feasibility of the system. We successfully extract the mean suck vacuum, maximum suck vacuum, frequency, burst duration, number of sucks per burst, number of sucks per minute, and number of bursts per minute. In addition, we highlight the discovery of three intraoral vacuum profile shapes that are found to be correlated to different levels of suckling characteristics. These results establish a framework for future studies to evaluate oromotor dysfunction that affect the appearance of these signals based on established normal profiles. Ultimately, with the ability to easily and quickly capture intraoral vacuum data, clinicians can more accurately perform suckling assessments to provide timely intervention and assist mothers and infants towards successful breastfeeding outcomes.

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Background: Parent-child saliva contact during infancy might stimulate the child’s immune system for effective allergy prevention. However, few studies have investigated its relation to allergy development in school-age children. Objective: We sought to investigate the relationship between parent-child saliva contact during infancy and allergy development at school age. Methods: We performed a large multicenter cross-sectional study involving Japanese school children and their parents. The self-administered questionnaires including questions from the International Study of Asthma and Allergies in Childhood were distributed to 3570 elementary and junior high school children in 2 local cities. Data were analyzed for the relationship between saliva contact during infancy (age

Craniofacial growth and development have been shown to be influenced by various environmental factors that impact child development. This study aims to analyze the different patterns of feeding during early childhood, starting from birth, and assess the variability of nutrition during the first stage of childhood, along with the habits developed, to study their impact on jaw development. The study was conducted on a sample of twenty-five patients aged 3 to 5, following approval from the ethics committee of the Catholic University of Valencia. Informed consent was obtained from the fathers, mothers, and/or legal guardians, who were administered surveys on habits and diet. Cephalometric measurements within the parameters of ideal occlusion were subsequently taken. While previous studies examined this subject, the findings are challenging to evaluate. However, this study identified significant associations (p = 0.001) between clinical measurements and children’s eating habits. The growth and development of the craniofacial cavity are influenced by multiple factors, including a child’s diet and habits. Nonetheless, further research is required to determine whether diet can be considered a determining factor in proper jaw growth.

Abstract Background Pacifiers have been shown to affect maxillary growth related to the anatomic structure of the palate and forces placed upon it during sucking. This study compares and evaluates the mechanical behavior of pacifiers of different design and size (i.e., fit), identified by brand and size, positioned in age-specific palatal models with respect to both contact area and force when subjected to peristaltic tongue function and intraoral pressure related to non-nutritive sucking. Methods Nonlinear finite element analyses were used to simulate dynamic mechanical interaction between the pacifiers and palates. Time-varying, external pressure loads were applied which represent intraoral pressure arising from non-nutritive sucking and peristaltic behavior of the tongue. The silicone rubber pacifier bulb was represented using a hyperelastic material model. Results Results from the finite element analyses include deformation, stress, strain, contact area, and contact force. Mechanical interaction was evaluated in terms of the spatial distribution of the contact area and force between the pacifier and the palate. The resulting palatal interaction profiles were quantitatively compared to assess how pacifier fit specifically affects the support provided to two areas of the palate, the palatal vault and the Tektal wall. Conclusions Pacifiers interact with the palate differently based on their fit (i.e., design and size) regardless of whether they are labeled conventional or orthodontic. Finite element analysis is an effective tool for evaluating how a pacifier’s design affects functional mechanics and for providing guidance on biometric sizing.

Introduction: The most important purpose in neonatal pain management is to minimize the pain felt by newborns and to help the newborn cope with pain. This study planned to examine the effects of two non-pharmacological methods, using pacifiers or maternal holding, on neonates’ pain admitted to the outpatient clinic (OC) and hospitalized in the Neonatal Intensive Care Unit (NICU). Material and Methods: Ninety newborns (30 used pacifiers, 30 maternal holding,30 control) who applied to the OC and 60 newborns (30 used pacifiers, 30 control) admitted to the NICU were prospectively included in this study. The Neonatal Infant Pain Scale (NIPS) was used to evaluate behavioral responses to pain perception. Physiological parameters of newborns and their durations of crying were also evaluated. Results: When the NIPS scores were analyzed in OC group during and after the procedure, the lowest score was found in the group using pacifiers (p lt;0.001). As for the NICU patients, both during and after the procedure, NIPS scores were found to be significantly lower in the pacifier users (p lt;0.001). It was observed that giving pacifiers and mathernal holding had positive effects on physiological parameters and duration of crying in OC patients (p lt;0.05). No significant difference in the NIPS score was found between OC and NICU group. Conclusion: This study showed that giving pacifiers and maternal holding during the procedure of blood sampling decreased the NIPS score, restored the changes in physiological parameters and decreased the duration of crying.

Background: Infant care, crucial for the well-being of infants, is an inherent human practice. Although there are important implications of infant care practices on infant health, there is a dearth of comprehensive studies covering all important aspects of infant care in an individual study. Objectives: To determine practices regarding infant feeding, infant sleep, use of pacifiers, and immunization, and to explore the association of these practices with mother's demographic data. Methods: A cross-sectional study was conducted using a self-administrated questionnaire distributed among mothers attending well-baby clinics in Primary Health Care Centers (PHCCs), Unaizah city, Qassim region, Saudi Arabia. By using the two-stage cluster sampling method, 50 women participated from each of the four selected PHCCs, leading to a total of 200 participants. The survey was conducted from December 2020 to February 2021. Data were analyzed using SPSS software. Results: A total of 124 (62%) respondents were between the ages of 26 and 35 years, 64% had a bachelor's degree, and 69.5% were housewives. Breastfeeding was practiced by 88% of women, 48% began infant weaning at 6 months of age, and 49% put their infant to sleep on their back. Up-to-date vaccination was reported for 188 (94%) infants. Infant pacifier use was reported by 58% of the respondents, and 82.5% of the participants had been offered formula milk for the newborn at the hospital. Vaginal delivery, absence of complications during pregnancy or labor, presence of a housemaid, and family income of more than 10,000 Saudi Riyals were significantly associated with better infant care practices. Conclusion: The study participants have good practices for certain infant care aspects such as immunization; however, improvement is needed for other practices, including weaning at the proper age, infant sleep position, and the use of pacifiers. Administrative measures are required to monitor the use of formula milk at hospitals and to enhance health education for mothers.

Background: Breastfeeding is very important for the proper nutrition and growth of the child, as well as, the health of the mother. To start breastfeeding, the neonate must have extensive oral capacities for sucking functions but, premature neonates may not have the muscle strength needed to suck successfully. However, the non-nutritive sucking achieved by using a pacifier, has been identified by previous research as a factor associated with shorter duration and exclusivity of breastfeeding. This study aims to perform a systematic review to investigate the relationship between pacifier use in preterm neonates and breastfeeding in infancy. Methods: We included prospective studies, as well as randomized controlled studies that evaluated the association between pacifier use by preterm neonates and of breastfeeding in infancy. Ten research articles from PubMed/Medline, Google Scholar and Crossref were included in the review from a total of 1455 articles. The results differ depending on the type of study.Most prospective studies have shown a negative correlation between pacifier use and breastfeeding, while the randomized controlled studies found a positive correlation. Conclusions: Pacifier use in preterm infants helps transition from tube to oral feeding, breastfeeding, faster weight gain and earlier discharge from the NICU. However, the relationship between pacifiers and breastfeeding is more complicated, as it appears to be influenced by additional risk factors. [ABSTRACT FROM AUTHOR]

Abstract Objectives The objective of this study is to demonstrate that computational finite element models can be used to reliably simulate dynamic interaction between a pacifier, the palate, and the tongue during nonnutritive sucking (NNS). The interactions can be quantified by the results of finite element analyses which include deformation, strain, stress, contact force, and contact area. Materials and Methods A finite element model was created based upon CAD solid models of an infant pacifier and palate. The silicone pacifier bulb is represented by a hyperelastic constitutive law. Contact surfaces are defined between the pacifier and palate. A time and spatially varying pressure load is applied to the bulb representing peristaltic interaction with the tongue. A second time‐varying, periodic pressure representing NNS is applied to the model simultaneously. A large displacement, nonlinear transient dynamic analysis is run over two NNS cycles. Results Results from the finite element analysis show the deformed shape of the bulb with maximum principal elastic strain of 0.23 and a range of maximum principal stress on the palate from 0.60 MPa (tensile) to −0.27 MPa (compressive) over the NNS cycles. The areas of contact between the pacifier and the palate are shown in surface contour plots. Conclusions A nonlinear transient dynamic finite element model can simulate the mechanical behavior of a pacifier and its interaction with the tongue and contact with the palate subject to NNS. Quantitative results predicting deformation, strain, stress, contact force, and contact area can be used in comparative studies to provide insight on how pacifiers cause changes in dental, orthognathic, and facial development.

The purpose of this study is to assess whether pacifier use is associated with breastfeeding success in term and preterm newborns and whether it influences hospitalization time in preterm newborns. Four databases were searched for randomized controlled trials (RCTs), and a systematic review and meta-analysis were conducted. The risk of bias and evidence quality, according to the GRADE methodology, were analyzed. Risk ratios with 95% confidence intervals (CI) for dichotomous outcomes and mean difference (MD) for continuous outcomes were used. The random effect model was used if heterogeneity was high (I2 over 40%). We screened 772 abstracts, assessed 44 full texts, and included 10 studies, of which 5 focused on term and 5 on preterm newborns. There were a few concerns about the risk of bias in 9 of the 10 studies. Breastfeeding rates were analyzed at 2, 3, 4, and 6 months, and the success rates were similar between the restricted and free pacifier use groups (evidence quality was moderate to high). In preterm neonates, the use of a pacifier shortened the duration of hospitalization by 7 days (MD 7.23, CI 3.98-10.48) and the time from gavage to total oral feeding by more than 3 days (MD 3.21 days, CI 1.19-5.24) (evidence quality was ranked as moderate).   Conclusions: Based on our meta-analysis, pacifier use should not be restricted in term newborns, as it is not associated with lower breastfeeding success rates. Furthermore, introducing pacifiers to preterm newborns should be considered, as it seems to shorten the time to discharge as well as the transition time from gavage to total oral feeding. What is Known: • Observational studies show that infants who use a pacifier are weaned from breastfeeding earlier. • Previous randomized studies have not presented such results, and there have been no differences in the successful breastfeeding rates regardless of the use of pacifier. What is New: • Term and preterm newborns do not have worse breastfeeding outcomes if a pacifier is introduced to them, and additionally preterm newborns have shorter hospitalization times. • The decision to offer a pacifier should depend on the caregivers instead of hospital policy or staff recommendation, as there is no evidence to support the prohibition or restriction. [ABSTRACT FROM AUTHOR]

Background: Infant care, crucial for the well-being of infants, is an inherent human practice. Although there are important implications of infant care practices on infant health, there is a dearth of comprehensive studies covering all important aspects of infant care in an individual study. Objectives: To determine practices regarding infant feeding, infant sleep, use of pacifiers, and immunization, and to explore the association of these practices with mother's demographic data. Methods: A cross-sectional study was conducted using a self-administrated questionnaire distributed among mothers attending well-baby clinics in Primary Health Care Centers (PHCCs), Unaizah city, Qassim region, Saudi Arabia. By using the two-stage cluster sampling method, 50 women participated from each of the four selected PHCCs, leading to a total of 200 participants. The survey was conducted from December 2020 to February 2021. Data were analyzed using SPSS software. Results: A total of 124 (62%) respondents were between the ages of 26 and 35 years, 64% had a bachelor's degree, and 69.5% were housewives. Breastfeeding was practiced by 88% of women, 48% began infant weaning at 6 months of age, and 49% put their infant to sleep on their back. Up-to-date vaccination was reported for 188 (94%) infants. Infant pacifier use was reported by 58% of the respondents, and 82.5% of the participants had been offered formula milk for the newborn at the hospital. Vaginal delivery, absence of complications during pregnancy or labor, presence of a housemaid, and family income of more than 10,000 Saudi Riyals were significantly associated with better infant care practices. Conclusion: The study participants have good practices for certain infant care aspects such as immunization; however, improvement is needed for other practices, including weaning at the proper age, infant sleep position, and the use of pacifiers. Administrative measures are required to monitor the use of formula milk at hospitals and to enhance health education for mothers. [ABSTRACT FROM AUTHOR]

This retrospective case-control study is the first to examine the spatial conformity between pacifiers and palates in 39 preterm infants (12 females, 27 males) and 34 term infants (19 females, 15 males), taking into account the facial-soft-tissue profile and thickness. The shape of 74 available pacifiers was spatially matched to the palate, and conformity was examined using width, height, and length measurements. In summary, the size concept of pacifiers is highly variable and does not follow a growth pattern, like infant palates do. Pacifiers are too undersized in width, length, and height to physiologically fit the palate structures from 0 to 14 months of age. There are two exceptions, but only for premature palates: the palatal depth index at 9–11 months of age, which has no clinical meaning, and the nipple length at <37 weeks of age, which bears a resemblance to the maternal nipple during non-nutritive sucking. It can be concluded that the age-size concept of the studied pacifiers does not correspond to any natural growth pattern. Physiologically aligned, pacifiers do not achieve the age-specific dimensions of the palate. The effects attributed to the products on oral health in term infants cannot be supposed. [ABSTRACT FROM AUTHOR]

Objective: The aim was to investigate the influence of pacifier removal on the development of masticatory function and taste sensitivity in preschool children. Methods: Sixty children (mean age 48.2 months) were divided into two groups: pacifier group (n = 28) and a control group (n = 32), which were evaluated and followed up for a period of 12 months (at baseline, 6 months, and 1 year). Masticatory and swallowing functions were assessed using the Mastication Observation and Evaluation (MOE) protocol and Orofacial Myofunctional Rating (MBGR), respectively. Detection thresholds for sucrose and urea were measured by the staircase method. The two-way ANOVA mixed model was used for time*group interaction analysis. Results: MOE scores improved significantly over time in both groups, although a significant difference between groups persisted after 1 year. On the other hand, swallowing scores were significantly different at baseline, but within 1 year, the scores were no longer different between groups. Chewing time and the number of cycles were not different between groups and both decreased after 1 year. Sucrose sensitivity was significantly greater in the control group at baseline and changed over time (p < 0.05), being no longer different between groups after 6 months. Bitter sensitivity did not differ over time nor between groups. Conclusions: Detection threshold for sucrose differed significantly between children with and without pacifier habit at a mean age of 42 months. Total masticatory function did not self-correct after sucking habit removal within a 1-year period. Clinical relevance: Children with pacifier habit showed important changes in masticatory function that did not self-correct 1 year after cessation of the habit, highlighting the need for prevention and habit interruption as early as possible. [ABSTRACT FROM AUTHOR]

Background: Pacifiers have been shown to affect maxillary growth related to the anatomic structure of the palate and forces placed upon it during sucking. This study compares and evaluates the mechanical behavior of pacifiers of different design and size (i.e., fit), identified by brand and size, positioned in age-specific palatal models with respect to both contact area and force when subjected to peristaltic tongue function and intraoral pressure related to non-nutritive sucking. Methods: Nonlinear finite element analyses were used to simulate dynamic mechanical interaction between the pacifiers and palates. Time-varying, external pressure loads were applied which represent intraoral pressure arising from non-nutritive sucking and peristaltic behavior of the tongue. The silicone rubber pacifier bulb was represented using a hyperelastic material model. Results: Results from the finite element analyses include deformation, stress, strain, contact area, and contact force. Mechanical interaction was evaluated in terms of the spatial distribution of the contact area and force between the pacifier and the palate. The resulting palatal interaction profiles were quantitatively compared to assess how pacifier fit specifically affects the support provided to two areas of the palate, the palatal vault and the Tektal wall. Conclusions: Pacifiers interact with the palate differently based on their fit (i.e., design and size) regardless of whether they are labeled conventional or orthodontic. Finite element analysis is an effective tool for evaluating how a pacifier's design affects functional mechanics and for providing guidance on biometric sizing. [ABSTRACT FROM AUTHOR]

Objective The aim of this narrative review is to highlight the association of ineffective feeding practices with the development of malocclusion in children and the role of a pediatric dentist in identifying the cues and signs of improper feeds, and encourage effective breastfeeding practices. Introduction There has been an ongoing debate on the role of effective breastfeeding in the prevention of malocclusion. Although no specific claim supports the positive impact of the same, a detailed reviewing of the literature helps to identify the method of feeding to be chosen considering health benefits and personal preference. Materials and Methods A broad search of all resources linked to the topic was performed in PubMed, Medline, World Health Organization web site, government web sites, and Google Scholar search engine. Keywords used in the search included breastfeeding, ineffective breastfeeding, bottle feeding, pacifier, and malocclusion. A total of 60 articles published in the period from 2000 to 2019 were segregated. Selected articles comprised original research, meta-analysis, and systematic reviews. Results Parameters such as duration, posture, and non-nutritive sucking habits had an impact on effective breastfeeding. Discussion Effective breastfeeding and maintaining appropriate posture and duration helps to positively impact the normal growth and development of the jaws, muscular functioning, and speech. Thereby, the risk of developing malocclusion in primary dentition can be prevented. Conclusion An understanding of the role of breastfeeding and malocclusion will help in the early intervention and prevention of malocclusion and deviated muscular function. Highlighting the role of counseling and effective feeding practices is also an area that should be focused upon by budding clinicians. [ABSTRACT FROM AUTHOR]

Introduction:Breast milk is not only the ideal nourishment for babies, but is also unique in terms of its health benefits for mothers and economic benefits for the society. The World Health Organization and United Nations Children’s Fund support exclusive breastfeeding for the first 6 months of post-natal life.Methods:A total of 355 mothers who all delivered in our hospital were included in this study. A questionnaire was created to include questions regarding the mothers’ opinions about breast milk and their reasons for continuing or discontinuing exclusive breastfeeding. We collected other data separately, including the socio-cultural and socio-economic characteristics of the mothers, fathers and babies. Using the data collected, the mothers were grouped and compared according to their breastfeeding behaviour. Fathers were also grouped according to their paternal characteristics and their potential impact on the mothers’ breastfeeding behaviour was investigated.Results:In this study, 49% of the mothers expressed the belief that breast milk is healthy and protects babies from diseases. Of the mothers who discontinued exclusive breastfeeding, 44.3% did so because they thought their milk was insufficient for their babies. In addition, 56.5% of mothers continued exclusive breastfeeding at post-natal month 4 and 35.2% at month 6. A higher percentage of mothers with a high level of education continued exclusive breastfeeding (p=0.011). There was no statistically significant difference between the different age groups in terms of breastfeeding behaviour. Mothers with healthy medical histories were found to have continued exclusive breastfeeding for longer periods than the others (p=0.037). Mothers who had help at home also continued exclusive breastfeeding for longer periods (p=0.031). Mothers using pacifiers were found to have a higher exclusive breastfeeding discontinuation rate than the others (p=0.007).Conclusion:The leading reasons for discontinuing breastfeeding are incorrect and inadequate information about breastfeeding. Therefore, it is imperative that mothers are supported with appropriate and consistent education, both before and after birth, regarding the benefits of continued breastfeeding.

Objectives: The objective of this study is to demonstrate that computational finite element models can be used to reliably simulate dynamic interaction between a pacifier, the palate, and the tongue during nonnutritive sucking (NNS). The interactions can be quantified by the results of finite element analyses which include deformation, strain, stress, contact force, and contact area. Materials and Methods: A finite element model was created based upon CAD solid models of an infant pacifier and palate. The silicone pacifier bulb is represented by a hyperelastic constitutive law. Contact surfaces are defined between the pacifier and palate. A time and spatially varying pressure load is applied to the bulb representing peristaltic interaction with the tongue. A second time‐varying, periodic pressure representing NNS is applied to the model simultaneously. A large displacement, nonlinear transient dynamic analysis is run over two NNS cycles. Results: Results from the finite element analysis show the deformed shape of the bulb with maximum principal elastic strain of 0.23 and a range of maximum principal stress on the palate from 0.60 MPa (tensile) to −0.27 MPa (compressive) over the NNS cycles. The areas of contact between the pacifier and the palate are shown in surface contour plots. Conclusions: A nonlinear transient dynamic finite element model can simulate the mechanical behavior of a pacifier and its interaction with the tongue and contact with the palate subject to NNS. Quantitative results predicting deformation, strain, stress, contact force, and contact area can be used in comparative studies to provide insight on how pacifiers cause changes in dental, orthognathic, and facial development. [ABSTRACT FROM AUTHOR]

Objective To evaluate two different feeding methods for Yinzhihuang oral liquid in the treatment of neonatal jaundice. Methods Totally 200 neonatal jaundice cases requiring oral administration of Yinzhihuang oral liquid were randomly divided into the control group and the observation group, with 100 cases in each group. The disposable 5ml syringe was used to feed neonates with Yinzhihuang oral liquid in the control group, and the disposable pacifier was used as an auxiliary feeding device in the observation group. The adverse reactions to oral administration and length of time spent in medication were recorded. Results The incidences of choking cough, vomiting and overflowing drug liquid in the observation group were lower than those in the control group (P＜0. 05), and length of time spent in medication was shorter in the observation group were lower than that in the control group (P＜0. 05). Conclusion In the treatment of neonatal jaundice, the combined use of disposable pacifier and disposable syringe is effective to reduce the risk of choking cough, vomiting and overflowing drug liquid, and shorten the length of time spent in oral medication. (目的 对比两种不同喂药方法在茵栀黄口服液治疗新生儿黄疸中的应用效果。方法 选取入住新生儿科的200例需要口服茵栀黄的黄疸患儿, 随机分为2组, 对照组(n=100)采用一次性5 mL注射器喂药, 观察组(n=100)采用一次性奶嘴辅助一次性注射器喂药。对比2组黄疸患儿的反应、喂药时间等方面的差异。结果 观察组黄疸患儿呛咳、呕吐、溢药等不良反应发生率低于对照组, 喂药所需时间较对照组少, 差异有统计学意义(P＜0. 05)。结论 茵栀黄口服液治疗新生儿黄疸中, 采用一次性奶嘴辅助一次性注射器能有效降低新生儿呛咳、呕吐、溢药的发生风险, 缩短口服给药所需时间。)

Background: Breastfeeding is very important for the proper nutrition and growth of the child, as well as, the health of the mother. To start breastfeeding, the neonate must have extensive oral capacities for sucking functions but, premature neonates may not have the muscle strength needed to suck successfully. However, the non-nutritive sucking achieved by using a pacifier, has been identified by previous research as a factor associated with shorter duration and exclusivity of breastfeeding. This study aims to perform a systematic review to investigate the relationship between pacifier use in preterm neonates and breastfeeding in infancy. Methods: We included prospective studies, as well as randomized controlled studies that evaluated the association between pacifier use by preterm neonates and of breastfeeding in infancy. Ten research articles from PubMed/Medline, Google Scholar and Crossref were included in the review from a total of 1455 articles. The results differ depending on the type of study.Most prospective studies have shown a negative correlation between pacifier use and breastfeeding, while the randomized controlled studies found a positive correlation. Conclusions: Pacifier use in preterm infants helps transition from tube to oral feeding, breastfeeding, faster weight gain and earlier discharge from the NICU. However, the relationship between pacifiers and breastfeeding is more complicated, as it appears to be influenced by additional risk factors.

Background: Literature on pacifier use remains controversial, but mostly suggests an inverse association with childhood intelligence. Objectives: The objective of this study was to assess the association between pacifier use and intelligence quotient (IQ) in six‐year‐old children from a birth cohort. Methods: Data from 3532 children from the 2004 Pelotas (Brazil) Birth Cohort were analysed. Children were recruited and assessed at birth and followed up at 3 months, and 1, 2, 4, and 6 years. Data on pacifier use duration and intensity were obtained via interviews with mothers in all six follow‐up visits. IQ was estimated at 6 years using the Wechsler Intelligence Scale for Children and standardised for the analyses. Crude and adjusted coefficients were calculated (linear regression) for all the data collected in follow‐up assessments for pacifier use. Results: IQ was inversely associated with all pacifier use indicators. Children who used a pacifier all day long (ADL) at any follow‐up showed an IQ 0.18 (95% confidence interval [CI] 0.11, 0.24) standard deviations below those who never used it ADL, after adjusting for confounders. The strength of association increased with number of assessments reporting ADL pacifier use, from a reduction in IQ of 0.13 (95% CI 0.06, 0.21) to 0.34 (95% CI 0.15, 0.52) standard deviations for ADL use in one and in all four follow‐up visits, respectively. Conclusions: We found a strong association between intense pacifier use up to 4 years of age and lower IQ at 6 years. A dose‐response gradient was observed, with greater IQ deficits in children who used a ADL pacifier for longer durations. The mechanisms underlying this association need to be clarified. One hypothesis is that children using a pacifier, especially those who use it more intensely, are less stimulated. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

SIDS - Sudden Infant Death Syndrome is a sudden, unexpected death of an infant during sleep, which can not be justified by a medical history or post-mortem examination. This is undoubtedly one of the worst situations that young parents can encounter. Fear for child is enormous and often man tries to do everything to protect his offspring from danger, pain and illness. Unfortunately, SIDS concern healthy-growing infants, who are not suspected of any disease. The vast majority of cases occur in a baby cot, less often in the bed of parents, a pram or a car seat. It mainly concerns children up to 6 months old, but it also happens at a later age. The aim of this work is to discuss the risk factors and prevention of Sudden Infant Death Syndrome

The use of a pacifier is recommended to support sucking reflex during transition from gavage feeding to oral feeding and ensure readiness for feeding. A randomized controlled experimental design was used to determine the effect of a pacifier given before feeding on physiological characteristics and feeding performance in preterm infants initially fed orally. The data were obtained from preterm infants (N = 72) born before 31st gestational week, who were admitted to Newborn Intensive Care Unit of a training and research hospital affiliated with Ministry of Health between January 2017–July 2018 and met the case selection criteria. Heart rates, oxygen saturation levels and feeding performances of preterm infants in both groups before, during, and after feeding were compared. Heart rates of preterm infants in the experimental group were statistically significantly lower (Experimental: 139.64 ± 10.16; Control: 149.31 ± 8.40; p < 0.01) and their oxygen saturation levels were higher (Experimental: 97.22 ± 2.22; Control: 96.33 ± 1.93; p < 0.05). Feeding efficiency rates (Experimental: 1.94 ± 1.19; Control: 0.69 ± 0.34; p < 0.01) and the percentage of food intake (Experimental: 89.5 ± 23.93; Control: 70.86 ± 27.41; p < 0.01) of newborns in the experimental group were statistically significantly higher and their feeding duration was shorter (Experimental: 10.58 ± 8.29; Control: 16.14 ± 8.31; p < 0.01). It was determined that a pacifier given before feeding is effective on regulating physiological parameters and supporting feeding performance in preterm infants. The use of a pacifier in the first transition to oral feeding in preterm infants supports their sucking reflex, calms them down, and ensures the readiness for feeding. • The use of a pacifier in preterm infants prior to feeding facilitates sucking, swallowing, and breathing during oral feeding. • The use of a pacifier before feeding in preterm infants increases the feeding efficiency rate and the amount of food taken. • NNS application supports the oral feeding performance and development of sucking ability in preterm infants. • The use of a pacifier before initial feeding in preterm infants lowers heart rate of the infants during and after feeding. • NNS before initial feeding in preterm infants leads to higher oxygen saturation levels of the infants during and after feeding. [ABSTRACT FROM AUTHOR]

This retrospective case-control study is the first to examine the spatial conformity between pacifiers and palates in 39 preterm infants (12 females, 27 males) and 34 term infants (19 females, 15 males), taking into account the facial-soft-tissue profile and thickness. The shape of 74 available pacifiers was spatially matched to the palate, and conformity was examined using width, height, and length measurements. In summary, the size concept of pacifiers is highly variable and does not follow a growth pattern, like infant palates do. Pacifiers are too undersized in width, length, and height to physiologically fit the palate structures from 0 to 14 months of age. There are two exceptions, but only for premature palates: the palatal depth index at 9–11 months of age, which has no clinical meaning, and the nipple length at

Background: The association between prolonged non‐nutritive sucking habits (NNSHs, ie, sucking pacifiers or fingers) and maxillofacial growth anomalies in the general population has been widely described. Because maturation of sucking abilities is not fully achieved in very preterm infants (<32 weeks' gestation), neonatal services worldwide rely on the use of pacifiers to promote the development of adequate sucking reflexes, possibly prolonging NNSHs during infancy. Objective: We aimed to describe the frequency and to identify factors associated with NNSHs at age 2 years in very preterm children. Methods: The study was based on data from EPIPAGE‐2, a French national prospective cohort study of preterm births during 2011 that included 2593 children born between 24 and 31 weeks' gestation. The primary outcome was NNSHs at 2 years. Multivariable log‐linear regression models with generalized estimation equations were used to study the association between the characteristics studied and NNSHs. Multiple imputations were used to take into account missing data. Results: The frequency of NNSHs was 69% in the overall sample but higher among girls (adjusted risk ratio [RR] 1.12, 95% confidence interval [CI] 1.05, 1.17), children born from multiple pregnancies (eg, twins/triplets) (RR 1.07, 95% CI 1.00, 1.11), children who were fed by nasogastric tube (RR 1.07, 95% CI 1.01, 1.13), or those who benefitted from developmental care programmes (RR 1.10, 95% CI 1.02, 1.19). The NNSHs frequency was lower if mothers were not born in France (RR 0.70, 95% CI 0.64, 0.77), children had 2 or more older siblings (RR 0.88, 95% CI 0.82, 0.96), or children were breast‐fed at discharge (RR 0.90, 95% CI 0.85, 0.95). Conclusions: NNSHs at 2 years seemed associated with cultural background, development care programmes, and breast feeding. Whether NNSHs at 2 years among very preterm children are associated with future maxillofacial growth anomalies deserves further attention. [ABSTRACT FROM AUTHOR]

Background: Pacifier use is a major cause of anterior open bite (AOB), which negatively impacts the quality of life of children affected. Aim: To assess the direct and indirect pathways related to pacifier sucking habit and AOB in preschool children. Design: This 2‐year cohort study evaluated a random sample of preschool children (2‐5 years of age) from Southern Brazil. Caregivers answered a questionnaire addressing socio‐economic and behavioural characteristics. Anterior open bite was recorded following the criteria recommended by Foster and Hamilton. Structural equation model was performed to assess the direct and indirect pathways among variables at baseline (T1) to predict the AOB at follow‐up (T2). Results: Regarding the AOB, 407 children were evaluated at T1 and 187 at T2. The prevalence of AOB was 32.9% at baseline and 16.0% at follow‐up. The presence of AOB at follow‐up was directly affected by the change in pacifier sucking habit from T1 to T2. Considering the indirect paths, the AOB at T1 influenced the AOB in T2 via a change of pacifier sucking habit. Conclusion: These findings suggest that the non‐habit of sucking pacifiers is a fundamental strategy for the prevention of AOB as well as the promotion of health in childhood. [ABSTRACT FROM AUTHOR]

Few things affect us as much as facial expressions, as they inform us about others’ feelings and intentions, thereby influencing our own emotions and behaviors. A substantial body of literature links the critical abilities of recognizing and understanding emotion displays with facial mimicry, a sensorimotor process involving rapid imitation of perceived expressions. For example, blocking or altering facial mimicry in adults leads to disruptions in judgments in emotion recognition or emotional language processing. The present review focuses on pacifier use in infancy, a common practice that has the potential to interfere with infants’ facial movements in ways identical to laboratory paradigms designed to block facial mimicry. Despite this similarity and the widespread use of infant soothers, little is known about their long-term effects. Here we review studies exploring the psychological correlates and implications of pacifier use. In particular, we discuss how soothers may interfere with the development of social skills in infants and present evidence linking pacifier use with disrupted adults’ mimicry of facial expressions displayed by infants. Other preliminary findings reveal negative correlations between the use of soothers and children’s spontaneous facial mimicry as well as emotional competence of young adults. Such studies, although correlational, suggest that this widespread parenting practice may affect the development of social skills by influencing emotional coordination. We discuss the implications of these findings and propose avenues for future research that can provide insights into the role of embodied processes in the development of emotional competence and adult functioning.

Abstract Background Although breastfeeding duration in New Zealand’s indigenous Māori is shorter than in non-Māori, we know little about barriers or motivators of breastfeeding in this community. The aim of this analysis was to identify predictors for extended duration of breastfeeding amongst participants drawn from predominantly Māori communities in regional Hawke’s Bay. Methods Mother/baby dyads were recruited from two midwifery practices serving predominantly Māori women in mostly deprived areas, for a randomised controlled trial comparing the risks and benefits of an indigenous sleeping device (wahakura) and a bassinet. Questionnaires were administered at baseline (pregnancy) and at one, three and six months postnatal. Several questions relating to breastfeeding and factors associated with breastfeeding were included. The data from both groups were pooled to examine predictors of breastfeeding duration. Results Māori comprised 70.5% of the 197 participants recruited. The median time infants were fully breastfed was eight weeks and Māori women were more likely to breastfeed for a shorter duration than New Zealand European women with an odds-ratio (OR) of 0.45 (95% CI 0.24, 0.85). The key predictors for extended duration of breastfeeding were the strong support of the mother’s partner (OR = 3.64, 95% CI 1.76, 7.55) or her mother for breastfeeding (OR = 2.47, 95% CI 1.27, 4.82), longer intended duration of maternal breastfeeding (OR = 1.02, 95% CI 1.00, 1.03) and being an older mother (OR = 1.07, 95% CI 1.02, 1.12). The key predictors for shorter duration of breastfeeding were pacifier use (OR = 0.28, 95% CI 0.17, 0.46), daily cigarette smoking (OR = 0.51, 95% CI 0.37, 0.69), alcohol use (OR = 0.54, 95% CI 0.31, 0.93) and living in a more deprived area (OR 0.40, 95% CI 0.22, 0.72). Conclusions Breastfeeding duration in this group of mainly Māori women was shorter than the national average. Increasing the duration of breastfeeding by these mothers could be further facilitated by ante and postnatal education involving their own mothers and their partners in the support of breastfeeding and by addressing pacifier use, smoking and alcohol use.

Abstract Background Non-nutritive sucking habits may adversely affect the orofacial complex. This systematic literature review aimed to find scientific evidence on the effect of pacifier sucking on orofacial structures. Methods A search on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases was conducted to find all pertinent articles published from inception until February 2018, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the studies was evaluated using the risk of bias judgements in non-randomized studies of interventions (ROBINS-I). Results Among the 2288 articles found, 17 articles met the selection criteria: seven prospective cohort studies, nine cross-sectional studies, and one randomized clinical trial. Using ROBINS-I, 12 studies were evaluated to have a serious overall risk of bias and five, a moderate one. These studies claimed a strong association between a pacifier sucking habit and the presence of an anterior open bite and posterior crossbite. Functional/orthodontic pacifiers were shown to cause significantly less open bites than the conventional ones. Conclusions High level of evidence of the effect of sucking habits on orofacial structures is missing. The available studies show severe or moderate risk of bias; hence, the findings in the literature need to be very carefully evaluated. There is moderate evidence that the use of pacifier is associated with anterior open bite and posterior crossbite, thus affecting the harmonious development of orofacial structures. Functional/orthodontic pacifiers reduce the prevalence of open bite when compared to the conventional ones, but evidence is needed concerning the effects on posterior crossbite. Well-designed randomized controlled trials are needed to further analyze the effects of functional/orthodontic and conventional pacifiers on orofacial structures.

The majority of observational studies have found associations between pacifier use and shorter breastfeeding duration. Results from four randomised controlled trials did not reveal any difference in breastfeeding outcomes. The relationship between early pacifier use and breastfeeding outcomes remains unclear. To investigate whether a recommendation of early pacifier use affects the proportion of breastfeeding at six months compared to a recommendation to avoid pacifier use during the first two weeks. An open, randomised controlled trial with parallel group design; 239 primiparous mothers and their term infants were randomly assigned to an intervention group or a control group. The primary outcome was the proportion of breastfeeding at six months. Secondary outcomes were the proportions of breastfeeding and breastfeeding problems at two and four months. To investigate factors which may influence breastfeeding, a multivariate logistic regressions analysis was performed. A total of 209 participants (87.5%) completed the study. There were no significant differences between the groups with respect to breastfeeding at six months. No negative association for breastfeeding between early versus late introduction of pacifier was found. Factors significantly associated with cessation of breastfeeding at six months were: use of nipple shield, intention to breastfeed, severe breastfeeding problems at two weeks, pacifier use at two months and lower educational level. Early versus late recommendation of pacifier introduction did not affect the proportion of breastfeeding at six months. However, the compliance to the randomised group was insufficient. No negative association was found in the observational analysis. [ABSTRACT FROM AUTHOR]

Perturbations to the speech articulators induced by frequently using an interfering object during infancy (i.e., pacifier) might shape children's language experience and the building of conceptual representations. Seventy-one typically developing third graders performed a semantic categorization task with abstract, concrete and emotional words. Children who used the pacifier for a more extended period were slower than the others. Moreover, overusing the pacifier increased response time of abstract words, whereas emotional and (above all) concrete words were less affected. Results support the view that abstract words are grounded both in perception-action and in linguistic experience. [ABSTRACT FROM AUTHOR]

Introduction: Breast milk is not only the ideal nourishment for babies, but is also unique in terms of its health benefits for mothers and economic benefits for the society. The World Health Organization and United Nations Children's Fund support exclusive breastfeeding for the first 6 months of post-natal life. Methods: A total of 355 mothers who all delivered in our hospital were included in this study. A questionnaire was created to include questions regarding the mothers' opinions about breast milk and their reasons for continuing or discontinuing exclusive breastfeeding. We collected other data separately, including the socio-cultural and socio-economic characteristics of the mothers, fathers and babies. Using the data collected, the mothers were grouped and compared according to their breastfeeding behaviour. Fathers were also grouped according to their paternal characteristics and their potential impact on the mothers' breastfeeding behaviour was investigated. Results: In this study, 49% of the mothers expressed the belief that breast milk is healthy and protects babies from diseases. Of the mothers who discontinued exclusive breastfeeding, 44.3% did so because they thought their milk was insufficient for their babies. In addition, 56.5% of mothers continued exclusive breastfeeding at post-natal month 4 and 35.2% at month 6. A higher percentage of mothers with a high level of education continued exclusive breastfeeding (p=0.011). There was no statistically significant difference between the different age groups in terms of breastfeeding behaviour. Mothers with healthy medical histories were found to have continued exclusive breastfeeding for longer periods than the others (p=0.037). Mothers who had help at home also continued exclusive breastfeeding for longer periods (p=0.031). Mothers using pacifiers were found to have a higher exclusive breastfeeding discontinuation rate than the others (p=0.007). Conclusion: The leading reasons for discontinuing breastfeeding are incorrect and inadequate information about breastfeeding. Therefore, it is imperative that mothers are supported with appropriate and consistent education, both before and after birth, regarding the benefits of continued breastfeeding. [ABSTRACT FROM AUTHOR]

Few things affect us as much as facial expressions, as they inform us about others' feelings and intentions, thereby influencing our own emotions and behaviors. A substantial body of literature links the critical abilities of recognizing and understanding emotion displays with facial mimicry, a sensorimotor process involving rapid imitation of perceived expressions. For example, blocking or altering facial mimicry in adults leads to disruptions in judgments in emotion recognition or emotional language processing. The present review focuses on pacifier use in infancy, a common practice that has the potential to interfere with infants' facial movements in ways identical to laboratory paradigms designed to block facial mimicry. Despite this similarity and the widespread use of infant soothers, little is known about their long-term effects. Here we review studies exploring the psychological correlates and implications of pacifier use. In particular, we discuss how soothers may interfere with the development of social skills in infants and present evidence linking pacifier use with disrupted adults' mimicry of facial expressions displayed by infants. Other preliminary findings reveal negative correlations between the use of soothers and children's spontaneous facial mimicry as well as emotional competence of young adults. Such studies, although correlational, suggest that this widespread parenting practice may affect the development of social skills by influencing emotional coordination. We discuss the implications of these findings and propose avenues for future research that can provide insights into the role of embodied processes in the development of emotional competence and adult functioning. [ABSTRACT FROM AUTHOR]

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The aim of this study was to verify whether sucking habits influence the position of the primary incisors. The sample comprised 34 preschool children (mean age 44 months ± 9 months). They were divided into three groups: group B (n = 9) with a baby bottle habit; group BP (n = 13) with baby bottle and pacifier habits; and a control group C (n = 12) with no sucking habit. Data were derived from face- to- face interviews with the parents/guardians, oral examinations, study casts, facial photographs (frontal/lateral views), and cephalograms. The cephalograms were scanned and subsequently analyzed by one trained and calibrated operator. The cephalometric parameters recorded were: interincisal angle (U1/L1), U1/NA (angle/distance), and L1/NB (angle/distance). The data were analyzed using Stata 7.0. The Kruskall-Wallis test was used to compare the cephalometric measurements in the children with and without sucking habits. The level of significance was set at P ⩽ .05. This study found a significant relationship between existing sucking habits and a protrusion of the maxillary and mandibular primary incisors. [ABSTRACT FROM AUTHOR]

Abstract Background The use of pacifiers is an ancient practice, but often becomes a point of debate when parents and professionals aim to protect and promote breastfeeding as most appropriately for nurturing infants. We discuss the current literature available on pacifier use to enable critical decision-making regarding justifiable use of pacifiers, especially in the Baby-Friendly Hospital Initiative context, and we provide practical guidelines for clinicians. Discussion Suck-swallow-breathe coordination is an important skill that every newborn must acquire for feeding success. In most cases the development and maintenance of the sucking reflex is not a problem, but sometimes the skill may be compromised due to factors such as mother–infant separation or medical conditions. In such situations the use of pacifiers can be considered therapeutic and even provide medical benefits to infants, including reducing the risk of sudden infant death syndrome. The argument opposing pacifier use, however, is based on potential risks such as nipple confusion and early cessation of breastfeeding. The Ten Steps to Successful Breastfeeding as embedded in the Baby-Friendly Hospital Initiative initially prohibited the use of pacifiers in a breastfeeding friendly environment to prevent potential associated risks. This article provides a summary of the evidence on the benefits of non-nutritive sucking, risks associated with pacifier use, an identification of the implications regarded as ‘justifiable’ in the clinical use of pacifiers and a comprehensive discussion to support the recommendations for safe pacifier use in healthy, full-term, and ill and preterm infants. Summary The use of pacifiers is justifiable in certain situations and will support breastfeeding rather than interfere with it. Justifiable conditions have been identified as: low-birth weight and premature infants; infants at risk for hypoglyceamia; infants in need of oral stimulation to develop, maintain and mature the sucking reflex in preterm infants; and the achievement of neurobehavioural organisation. Medical benefits associated with the use of pacifiers include providing comfort, contributing towards neurobehavioural organisation, and reducing the risk of sudden infant death syndrome. Guidelines are presented for assessing and guiding safe pacifier use, for specific design to ensure safety, and for cessation of use to ensure normal childhood development.