Abstract
The use of non-nutritive sucking materials like pacifiers and fingers poses health challenges to children in resource-limited settings, where hygiene practices and provision of clean water are poor. This study was designed to determine the prevalence of non-nutritive sucking habits and its association with acute diarrhea in children aged 6-23 months in urban communities of Nigeria. In this cross-sectional study, 12 communities from 4 out of 12 geopolitical wards in Ibadan North Local Government Area and 427 mothers of children aged 6-24 months were randomly selected. A pre-tested, interviewer-administered questionnaire was used to obtain information on socio-demographic characteristics, recent history of diarrhea (3 months prior to visit) and use of non-nutritive sucking materials. Descriptive statistics, Chi-square, and logistic regression were used for data analysis at p = 0.05. Mean age of the children was 13.9 ± 5.3 months and 50.6% were males. Prevalence of non-nutritive sucking was 45.2%. Prevalence of non-nutritive sucking was not significantly different between males (45.8%) and females (44.5%). The odds ratio of engaging in non-nutritive sucking increases by 6.0% with increasing age (OR = 1.06; 1.02; 1.10). More children who were not exclusively breastfed (53.5%) than exclusively breastfed (26.2%) were likely to engage in non-nutritive sucking (OR = 3.25; 95% CI = 2.07, 5.12). Acute diarrhea was more frequently reported in non-nutritive sucking group than the other (OR = 1.51; 95% CI = 1.03, 2.22). Non-nutritive sucking was linked with failure to practice exclusive breastfeeding, worse with increasing age, and predisposes to acute diarrhea. Further studies are necessary to verify the nature of these associations.
Highlights
Non-nutritive sucking habit is the use of natural or artificial nipple-like objects, for the purpose of “comforting, soothing, or calming the infants and even alleviating the burning and itching of the gums” [1]
This study revealed that prevalence of non-nutritive sucking habits among children aged 6–23 months in the study area was 45.2% and acute diarrhea was more frequent among those who engaged in non-nutritive sucking (60.6%) than those who did not (50.4%)
One cannot be absolutely sure of the link between pacifier colonization and the incidence of acute diarrhea reported by the mothers. Another issue that cannot be absolutely argued from our data is that the lower prevalence of breastfeeding among children who engaged in non-nutritive sucking compared with those who did not was not responsible for the higher incidence of diarrhea, despite the use of logistic regression to adjust for confounders
Summary
Non-nutritive sucking habit is the use of natural or artificial nipple-like (pacifier) objects (on which the children suck), for the purpose of “comforting, soothing, or calming the infants and even alleviating the burning and itching of the gums” [1]. Non-nutritive sucking habit is a societal norm in many countries [1] and may be related to a variety of inter-related factors including mother level of education, cultural, and socio-economic factors. These factors play major roles in influencing mothers and caregivers in the decision to introduce pacifier to children [2,3,4]. This study was designed to determine the prevalence of non-nutritive sucking habits and its association with acute diarrhea in children aged 6–23 months in urban communities of Nigeria
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