The relationship of bottle feeding and other sucking behaviors with speech disorder in Patagonian preschoolers

<p>Abstract</p> <p>Background</p> <p>Previous studies have shown that children's nonnutritive sucking habits may lead to delayed development of their oral anatomy and functioning. However, these findings were inconsistent. We investigated associations between use of bottles, pacifiers, and other sucking behaviors with speech disorders in children attending three preschools in Punta Arenas (Patagonia), Chile.</p> <p>Methods</p> <p>Information on infant feeding and sucking behaviors, age starting and stopping breast- and bottle-feeding, pacifier use, and other sucking behaviors, was collected from self-administered questionnaires completed by parents. Evaluation of speech problems was conducted at preschools with subsequent scoring by a licensed speech pathologist using age-normative standards.</p> <p>Results</p> <p>A total of 128 three- to five-year olds were assessed, 46% girls and 54% boys. Children were breastfed for an average of 25.2 (SD 9.6) months and used a bottle 24.4 (SD 15.2) months. Fifty-three children (41.7%) had or currently used a pacifier for an average of 11.4 (SD 17.3) months; 23 children (18.3%) were reported to have sucked their fingers. Delayed use of a bottle until after 9 months appeared to be protective for subsequent speech disorders. There was less than a one-third lower relative odds of subsequent speech disorders for children with a delayed use of a bottle compared to children without a delayed use of a bottle (OR: 0.32, 95% CI: 0.10-0.98). A three-fold increase in relative odds of speech disorder was found for finger-sucking behavior (OR: 2.99, 95% CI: 1.10-8.00) and for use of a pacifier for 3 or more years (OR: 3.42, 95% CI: 1.08-10.81).</p> <p>Conclusion</p> <p>The results suggest extended use of sucking outside of breastfeeding may have detrimental effects on speech development in young children.</p

Methodological aspects of the 1993 Pelotas (Brazil) Birth Cohort Study.

This paper describes the main methodological aspects of a cohort study, with emphasis on its recent phases, which may be relevant to investigators planning to carry out similar studies. In 1993, a population based study was launched in Pelotas, Southern Brazil. All 5,249 newborns delivered in the city's hospitals were enrolled, and sub-samples were visited at the ages of one, three and six months and of one and four years. In 2004-5 it was possible to trace 87.5% of the cohort at the age of 10-12 years. Sub-studies are addressing issues related to oral health, psychological development and mental health, body composition, and ethnography. Birth cohort studies are essential for investigating the early determinants of adult disease and nutritional status, yet few such studies are available from low and middle-income countries where these determinants may differ from those documented in more developed settings

Características da sucção nutritiva na liberação da via oral em recém-nascidos pré-termo de diferentes idades gestacionais Characteristics of nutritive sucking in the release for oral feeding in preterm newborns of different gestational ages

OBJETIVO: Analisar as características da sucção nutritiva na liberação da via oral em recém-nascidos pré-termo (RNPT) de diferentes idades gestacionais. MÉTODOS: A amostra constou de 32 RNPT, avaliados no momento da liberação para alimentação por via oral, dividida em dois grupos: Grupo 1 (G1) com idade gestacional inferior a 34 semanas; e Grupo 2 (G2) com idade gestacional igual ou superior a 34 semanas. O desempenho da sucção nutritiva foi avaliado observando-se presença ou ausência de blocos de sucção, número e tempo das sucções nos três primeiros blocos apresentados, e presença ou ausência de coordenação entre sucção/deglutição/respiração (S/D/R). Nenhum RNPT recebeu estimulação fonoaudiológica prévia. RESULTADOS: O G2 apresentou, na maioria dos RNPT, presença de coordenação entre S/D/R, além de melhor desempenho em relação ao número e ao tempo de sucção nos blocos de sucção quando comparado ao G1. Na correlação do número versus tempo de sucção por bloco, o G1 apresentou resultados aproximados aos do G2. Considerando-se a classificação quanto ao desenvolvimento intra-útero adequado para a idade gestacional, os RNPT do G1 apresentaram desempenho semelhante aos do G2, no primeiro e segundo blocos, observando-se queda, no G1, apenas no terceiro bloco. CONCLUSÃO: O melhor desempenho no padrão de sucção nutritiva foi apresentado pelo G2, sugerindo que a idade gestacional corrigida dos RNPT interfere diretamente nos resultados obtidos na avaliação da sucção nutritiva. Assim sendo, esta também é uma variável a ser considerada para liberação da alimentação por via oral.<br>PURPOSE: To analyze the characteristics of nutritive sucking in preterm infants of different gestational ages after the medical prescription for oral feeding. METHODS: The sample comprised 32 preterm infants who were evaluated at the time they were released for oral feeding. The subjects were divided into two groups: Group 1 (G1), with gestational ages below 34 weeks; and Group 2 (G2), with gestational ages equal or above 34 weeks. Performance during nutritive sucking was evaluated by observing presence or absence of suction blocks, number and duration of suctions in the first three blocks, and presence or absence of suction/swallowing/breathing (S/S/B) coordination. None of the preterm infants in this sample had previously received oral motor sensory stimulation. RESULTS: Group 2 showed, in most preterm infants, the presence of S/S/B coordination, besides a better performance regarding number and duration of sucking blocks, when compared to Group 1. Regarding correlation between number and duration of sucking by block, G1 and G2 had similar results. Considering the intrauterine development of the subjects suitable to the gestational age, G1 and G2 presented similar performances both in the first and second sucking blocks. A decrease was observed in G1 in the third block. CONCLUSION: Group 2 showed better development of the nutritive sucking pattern, suggesting that the corrected gestational age of preterm infants interfered in the results obtained at the nutritive sucking evaluation. Therefore, this is also a relevant variable to be considered for oral feeding release