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Fulltext Pacifier Use and its Association with Breastfeeding and Acute Respiratory Infection (ARI) in Children Below 2 Years Old

Mahmud SZ, Joanita S, Khairun Nisa J, Balkish MN, Tahir A

Med J Malaysia, 2013 Apr;68(2):125-8.
PMID: 23629557 MyJurnal

Extensive literature reviews showed that pacifier usage is associated with early cessation of breast feeding, as well as respiratory infection. This cross sectional study was a part of the bigger study of The Third National Health Morbidity Survey conducted throughout Malaysia in 2006. Survival and pearson cox regression was done to find association between pacifier user and breast feeding duration. Logistic Regression was done to find association between variables of interest. The prevalence of pacifier use was 32.9%. Chinese children reported significantly higher usage of pacifier (95% CI; 47.5, 58.7) as well as those resided in urban area (95% CI;32.5,37.7). One third of pacifier user had stopped breastfeeding at 6 months of age. Those with pacifier users were significantly shorter in breast feeding duration and significantly associated with non exclusivity in breastfeeding. Those without pacifier user were significantly associated with ever breast fed.(p value=0.001). There was no significant association between pacifier use with acute respiratory infection. Factors such as ethnicity and residential are non modifiable whereas modifiable factor such as pacifier use is certainly needed to be addressed at maternal and child health care level.
Study name: National Health and Morbidity Survey (NHMS-2006)

Matched MeSH terms: Pacifiers*
Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding

Jaafar SH, Jahanfar S, Angolkar M, Ho JJ

Cochrane Database Syst Rev, 2011.
PMID: 21412899 DOI: 10.1002/14651858.CD007202.pub2

To successfully initiate and maintain breastfeeding for a longer duration, the World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of artificial teats or pacifiers for breastfeeding infants. Offering the pacifier instead of the breast to calm the infant may lead to less frequent episodes of breastfeeding and as a consequence may reduce breast milk production and shorten duration of breastfeeding; however, this remains unclear.

Matched MeSH terms: Pacifiers/adverse effects; Pacifiers/statistics & numerical data*
Fulltext Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding

Jaafar SH, Ho JJ, Jahanfar S, Angolkar M

Cochrane Database Syst Rev, 2016 Aug 30;2016(8):CD007202.
PMID: 27572944 DOI: 10.1002/14651858.CD007202.pub4

BACKGROUND: To successfully initiate and maintain breastfeeding for a longer duration, the World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of artificial teats or pacifiers for breastfeeding infants. Concerns have been raised that offering the pacifier instead of the breast to calm the infant may lead to less frequent episodes of breastfeeding and as a consequence may reduce breast-milk production and shorten duration of breastfeeding.
OBJECTIVES: To assess the effect of restricted versus unrestricted pacifier use in healthy full-term newborns whose mothers have initiated breastfeeding and intend to exclusively breastfeed, on the duration of breastfeeding, other breastfeeding outcomes and infant health.
SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2016) and reference lists of retrieved studies.
SELECTION CRITERIA: Randomised and quasi-randomised controlled trials comparing restricted versus unrestricted pacifier use in healthy full-term newborns who have initiated breastfeeding.
DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The quality of the evidence was assessed using the GRADE approach.
MAIN RESULTS: We found three trials (involving 1915 babies) for inclusion in the review, but have included only two trials (involving 1302 healthy full-term breastfeeding infants) in the analysis. Meta-analysis of the two combined studies showed that pacifier use in healthy breastfeeding infants had no significant effect on the proportion of infants exclusively breastfed at three months (risk ratio (RR) 1.01; 95% confidence interval (CI) 0.96 to 1.07, two studies, 1228 infants), and at four months of age (RR 1.01; 95% CI 0.94 to 1.09, one study, 970 infants, moderate-quality evidence), and also had no effect on the proportion of infants partially breastfed at three months (RR 1.00; 95% CI 0.98 to 1.02, two studies, 1228 infants), and at four months of age (RR 0.99; 95% CI 0.97 to 1.02, one study, 970 infants). None of the included trials reported data on the other primary outcomes, i.e. duration of partial or exclusive breastfeeding, or secondary outcomes: breastfeeding difficulties (mastitis, cracked nipples, breast engorgement); infant's health (dental malocclusion, otitis media, oral candidiasis; sudden infant death syndrome (SIDS)); maternal satisfaction and level of confidence in parenting. One study reported that avoidance of pacifiers had no effect on cry/fuss behavior at ages four, six, or nine weeks and also reported no effect on the risk of weaning before age three months, however the data were incomplete and so could not be included for analysis.
AUTHORS' CONCLUSIONS: Pacifier use in healthy term breastfeeding infants, started from birth or after lactation is established, did not significantly affect the prevalence or duration of exclusive and partial breastfeeding up to four months of age. Evidence to assess the short-term breastfeeding difficulties faced by mothers and long-term effect of pacifiers on infants' health is lacking.

Matched MeSH terms: Pacifiers/adverse effects; Pacifiers/statistics & numerical data*
Fulltext Reducing painful experiences in neonates during routine minor procedures in special care nursery: A quality improvement project

Salwana Ku Md Saad, Koik, Boon Hong, Nur Faradilla Mohamad Bakri, Abdul Nasir Mohamed Abdul Kadher, Karniza Khalid

Q Bulletin, 2020;1(29):4-14.
MyJurnal

Neonates in Special Care Nursery (SCN) are constantly exposed to routine procedures that are painful. Repetitive painful exposures in neonates are known to have long-term deleterious effects that may surpass adulthood. A quality improvement project was designed to reduce the pain experienced by neonates during routine minor procedures in SCN unit of Hospital Tuanku Fauziah (HTF), a tertiary state hospital in Perlis, Malaysia. The Neonatal Infant Pain Scale (NIPS) was used as a pain assessment tool in neonates throughout the study. Several factors contributing to neonatal painful experience during routine procedures were identified, including poor awareness on neonatal pain perception, poor procedural etiquette among paediatric house officers, and lack of non-pharmacological pain relief used during the procedures. Interventional measures included adjunctive use of non-nutritive sucking via orthodontic Avent® pacifier, use of adjustable swaddling blanket via SwaddleMe® size S, and introduction of a clinical training module for the house officers. There were 159 neonates recruited in the pre-intervention period and 163 neonates evaluated in the post-intervention period. Our study revealed a significant decrease in neonatal painful experience during routine procedures, from 49.7% to 17.8% (p

Matched MeSH terms: Pacifiers
Infectious agents causing diarrhoea in Malaysian children

Koe, S.L., Puthucheary, S.D., Lam, S.K.

Malaysian Journal of Child Health, 1991;3(1):29-33.
MyJurnal

The stools of 97 children with acute gastroenteritis, attending a private paediatric clinic, were studied for infectious agents. Putative pathogenic microorganisms were identified in 47 cases (48.5%). Food poisoning Salmonella was the most common bacteria detected, 25 cases (25.8%). Rotavirus was present in 9 cases (9.2%). Interview of the parents and care-persons revealed a general lack of knowledge in the proper cleaning and sterilisation of milk bottles, rubber teats and pacifiers. In 44 households there were at least one animal kept and there were positive bacterial isolates from 47% of such households. However, positive isolates were found in only 26% of households with no kept animals. The implications of these findings are discussed. (Copied from article).

Matched MeSH terms: Pacifiers
Analysis of biofilms formation by cronobacter sp. During growth in infant formula milk

Aishah Faiqah Mohd Yusof, Prabhakaran P, Nur Diyana Azli, Norrakiah Abdullah Sani, Wan Syaidatul Aqma

Sains Malaysiana, 2017;46:903-908.

Pacifier nipples are in permanent contact with saliva and with the oral microflora therefore, act as a favoured site for the growth of biofilms. This research was conducted to identify the bacterial biofilms that has been found on the pacifiers that collected from local child nursery and to analyse the formation of biofilms by Cronobacter sp. during growth in infant formula milk. Pacifiers collected were analysed to obtain colony forming unit (CFU) and isolated bacteria were identified using several biochemical tests according to Bergey's Manual. Biofilm assay of three Cronobacter sp. were conducted using 24 wells microtiter plate and stained with 1% of crystal violet solution at different time interval: 6, 12, 18 and 24 h. The hydrophobicity of the bacterial cell suspension was evaluated using bacterial adhesion to hydrocarbons (BATH) method. Extracellular polymeric substances (EPS) analysis was done to identify percentage of carbohydrate and protein content by using phenol sulphuric acid method and Bradford method, respectively. The results obtained showed that the normal microflora bacteria were the most abundant microorganisms that were found on the pacifier with the main genus isolated was Staphylococcus sp., Enterobacteriaceae sp. and Clostridium sp. Based on biofilm and EPS analysis, Cronobacter sakazakii formed a strong biofilms after 18 h, with carbohydrate was identified as main component of EPS.

Matched MeSH terms: Pacifiers