Determinants of pacifier use among infants attending an
					interdisciplinary breastfeeding promotion program

Carrascoza, Karina Camilo; Possobon, Rosana da Fátima; Ambrosano, Gláucia Maria Bovi; Costa Júnior, Áderson Luiz; Moraes, Antonio Bento Alves de

doi:10.1590/1982-021620149712

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ORIGINAL ARTICLES • Rev. CEFAC 16 (2) • Mar-Apr 2014 • https://doi.org/10.1590/1982-021620149712 copy

Determinants of pacifier use among infants attending an interdisciplinary breastfeeding promotion program

Authorship SCIMAGO INSTITUTIONS RANKINGS

Purpose

to evaluate the introduction of pacifiers in children assisted by an interdisciplinary program of encouraging breastfeeding during the first six months of life, investigating the possible determinants of their use.

Methods

a descriptive, exploratory, longitudinal, quantitative study, through monitoring of 120 mothers and their children. Data were collected on personal characteristics, and demographic variables related to pre-, peri-and postnatal. Bivariate analysis were performed by Chi-square and Fisher exact test and multiple regression analysis with robust adjustment Poisson standard error.

Results

the analysis revealed that 13.33% of children using pacifiers at the end of the first month of life and 23.33% had this habit at the end of the sixth month. Pacifier use was positively associated with lack of exclusive breastfeeding for the first month (PR: 5.44, CI95%:2.38-12, 44). At the end of the sixth month, this habit was associated with absence of exclusive breastfeeding at discharge from hospital (PR: 4.91, CI95%:1.79-13, 48) and lack of exclusive breastfeeding at six months of life (PR: 2.32, CI95%:1.32-4, 08).

Conclusion

the use of pacifiers during the first six months of life for children assisted by a program to promote breastfeeding was associated with lack of exclusive breastfeeding.

Habits; Pacifiers; Breast Feeding; Health Promotion; Prospective Studies

Personal and Demographic Characteristics		Sample		Infants who used pacifiers
		Sample		At the end of the 1st month			At the end of the 6th month

		N	%	N	%	P	N	%	p
Father´s schooling
	≤ 8 years	31	25.83	4	12.90	1.0000	5	16.13	0.3309
	> 8 years	89	74.17	12	13.48		23	25.84
Mother´s schooling
	≤ 8 years	20	16.67	2	10.00	1.0000	3	15.00	0.4012
	> 8 years	100	83.33	14	14.00		25	25.00
Socioeconomic level*
	High	68	56.67	6	8.82	0.1110	16	23.53	0.9537
	Low	52	43.33	10	19.23		12	23.08
Father´s age
	< 30 years	57	47.50	10	17.54	0.1968	16	28.07	0.2432
	≥ 30 years	63	52.50	6	9.52		12	19.05
Mother´s age
	< 30 years	88	73.33	12	13.64	1.0000	22	25.00	0.4741
	≥ 30 years	32	26.67	4	12.50		6	18.75
Mother´s civil status
	Married/Stable union	109	90.83	14	12.84	0.6402	25	22.94	0.7171
	Single/Separated/ Divorced	11	9.17	2	18.18		3	27.27
Primiparity
	Yes	75	62.50	12	16.00	0.4061	22	29.33	0.0448
	No	45	37.50	4	8.89		6	13.33
Previous breastfeeding experience†
	Yes	23	19.17	1	4.35	0.3029	2	8.70	0.0977
	No	97	80.83	15	15.46		26	26.80

Characteristics of the Prenatal and Perinatal periods		Sample		Infants who used pacifiers
		Sample		At the end of the 1st month			At the end of the 6th month
		N	%	N	%	p	N	%	P
Prenatal Period
Beginning of Prenatal care
	Before the 4th month	108	90.00	14	12,96	0.6615	24	22,22	0.4715
	After the 4th month	12	10.00	2	16,67		4	33,33
Number of consultations
	< 6	8	6.67	1	12,50	1.0000	1	12,50	0.6792
	≥ 6	112	93.33	15	13,39		27	24,11
Perinatal Period
Type of delivery
	Normal	39	32.50	5	12.82	1.0000	9	23.08	0.9632
	C-section	81	67.50	11	13.58		19	23.46
Prematurity*
	Yes	6	5.00	0	0.00	1.0000	1	16.67	1.0000
	No	114	95.00	16	14.04		27	23.68
Low birthweight†
	Yes	3	2.50	0	0.00	1.0000	1	33.33	0.5528
	No	117	97.50	16	13.68		27	23.08
Rooming-in stay
	Yes	113	94.17	15	13.27	1.0000	25	22.12	0.3519
	No	7	5.83	1	14.29		3	42.86
Beginning of breastfeeding after delivery
	< 4 hours	55	45.83	5	9.09	0.2833	9	16.36	0.0968
	≥ 4 hours	65	54.17	11	16.92		19	29.23
Exclusive breastfeeding at hospital discharge
	Yes	115	95.83	15	13.04	0.5175	24	20.87	0.0104
	No	5	4.17	1	20.00		4	80.00

Characteristics of the postnatal period		Sample				Infants who used pacifiers
		1st month		6th month		At the end of the 1st month			At the end of 6th the month
		N	%	N	%	N	%	p	N	%	P
Occurrence of breast problems*
	Yes	43	35.83	51	42.50	5	11.63	0.7846	7	13.73	0.0324
	No	77	64.17	69	57.50	11	14.29		21	30.43
Mothers who returned to work*
	Yes	4	3.33	45	37.50	0	0.00	1.0000	11	24.44	0.8236
	No	116	96.67	75	62.50	16	13.79		17	22.67
Exclusive maternal breastfeeding†
	Yes	105	87.50	57	47.50	9	8.57	<.0001	4	7.02	<.0001
	No	15	12.50	63	52.50	7	46.67		24	38.10
Feeling of lack of milk*
	Yes	10	8.33	43	35.83	2	20.00	0.6213	14	32.56	0.0742
	No	110	91.67	77	64.17	14	12.73		14	18.18
Use of nursing bottle†
	Yes	16	13.33	43	35.83	6	37,50	0.0023	19	44.19	<.0001
	No	104	86.67	77	64.17	10	9.62		9	11.69

Variable	Used pacifiers at the end of the 1st month		Adjusted values *
Variable	N	%	PR	CI95%	P
Exclusive maternal breastfeeding
Yes	9	8.57	Reference
No	7	46.67	5.44	2.38-12.44	<0.0001
Variable	Used pacifiers at the end of the 6th month		Adjusted values ^*
Variable	N	%		N	%
Exclusive maternal breastfeeding
Yes	4	7.02	reference
No	24	38.10	4.91	1.79-13.48	0.0020
Exclusive breastfeeding at hospital discharge
Yes	24	20.87	reference
No	4	80.00	2.32	1.32-4.08	0.0034

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[1] Mailing address: Rosana de Fátima Possobon Faculdade de Odontologia de Piracicaba – Unicamp Av. limeira, 901 – Bairro Areião Piracicaba – SP CEP: 13.414-903 E-mail: possobon@fop.unicamp.br