Používanie cumlíkov a zápal stredného ucha
Používanie cumlíka nielenže znižuje úspešnosť dojčenia, ale podľa viacerých prác existuje súvislosť medzi cumlíkovaním a rizikom výskytu otitis media (zápalu stredného ucha).
Pediatr Dent 1999 Jul-Aug;21(4):255-60 |
Pacifier use and otitis media in infants twelve months of age or younger.
Jackson JM, Mourino AP
Advanced Education Program in Pediatric Dentistry, The Medical College of Virginia School of Dentistry, USA.
PURPOSE: The purpose of this study was two fold: to determine if within a selected population of infants the prevalence of otitis media was greater in pacifier users than in non-pacifier users, and to reveal if an association existed between otitis media and pacifier use. METHODS: The study consisted of 200 children, 12 months of age or younger. Parents were surveyed regarding children's pacifier habits, day care attendance, feeding habits, thumb sucking habits, exposure to parental smoking, and parental education level. RESULTS: The prevalence of otitis media in pacifier users (36%) was larger than that of non-pacifier users (23%), P < 0.05. A logistic regression analysis determined an association existed between otitis media and pacifier use, bottle feeding, thumb sucking, and day care utilization, P < or = 0.05. No association was discovered between otitis media and breast feeding, parental smoking and parental education level. CONCLUSION:The risk of developing otitis media in an infant is two times greater if a pacifier is used and five times greater if bottle fed or attending a day care facility.
Jackson JM, Mourino AP
Advanced Education Program in Pediatric Dentistry, The Medical College of Virginia School of Dentistry, USA.
PURPOSE: The purpose of this study was two fold: to determine if within a selected population of infants the prevalence of otitis media was greater in pacifier users than in non-pacifier users, and to reveal if an association existed between otitis media and pacifier use. METHODS: The study consisted of 200 children, 12 months of age or younger. Parents were surveyed regarding children's pacifier habits, day care attendance, feeding habits, thumb sucking habits, exposure to parental smoking, and parental education level. RESULTS: The prevalence of otitis media in pacifier users (36%) was larger than that of non-pacifier users (23%), P < 0.05. A logistic regression analysis determined an association existed between otitis media and pacifier use, bottle feeding, thumb sucking, and day care utilization, P < or = 0.05. No association was discovered between otitis media and breast feeding, parental smoking and parental education level. CONCLUSION:The risk of developing otitis media in an infant is two times greater if a pacifier is used and five times greater if bottle fed or attending a day care facility.
Clin Infect Dis 1996 Jun;22(6):1079-83 |
A meta-analytic review of the risk factors for acute otitis media.
Uhari M, Mantysaari K, Niemela M
Department of Pediatrics, University of Oulu, Finland.
The occurrence of acute otitis media (AOM) has increased steadily during the last 15 years. The possible environmental risks associated with AOM should be well identified to prevent any further increase in its occurrence. A meta-analysis of the studies evaluating the risk factors for AOM was performed. A MEDLINE search of the medical literature from 1966 to 1994 with the key words children, risk, acute otitis media, and recurrent acute otitis media was performed, and the references of the articles that were found served as the sources for the studies used in the meta-analysis. Sixty-one studies were identified. Twenty-two (36%) of these studies were accepted for the meta-analysis. Depending on the risk factor, there were two to seven different studies from which risk ratios (RRs) could be pooled. The studies were performed in six different countries. If any other member of the family had had AOM, the risk increased (RR, 2.63; 95% confidence interval [CI], 1.86-3.72; P = .00001). The risk of AOM increased with day care outside the home (RR, 2.45; 95% CI, 1.51-3.98; P = .0003) and family day care (RR, 1.59; 95% CI, 1.19-2.13, P = .002). The risk of AOM increased with parental smoking (RR, 1.66; 95% CI, 1.33-2.06; P < .00001). Breast-feeding for at least 3 months reduced the risk of AOM (RR, 0.87; 95% CI, 0.79-0.95; P = .003). The use of a pacifier increased the risk of AOM (RR, 1.24; 95% CI, 1.06-1.46; P = .008).Child care outside the home and parental smoking were the factors that most significantly increased the occurrence of AOM
Uhari M, Mantysaari K, Niemela M
Department of Pediatrics, University of Oulu, Finland.
The occurrence of acute otitis media (AOM) has increased steadily during the last 15 years. The possible environmental risks associated with AOM should be well identified to prevent any further increase in its occurrence. A meta-analysis of the studies evaluating the risk factors for AOM was performed. A MEDLINE search of the medical literature from 1966 to 1994 with the key words children, risk, acute otitis media, and recurrent acute otitis media was performed, and the references of the articles that were found served as the sources for the studies used in the meta-analysis. Sixty-one studies were identified. Twenty-two (36%) of these studies were accepted for the meta-analysis. Depending on the risk factor, there were two to seven different studies from which risk ratios (RRs) could be pooled. The studies were performed in six different countries. If any other member of the family had had AOM, the risk increased (RR, 2.63; 95% confidence interval [CI], 1.86-3.72; P = .00001). The risk of AOM increased with day care outside the home (RR, 2.45; 95% CI, 1.51-3.98; P = .0003) and family day care (RR, 1.59; 95% CI, 1.19-2.13, P = .002). The risk of AOM increased with parental smoking (RR, 1.66; 95% CI, 1.33-2.06; P < .00001). Breast-feeding for at least 3 months reduced the risk of AOM (RR, 0.87; 95% CI, 0.79-0.95; P = .003). The use of a pacifier increased the risk of AOM (RR, 1.24; 95% CI, 1.06-1.46; P = .008).Child care outside the home and parental smoking were the factors that most significantly increased the occurrence of AOM
Pediatrics 1995 Nov;96(5 Pt 1):884-8 |
A pacifier increases the risk of recurrent acute otitis media in children in day care centers.
Niemela M, Uhari M, Mottonen M
Department of Pediatrics, University of Oulu, Finland.
OBJECTIVE. To follow up a previous retrospective analysis in which we found the use of a pacifier to be a risk factor for recurrent acute otitis media (AOM). METHOD. In the present prospective study, the occurrence of AOM and the use of a pacifier were recorded in 845 children attending day care centers during a 15-month period. RESULTS. More than three attacks of AOM occurred in 29.5% of the children younger than 2 years using pacifiers and in 20.6% of those not doing so (relative risk, 1.6; 95% confidence interval [CI], 0.6, 4.1); in children 2 to 3 years of age, the figures were 30.6% and 13.2%, respectively (relative risk, 2.9; 95% CI, 1.2, 7.3). Logistic modeling with adjustment for age and the duration of monitoring showed the occurrence of AOM to be associated with the time during which a pacifier was used. The use of a pacifier increased the annual incidence of AOM from 3.6 (95% CI, 2.5, 4.9) to 5.4 episodes (4.4, 6.6) in children younger than 2 years and from 1.9 (1.4, 2.5) to 2.7 (2.2, 3.3) in children 2 to 3 years of age. The population-attributable risk of AOM attacks due to the use of a pacifier was 176 attacks, ie, 459 to 635 attacks per year, in the youngest children and 69 attacks, ie, from 264 to 333 attacks per year, in those 2 to 3 years of age. It can be calculated that the use of a pacifier was responsible for 25% of the attacks in children younger than 3 years. Breastfeeding, parental smoking, thumb sucking, using a nursing bottle, and the social class of the family failed to show such strong associations with the occurrence of AOM. CONCLUSION. We conclude that the use of a pacifier is a significant risk factor for recurrent AOM and suggest that pacifiers should be used only during the first 10 months of life, when need for sucking is strongest, and AOM is uncommon.
Niemela M, Uhari M, Mottonen M
Department of Pediatrics, University of Oulu, Finland.
OBJECTIVE. To follow up a previous retrospective analysis in which we found the use of a pacifier to be a risk factor for recurrent acute otitis media (AOM). METHOD. In the present prospective study, the occurrence of AOM and the use of a pacifier were recorded in 845 children attending day care centers during a 15-month period. RESULTS. More than three attacks of AOM occurred in 29.5% of the children younger than 2 years using pacifiers and in 20.6% of those not doing so (relative risk, 1.6; 95% confidence interval [CI], 0.6, 4.1); in children 2 to 3 years of age, the figures were 30.6% and 13.2%, respectively (relative risk, 2.9; 95% CI, 1.2, 7.3). Logistic modeling with adjustment for age and the duration of monitoring showed the occurrence of AOM to be associated with the time during which a pacifier was used. The use of a pacifier increased the annual incidence of AOM from 3.6 (95% CI, 2.5, 4.9) to 5.4 episodes (4.4, 6.6) in children younger than 2 years and from 1.9 (1.4, 2.5) to 2.7 (2.2, 3.3) in children 2 to 3 years of age. The population-attributable risk of AOM attacks due to the use of a pacifier was 176 attacks, ie, 459 to 635 attacks per year, in the youngest children and 69 attacks, ie, from 264 to 333 attacks per year, in those 2 to 3 years of age. It can be calculated that the use of a pacifier was responsible for 25% of the attacks in children younger than 3 years. Breastfeeding, parental smoking, thumb sucking, using a nursing bottle, and the social class of the family failed to show such strong associations with the occurrence of AOM. CONCLUSION. We conclude that the use of a pacifier is a significant risk factor for recurrent AOM and suggest that pacifiers should be used only during the first 10 months of life, when need for sucking is strongest, and AOM is uncommon.
Pediatrics 1999 Oct;104(4):e50 |
Breastfeeding patterns in relation to thumb sucking and pacifier use.
Aarts C, Hornell A, Kylberg E, Hofvander Y, Gebre-Medhin M
Department of Women's and Children's Health, Section for International Maternal and Child Health, Uppsala University, Uppsala, Sweden. clara.aarts@ich.uu.se
OBJECTIVES: To analyze the influence of thumb sucking and pacifier use on breastfeeding patterns in exclusively breastfed infants, on the duration of exclusive breastfeeding, and on the total breastfeeding duration. STUDY DESIGN: Descriptive, longitudinal, prospective study. SETTING: The subjects were recruited from a population of 15 189 infants born in the maternity ward at the University Hospital, Uppsala, Sweden between May 1989 and December 1992. STUDY POPULATION: 506 mother-infant pairs. METHODS: Daily recordings by the mothers on infant feeding from the first week after delivery through the duration of the study. Fortnightly home visits with structured interviews by a research assistant. RESULTS: Pacifier use was associated with fewer feeds and shorter suckling duration per 24 hours, shorter duration of exclusive breastfeeding, and shorter total breastfeeding duration compared with no pacifier use. These associations were not found for thumb sucking. The possible negative effects of pacifiers on breastfeeding seemed to be related to the frequency of their use. Maternal age and education only slightly modified the association between pacifier use and breastfeeding duration. CONCLUSIONS: More frequent use of a pacifier was associated with shorter breastfeeding duration, even among a group of mothers who were highly motivated to breastfeed.
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