Preterm Birth, Pacifier use and Breastfeeding: is there a Relationship?

Abstract The immaturity of born to preterm infants may predispose to sucking difficulties. This research aimed to evaluate if pacifier use is associated with preterm birth and influenced in type of infant feeding. This comparative cross-sectional study was conducted in Belo Horizonte, Brazil and evaluated 250 children aged 3 to 5 years. As a sample, two groups were established: the normal term children group (n=125) was selected at a day-care centre and the group of preterm children (125) was identified at a public university hospital with a preterm care project from birth to seven years of age. To collect data, a pre-tested questionnaire regarding information on gestational age, infant development, infant feeding and non-nutritive sucking habits was used for both groups. Bivariate and multivariate Poisson regression was used for the statistical analysis. Pacifier use was more prevalent in the preterm group (PR=1.20, 95% CI=1.02-1.42) who used the bottle (PR=1.38, 95% CI=1.15-1.64) and were breastfed for less than six months (PR=1.19, 95% CI=1.01-1.41). The majority of breastfed infants were of normal term birth (PR=1.14, 95% CI=1.04-1.20) and had monthly family income greater than USD 450.28 (RP= 1.10, 95% CI=1.01-1.20). In this study, pacifier use was more prevalent among preterm infants and associated with less than six months of breastfeeding and used of bottle. Monthly family income was associated with a prevalence of breastfeeding.

摘要 早产儿（preterm infants）因发育未成熟，易出现吸吮困难。本研究旨在评估安抚奶嘴（pacifier）使用是否与早产相关，以及是否会影响婴儿喂养方式。本研究为对比性横断面研究（comparative cross-sectional study），在巴西贝洛奥里藏特开展，共纳入250名3~5岁儿童。研究设置两组受试者：足月组（n=125）从日间照料中心招募，早产组（n=125）来自某公立大学附属医院的早产儿童长期照护项目（随访周期为出生至7岁）。两组均采用经过预试验验证的问卷收集数据，内容涵盖胎龄（gestational age）、婴儿发育情况、喂养方式及非营养性吸吮习惯（non-nutritive sucking habits）等信息。统计分析采用双变量及多变量泊松回归（Poisson regression）方法。结果显示，早产组安抚奶嘴使用率更高（患病率比（Prevalence Ratio, PR）=1.20，95%置信区间（Confidence Interval, CI）=1.02~1.42），且该组中使用奶瓶喂养、母乳喂养时长不足6个月的儿童比例更高（使用奶瓶组PR=1.38，95%CI=1.15~1.64；母乳喂养不足6个月组PR=1.19，95%CI=1.01~1.41）。多数母乳喂养婴儿为足月产（PR=1.14，95%CI=1.04~1.20），且家庭月收入高于450.28美元（PR=1.10，95%CI=1.01~1.20）。本研究发现，早产儿安抚奶嘴使用率更高，且与母乳喂养时长不足6个月及奶瓶喂养存在关联；家庭月收入与母乳喂养率相关。