Prevalence and determinants of the use of pacifiers and feedingbottle: a study in Southwest Bahia

Vanessa Moraes Bezerra,Michele Pereira Netto,Itana Neves Pereira,Elma Izze Da Silva Magalhães,Daniela Da Silva Rocha,Andressa Tavares Gomes

doi:10.1590/1806-93042019000200004

Abstract

Abstract Objectives: to assess the use of pacifier and feedingbottle and their determinants in children from a municipality of Southwest Bahia. Methods: a cross-sectional study was performed with 354 children younger than 12 months old. The event was categorized in: exclusive use of pacifier, exclusive use of feeding bottle,use of pacifier and feeding bottle, and not use any of them. Multinomial analysis with logistic regression was applied, and those who did not use any artificial nipples were thereference variable. Results: it was observed that 11.9% of the children exclusively used pacifiers, 21.2% only use bottles and 32.8% used both of them. The following factors were associated with the exclusive use of pacifiers: low maternal schooling level (eight or less years of education), lack of previous experience with breastfeeding, difficulty in postpartum breastfeeding, and lack of incentive to breastfeeding in puericulture. The exclusive use of feeding bottle was associated with unmarried mothers, aged 35 years old or older, and with less years of education (eight or less years). Women who worked outside home and had difficulty in breastfeeding had greater chance of giving both artificial nipples to the children. Conclusions: the findingspresent different featuresrelated to the exclusive or combined use of pacifiers and feeding bottles, being important to direct health professionals conducts towards mothers’ orientation.

Highlights

The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommendnot offering pacifiers or feeding bottleto breastfed children as an important step towards breastfeeding success.[1]
Studies have shown that the use of pacifiers and/or feeding bottle favors early breastfeeding discontinuance, interferes with the development of orofacial structures, alterschild chewing and swallowing functions,[4] is associated with higher risk of cariesoccurrence[5] and teeth malocclusion,[6] besides it has been considered an important source of contamination by microorganisms harmful to health.[7]
The Brazilian Standard for Commercialization of Foods for Infants and Young Children, Pacifiers, and Baby Bottles (NBCAL - Norma Brasileira de Comercialização de Alimentos para Lactentes e Crianças de 1a Infância, Bicos, Chupetas e Mamadeiras), later changed into Law No 11265/2006,8 aims to ensure the appropriate use of these products in a way that does not interfere with breastfeeding practice.Despite that, artificial nipples are still widely used in Brazil and in several countries worldwide, being a cultural practice widely disseminated in our environment.[4]

Summary

Introduction

The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommendnot offering pacifiers or feeding bottleto breastfed children as an important step towards breastfeeding success.[1]. Studies have shown that the use of pacifiers and/or feeding bottle favors early breastfeeding discontinuance, interferes with the development of orofacial structures, alterschild chewing and swallowing functions,[4] is associated with higher risk of cariesoccurrence[5] and teeth malocclusion,[6] besides it has been considered an important source of contamination by microorganisms harmful to health.[7]. The Brazilian Standard for Commercialization of Foods for Infants and Young Children, Pacifiers, and Baby Bottles (NBCAL - Norma Brasileira de Comercialização de Alimentos para Lactentes e Crianças de 1a Infância, Bicos, Chupetas e Mamadeiras), later changed into Law No 11265/2006,8 aims to ensure the appropriate use of these products in a way that does not interfere with breastfeeding practice.Despite that, artificial nipples are still widely used in Brazil and in several countries worldwide, being a cultural practice widely disseminated in our environment.[4]. Researches evaluating the use of artificial nipples have shown association with several factors, such as low maternal schooling, maternal age under 20 years old, nipple trauma, cohabitation with maternal grandmother, maternal work outside home, primiparity, cesarean section, low birth weight, lack of breastfeeding in the first hour of life, among others.[9,10,11,12,13] Most of these studieshave only assessed the determinants of exclusive use of pacifiers[9,10] or exclusive use feeding bottle,[11,12] studies investigating the combined use of both artificialnipples and their associated factors are still scarce.[13]

Objectives

Methods

Results