Påverkan på amning av tidig nappanvändning
Fråga och sammanfattning
Amning etableras oftast under barnets första levnadsveckor. Det är oklart om napp inverkar negativt på amning under etableringsfasen.
Fråga
Vilka vetenskapliga studier finns om effekten på etablering av amning vid introduktion av napp under de första två levnadsveckorna?
Frågeställare: Socialstyrelsen
Sammanfattning
Tidig introduktion av napp har lyfts fram som en möjlig orsak till problem vid amningsetablering. Ingen systematisk översikt har identifierats som undersökt effekten av tidig användning av napp på amningsetablering. Upplysningstjänsten har identifierat 13 primärstudier där sambandet mellan nappintroduktion under de första levnadsveckorna och amning under etableringsfas upp till de första tre månaderna var en av de aspekter som analyserats. Av dessa är elva studier observationsstudier, där studiedesignen gör det svårt att fastslå om det rör sig om orsakssamband mellan tidig nappintroduktion och amningsetablering. Amningsetableringen kan ha påverkats av andra faktorer än introduktion av napp.
Primärstudier granskas inte med avseende på risk för bias av Upplysningstjänsten så inga resultat eller slutsatser har redovisats i svaret, men studierna finns i tabellform i Bilaga 3 för den som önskar läsa mer.
På SBU:s upplysningstjänst identifierar och redovisar vi sammanställd forskning (systematiska översikter) eller identifierar vetenskapliga studier som svar på en avgränsad fråga. Vi bedömer risken för bias (överskattning eller underskattning av resultat) i systematiska översikter och presenterar författarnas slutsatser från systematiska översikter med låg eller måttlig risk för bias. I vetenskapliga primärstudier bedömer vi inte risken för bias och därför presenteras de bara som referenser. Vid behov bedömer vi kvalitet avseende ekonomiska aspekter och överförbarhet av resultat i hälsoekonomiska studier och presenterar författarnas slutsatser från de studier som bedöms ha minst medelhög kvalitet och överförbarhet. I svaren väger vi inte samman resultaten eller bedömer graden av vetenskaplig tillförlitlighet.
Bakgrund
Bröstmjölken innehåller den näring som behövs för spädbarn och ger ett visst skydd mot infektionssjukdomar [1]. År 2018 ammades 94 procent av barnen i Sverige vid en veckas ålder och 83 procent vid två månaders ålder [2]. WHO rekommenderar att amning inleds under den första levnadstimmen och upprätthålls under minst 6 månader [3].
Napp används för att tillfredsställa sugreflexen hos små barn och kan trösta och lugna barnen, framför allt vid insomning. Det finns en misstanke att tidig introduktion av napp, när introduktionen sker under de första levnadsveckorna, skulle kunna störa etablering av amningen. Orsaker skulle exempelvis kunna vara att det försvårar för föräldrarna att avläsa och svara på barnens amningssignaler, skapar förvirring kring sugteknik hos barnet eller stör mjölkproduktionen om barnet suger mindre vid bröstet.
Detta svar har tagits fram efter förfrågan från Socialstyrelsen i samband med arbetet med att uppdatera den gällande översättningen ”10 steg som främjar amning” från 2014 [4]. SBU:s upplysningstjänst publicerar två svar på denna fråga, detta svar samt svaret ”Napp mot plötslig spädbarnsdöd”.
Avgränsningar
Vi har gjort sökningar i databaserna i databaserna MedLine (Ovid), Embase, CINAHL och Scopus (se Bilaga 1).
Vi har formulerat frågan enligt följande PICO1:
- Population: Fullgångna, friska spädbarn och deras mödrar
- Intervention/Exponering: Napp som introduceras under barnets första två levnadsveckor.
- Control: Ingen nappanvändning eller begränsad nappanvändning.
- Outcome: Etablering av amning samt hel- och delamning upp till 3 månader.
För att vi skulle inkludera en artikel i svaret krävde vi att den var publicerad på engelska eller ett av de skandinaviska språken.
1. PICO är ett sätt att strukturera upp en frågeställning för att underlätta sökning och granskning. PICO är en förkortning för patient/population/problem, intervention/index test, comparison/control (jämförelseintervention) och outcome (utfallsmått).
Bedömning av risk för bias
Primärstudier bedöms inte för risk för bias av SBU:s upplysningstjänst eftersom det ställer krav på sakkunskap inom forskningsområdet. Det är därför möjligt att flera av studierna kan ha haft högre risk för bias än de studier som SBU inkluderar i andra rapporter.
Resultat från sökningen
Upplysningstjänstens litteratursökning genererade totalt 929 artikelsammanfattningar (abstrakt) efter dubblettkontroll. Ett flödesschema för urvalsprocessen visas i Bilaga 2. Två utredare på SBU läste alla artikelsammanfattningar och bedömde att 91 kunde vara relevanta. Dessa artiklar lästes i fulltext av två utredare och de artiklar som inte var relevanta för frågan exkluderades. Exkluderade artiklar finns listade i Bilaga 4.
Upplysningstjänsten identifierade ingen översikt som var relevant för frågan. 13 primärstudier bedömdes som relevanta och inkluderades.
Primärstudier
SBU:s upplysningstjänst identifierade 13 primärstudier [5–17], och dessa finns beskrivna i Bilaga 3. För primärstudier bedöms inte risken för bias och av det skälet finns inte resultat eller slutsatser beskrivna i text eller tabell.
Av de 13 inkluderade primärstudierna var 11 observationsstudier [5,6,8–16]. En svensk studie designades som en RCT, men analyserades även som en observationsstudie eftersom studiedeltagarna i de båda grupperna i hög grad avvek från den nappanvändning som föreskrevs i den studiegrupp de randomiserats till [7]. En äldre randomiserad studie jämförde en grupp där användning av alla sorters nappar och flaskor begränsades under BB-vistelsen med en grupp där nappar erbjöds alla barn och inga begränsningar kring flaskmatning gjordes [17].
Lästips
Fyra primärstudier motsvarade inte frågeställningen med avseende på tidpunkt för nappintroduktion eller uppföljningstid, men bedöms ändå vara intressanta.
I en svensk kohortstudie från år 2012 analyserade Almquist-Tangen och medarbetare vilka faktorer som inverkade på att amning upphörde under de första fyra levnadsveckorna [18].
Jakaité och medarbetare undersökte i en nyligen publicerad observationsstudie från år 2021 faktorer för helamning vid sex månader, bland annat tidig introduktion av napp [19].
Vogel och medarbetare fokuserar i en kohortstudie från år 2001 på hur nappanvändning påverkar flera olika amningsutfall [20].
En dansk observationsstudie från år 2009 av Kronborg och medarbetare undersökte nappanvändning och amningsteknik och dess påverkan på hur länge mödrarna ammade sina spädbarn [21].
Projektgrupp
Detta svar är sammanställt av Emma Palmqvist Wojda (utredare), Idha Kurtsdotter (utredare), Lisa Forsberg (utredare), Sara Fundell (projektadministratör), Irene Edebert (produktsamordnare), Per Lytsy (medicinskt sakkunnig) samt Pernilla Östlund (avdelningschef) vid SBU.
Referenser
- Livsmedelsverket. Bra mat för barn 0-5 år - handledning för barnhälsovård. Uppsala: Livsmedelsverket; 2013, version december 2020. [accessed Jun 21 2021]. Available from: https://www.livsmedelsverket.se/globalassets/publikationsdatabas/handbocker-verktyg/bra-mat-for-barn-0-5-ar---handledning-for-barnhalsovarden.pdf.
- Socialstyrelsen. Statistik om amning 2018. Stockholm: Socialstyrelsen; 2021. Artikelnummer 2021-5-7393. [accessed Jun 21 2021]. Available from: https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/statistik/2021-5-7393.pdf.
- World Health Organization. Guideline: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: World Health Organization; 2017. License CC BY-NC-SA 3.0 IGO. [accessed Jun 21 2021]. Available from: https://apps.who.int/iris/bitstream/handle/10665/259386/9789241550086-eng.pdf?sequence=1&isAllowed=y.
- Socialstyrelsen. 10 steg som främjar amning. Stockholm: Socialstyrelsen; 2014. Artikelnr 2016-11-6. [accessed Jun 21 2021]. Available from: https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/kunskapsstod/2014-10-27.pdf.
- Carbonell X, Botet F, Figueras J, Alvarez E, Riu A. The incidence of breastfeeding in our environment. J Perinat Med. 1998;26(4):320-4. Available from: https://doi.org/10.1515/jpme.1998.26.4.320.
- Declercq E, Labbok MH, Sakala C, O'Hara M. Hospital practices and women's likelihood of fulfilling their intention to exclusively breastfeed. Am J Public Health. 2009;99(5):929-35. Available from: https://doi.org/10.2105/AJPH.2008.135236.
- Hermanson A, Astrand LL. The effects of early pacifier use on breastfeeding: A randomised controlled trial. Women Birth. 2020;33(5):e473-e82. Available from: https://doi.org/10.1016/j.wombi.2019.10.001.
- Howard CR, Howard FM, Lanphear B, deBlieck EA, Eberly S, Lawrence RA. The effects of early pacifier use on breastfeeding duration. PEDIATRICS. 1999;103(3):E33. Available from: https://doi.org/10.1542/peds.103.3.e33.
- Ingram J, Johnson D, Greenwood R. Breastfeeding in Bristol: teaching good positioning, and support from fathers and families. Midwifery. 2002;18(2):87-101. Available from: https://doi.org/10.1054/midw.2002.0308.
- Kair LR, Colaizy TT. Association Between In-Hospital Pacifier Use and Breastfeeding Continuation and Exclusivity: Neonatal Intensive Care Unit Admission as a Possible Effect Modifier. Breastfeed Med. 2017;12:12-9. Available from: https://doi.org/10.1089/bfm.2016.0137.
- Kair LR, Kenron D, Etheredge K, Jaffe AC, Phillipi CA. Pacifier restriction and exclusive breastfeeding. PEDIATRICS. 2013;131(4):e1101-7. Available from: https://doi.org/10.1542/peds.2012-2203.
- Marques NM, Lira PI, Lima MC, da Silva NL, Filho MB, Huttly SR, et al. Breastfeeding and early weaning practices in northeast Brazil: a longitudinal study. PEDIATRICS. 2001;108(4):E66. Available from: https://doi.org/10.1542/peds.108.4.e66.
- Pineda R, Luong A, Ryckman J, Smith J. Pacifier use in newborns: related to socioeconomic status but not to early feeding performance. Acta Paediatr. 2018;107(5):806-10. Available from: https://doi.org/10.1111/apa.14253.
- Schliep KC, Denhalter D, Gren LH, Panushka KA, Singh TP, Varner MW. Factors in the Hospital Experience Associated with Postpartum Breastfeeding Success. Breastfeed Med. 2019;14(5):334-41. Available from: https://doi.org/10.1089/bfm.2018.0039.
- Sipsma HL, Kornfeind K, Kair LR. Pacifiers and Exclusive Breastfeeding: Does Risk for Postpartum Depression Modify the Association? J Hum Lact. 2017;33(4):692-700. Available from: https://doi.org/10.1177/0890334417725033.
- Huang YY, Lee JT, Gau ML, Huang CM. The study of pacifier use in relation to infant sucking, maternal perception of milk supply and breastfeeding duration. Macau Journal of Nursing. 2011;10(2).
- Schubiger G, Schwarz U, Tonz O. UNICEF/WHO baby-friendly hospital initiative: does the use of bottles and pacifiers in the neonatal nursery prevent successful breastfeeding? Neonatal Study Group. Eur J Pediatr. 1997;156(11):874-7. Available from: https://doi.org/10.1007/s004310050734.
- Almqvist-Tangen G, Bergman S, Dahlgren J, Roswall J, Alm B. Factors associated with discontinuation of breastfeeding before 1 month of age. Acta Paediatr. 2012;101(1):55-60. Available from: https://doi.org/10.1111/j.1651-2227.2011.02405.x.
- Jakaite V, Pestenyte A, Zakareviciene J, Snieckuviene V, Zitkute V, Ramasauskaite D, et al. Predictors of exclusive breastfeeding in the first six months: four consecutive surveys in a tertiary hospital in Lithuania. Int Breastfeed J. 2021;16(1):22. Available from: https://doi.org/10.1186/s13006-021-00364-6.
- Vogel AM, Hutchison BL, Mitchell EA. The impact of pacifier use on breastfeeding: a prospective cohort study. J Paediatr Child Health. 2001;37(1):58-63. Available from: https://doi.org/10.1046/j.1440-1754.2001.00581.x.
- Kronborg H, Vaeth M. How are effective breastfeeding technique and pacifier use related to breastfeeding problems and breastfeeding duration? Birth. 2009;36(1):34-42. Available from: https://doi.org/10.1111/j.1523-536X.2008.00293.x.
Bilaga 1 Litteratursökning
CINAHL via EBSCO 17 May 2021
Association between dummy use and breastfeeding
| AB = Abstract; AU = Author; DE = Term from the thesaurus; MH= Exact Subject Heading from CINAHL Subject Headings; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; N = Near Operator (N) finds the words if they are a maximum of x words apart from one another, regardless of the order in which they appear.; W = Within Operator (W) finds the words if they are within x words of one another, in the order in which you entered them. | ||
| Search terms | Items found | |
| Population | ||
| 1. | TI ( newborn OR neonate* OR infant* ) OR AB ( newborn OR neonate* OR infant* ) OR SU ( newborn OR neonate* OR infant* ) | 319 040 |
| Intervention/Exposure | ||
| 2. | TI ( pacifier* OR comforter* OR soother* OR dummy OR dummies OR (non N1 nutri* N1 sucking) ) OR AB ( pacifier* OR comforter* OR soother* OR dummy OR dummies OR (non N1 nutri* N1 sucking) ) OR SU ( pacifier* OR comforter* OR soother* OR dummy OR dummies OR (non N1 nutri* N1 sucking) ) | 2 644 |
| Outcome | ||
| 3. | TI ( breastfeed* OR ‘breast feed*’ OR breastfed OR ‘breast fed’ OR wean* OR lactat* OR (nurs* N1 (newborn OR infant* OR mother*)) ) OR AB ( breastfeed* OR ‘breast feed*’ OR breastfed OR ‘breast fed’ OR wean* OR lactat* OR (nurs* N1 (newborn OR infant* OR mother*)) ) OR SU ( breastfeed* OR ‘breast feed*’ OR breastfed OR ‘breast fed’ OR wean* OR lactat* OR (nurs* N1 (newborn OR infant* OR mother*)) ) | 59 353 |
| Combined sets | ||
| 4. | 1 AND 2 AND 3 | 381 |
| Limits | ||
| 5. | Academic journals | |
| Final result | ||
| 4 AND 5 | 333 | |
Embase via Elsevier 17 May 2021
Association between dummy use and breastfeeding
| /de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ' ' = Citation Marks; searches for an exact phrase; NEAR/n = Requests terms that are within 'n' words of each other in either direction; NEXT/n = Requests terms that are within 'n' words of each other in the order specified | ||
| Search terms | Items found | |
| Population | ||
| 1. | ’newborn’/exp | 618 595 |
| 2. | (newborn OR neonate* OR infant*):ti,ab,kw | 715 116 |
| 3. | 1 OR 2 | 1 063 443 |
| Intervention/Exposure | ||
| 4. | ‘pacifier’/exp | 908 |
| 5. | (pacifier* OR comforter* OR soother* OR dummy OR dummies OR (non NEAR/2 nutri* NEAR/2 sucking)):ti,ab.kw | 9 912 |
| 6. | 4 OR 5 | 10 103 |
| Outcome | ||
| 7. | ‘breast feeding’/exp OR ‘breast milk’/exp OR ‘lactation’/exp | 126 809 |
| 8. | (breastfeed* OR ‘breast feed*’ OR breastfed OR ‘breast fed’ OR wean* OR lactat*):ti,ab,kw | 62 628 |
| 9. | (nurs* NEAR/2 (newborn OR infant* OR mother*)):ti,ab,kw | 4 725 |
| 10. | 7 OR 8 OR 9 | 143 191 |
| Limits: | ||
| 11. | (‘article’/it OR ‘article in press’ OR ‘review’/it) | |
| Combined sets | ||
| 12. | 3 AND 6 AND 10 | 651 |
| Final result | ||
| 11 AND 12 | 539 | |
Medline via OvidSP 17 May 2021
Association between dummy use and breastfeeding
| .ab. = Abstract; .ab,ti. = Abstract or title; .af. = All fields; Exp = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; .sh. = Term from the Medline controlled vocabulary; .ti. = Title; / = Term from the Medline controlled vocabulary, but does not include terms found below this term in the MeSH hierarchy; * = Focus (if found in front of a MeSH-term); * or $ = Truncation (if found at the end of a free text term); .mp = Text, heading word, subject area node, title; “ “ = Citation Marks; searches for an exact phrase; ADJn = Positional operator that lets you retrieve records that contain your terms (in any order) within a specified number (n) of words of each other. | ||
| Search terms | Items found | |
| Population | ||
| 1. | infant, newborn/ | 619 168 |
| 2. | (newborn or infant* or neonat*).ab,kf,ti. | 724 224 |
| 3. | 1 or 2 | 1 036 640 |
| Intervention/Exposure | ||
| 4. | Pacifiers/ | 501 |
| 5. | (pacifier* or soother* or comforter* or dummy or dummies or (non adj1 nutriti* adj1 sucking)).ab,kf,ti. | 7 410 |
| 6. | 4 or 5 | |
| Outcome | ||
| 7. | Breast Feeding/ or Lactation/ or Lactation Disorders/ | 79 612 |
| 8. | (breastfeed* or breast feed* or breastfed or breast fed or wean* or lactat*).ab,kf,ti. | 211 289 |
| 9. | (nurs* adj2 (newborn or infant* or mother*)).ab,kf,ti. | 4 848 |
| 10. | 7 or 8 or 9 | |
| Combined sets | ||
| 11. | 3 and 6 and 10 | 529 |
| Final result | ||
| 529 | ||
Scopus via Elsevier 17 May 2021
Association between dummy use and breastfeeding
| TITLE-ABS-KEY = Title or abstract or keywords; ALL = All fields; PRE/n = "precedes by". The first term in the search must precede the second by a specified number of terms (n).; W/n = "Within". The terms in the search must be within a specified number of terms (n) in any order.; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; LIMIT-TO (SRCTYPE, "j" = Limit to source type journal; LIMIT-TO (DOCTYPE, "ar" = Limit to document type article; LIMIT-TO (DOCTYPE, "re" = Limit to document type review | ||
| Search terms | Items found | |
| Population | ||
| 1. | TITLE-ABS-KEY(infant OR newborn OR neonate) | 1 651 439 |
| Intervention/Exposure | ||
| 2. | TITLE-ABS-KEY(pacifier or dummy or comforter or soother or (non W/1 nutri* W/1 sucking)) | 24 419 |
| Outcome: Breast feeding | ||
| 3. | TITLE-ABS-KEY(breastfeed* OR “breast feed*” OR breastfed OR “breast fed” OR wean* OR lactat* OR (nurs* W/1 (newborn OR infant OR baby OR mother)) | 397 754 |
| Combined sets | ||
| 4. | 1 AND 2 AND 3 | 753 |
| Limits: | ||
| 5. | Limit to: article, review, letter | |
| Final result | ||
| 4 AND 5 | 711 | |
Bilaga 2 Flödesschema för urval av studier
Bilaga 3 Inkluderade primärstudier
| Included studies/ setting | Population/ Exposure | Measured outcome |
| Carbonell X et al, 1998 The incidence of breastfeeding in our environment. [5] |
||
| Study type: Observational Setting: Barcelona, Spain Maternity clinic in hospital |
Population: 329 mothers and infants born during the study period Exposure: Early pacifier, during the first days of life |
Measured outcome of interest: Breastfeeding at 3 months |
| Declercq E et al, 2009 Hospital practices and women's likelihood of fulfilling their intention to exclusively breastfeed. [6] |
||
| Study type: National survey (Listening to Mothers II) Setting: USA |
Population: 915 women aged 18 to 45 years who had given birth in 2005 in a hospital to a singleton, still-living infant and were non-Hispanic Black or Hispanic Exposure: Hospital practice – the baby was given a pacifier in the hospital |
Measured outcome of interest: Exclusive breastfeeding at 1 week, stratified by parity |
| Hermanson Å et al, 2020 The effects of early pacifier use on breastfeeding: A randomised controlled trial. [7] |
||
| Study type: Designed as RCT, also analysed on exposure as an observation study. Setting: Sweden, Linköping University hospital |
Population: 239 mother-infant pairs. Mothers were primiparous; intended to breastfeed their infants for at least four months and gave birth to healthy full-term infants (>37 weeks of gestation, birth weight >2500 g). Intervention: Recommendation to offer a pacifier to their newborn child from the first day of life. Control: Recommendation to avoid pacifier to their newborn child during the first two weeks. |
Measured outcome of interest: Exclusive and partial breastfeeding at 2 months Primary outcome: Full and partial breastfeeding at 6 months |
| Howard CR et al, 1999 The effects of early pacifier use on breastfeeding duration. [8] |
||
| Study type: Prospective cohort Data from a larger RCT Setting: USA Three independent, obstetric practices in six clinical offices in and around the Greater Rochester, NY, area. |
Population: 265 breastfeeding mother–infant dyads Exposure of interest: |
Measured outcome of interest: Breastfeeding at 2 and 3 months |
| Huang YY et al, 2011 The study of pacifier use in relation to infant sucking, maternal perception of milk supply and breastfeeding duration. [16] |
||
| Study type: Longitudinal Setting: Taiwan |
Population: 241 mother-infant pairs Exposure of interest: Pacifier use at day 3 and at 2 weeks after birth |
Measured outcome of interest: Infant sucking technique Exclusive breastfeeding at 3 days and two weeks |
| Ingram J et al, 2002 Breastfeeding in Bristol: teaching good positioning, and support from fathers and families. [9] |
||
| Study type: Non-randomised prospective cohort Setting: One postnatal hospital ward. |
Population: 1325 mothers that were breastfeeding Exposure: Dummy by 2 weeks |
Measured outcome of interest: Any breastfeeding at 2 weeks |
| Kair LR et al, 2013 Pacifier restriction and exclusive breastfeeding. [11] |
||
| Study type: Retrospective before and after study Setting: USA |
Population: 2249 infants admitted to the mother-baby unit at a university teaching hospital Exposure: Hospital practice – restricted routine pacifier distribution |
Measured outcome of interest: Exclusive breastfeeding in the hospital Exclusive formula-feeding in the hospital |
| Kair LR et al, 2017 Association Between In-Hospital Pacifier Use and Breastfeeding Continuation and Exclusivity: Neonatal Intensive Care Unit Admission as a Possible Effect Modifier. [10] |
||
| Study type: Cross-sectional survey CDC Pregnancy Risk Assessment Monitoring System (PRAMS) Survey at 4 months postpartum Setting: USA, 10 states |
Population: 37628 mothers who were chosen by random birth certificate sampling Exposure: Pacifier use during the birth hospitalization |
Measured outcome of interest: Exclusive breastfeeding ≥10 weeks Any breastfeeding ≥10 weeks |
| Marques NM et al, 2001 Breastfeeding and early weaning practices in northeast Brazil: a longitudinal study. [12] |
||
| Study type: Observational Setting: Hospitals, multicentre, Pernambuco state, Brazil |
Population: Mothers of infants with a birth weight of >2500 g (n=364) Exposure of interest:: Pacifier introduction ≥7 days of age. |
Measured outcome of interest: Introduction of other milk in first month of life |
| Pineda R et al, 2018 Pacifier use in newborns: related to socioeconomic status but not to early feeding performance. [13] |
||
| Study type: Observational; survey and feeding assessment Setting: Single hospital, United States |
Population: Mother-infant dyads (n=51). Infants born >37 weeks of gestation. Exposure: Pacifier use at hospital. |
Measured outcome of interest: Exclusively breastfed at hospital |
| Schliep KC et al, 2019 Factors in the Hospital Experience Associated with Postpartum Breastfeeding Success. [14] |
||
| Study type: Survey, Utah Pregnancy Risk Assessment Monitoring System (UT PRAMS) Setting: Hospitals, multicentre, Utah, United States |
Population: Mothers who gave birth in hospital (n=5501) Exposure of interest: Pacifier given by hospital staff |
Measured outcome of interest: Breastfeeding <2 months |
| Schubiger G et al, 1997 UNICEF/WHO baby-friendly hospital initiative: does the use of bottles and pacifiers in the neonatal nursery prevent successful breastfeeding? [17] |
||
| Study type: Multicentre prospective randomized trial. Setting: Maternity services at 10 hospitals, Switzerland. Included hospitals had established functioning breastfeeding programmes with early initiation of breastfeeding, lactation consultants, unrestricted rooming-in and policy of restricted infant formula use |
Population: 602 healthy newborns >37 weeks of gestation with mothers intending to stay at hospital for 5 days postpartum and planning to breast-feed for ≥3 months. Intervention/control:UNICEF group [adhering to step six and nine in Baby-friendly hospital initiative]: Bottles, teats and pacifiers strictly forbidden; supplements, administered by cup or spoon, only given if medically indicated. Standard group: Pacifiers offered to all infants without restriction; supplements conventionally offered by bottle after breastfeeding. |
Measured outcome of interest: Breastfeeding at day 5 and 2 months. |
| Sipsma HL et al, 2017 Pacifiers and Exclusive Breastfeeding: Does Risk for Postpartum Depression Modify the Association? [15] |
||
| Study type:: National survey Setting: Hospitals, multicentre, United States |
Population: Mothers of healthy singleton babies >37 weeks of gestation, planning to breastfeed exclusively or in combination with formula (n=1349) High risk for postpartum depression: 6.7% (n=91) Lower risk for postpartum depression: 93.3% (n=1258) Exposure: Receiving pacifier in hospital |
Measured outcome of interest: Exclusive breastfeeding at one week Exclusive breastfeeding at three weeks |
Bilaga 4 Exkluderade studier
| Exkluderade studier | Kommentar | |
| Systematiska översikter | ||
| Nasjonalt kunnskapssenter for helsetjenesten. Samsoving, smokk, amming og krybbedød – finnes det en sammenheng? 2005. | Fel napp-exponering och amningsutfall | |
| Buccini GDS, Pérez-Escamilla R, Paulino LM, Araújo CL, Venancio SI. Pacifier use and interruption of exclusive breastfeeding: Systematic review and meta-analysis. Matern Child Nutr. 2017;13(3). Available from: https://doi.org/10.1111/mcn.12384. | Fel napp-exponering och amningsutfall | |
| Callaghan A, Kendall G, Lock C, Mahony A, Payne J, Verrier L. Association between pacifier use and breast-feeding, sudden infant death syndrome, infection and dental malocclusion. Int J Evid Based Healthc. 2005;3(6):147-67. Available from: https://doi.org/10.1111/j.1479-6988.2005.00024.x. | Fel napp-exponering och amningsutfall | |
| Hewitt K, Binns C, Scott J, Forbes D. Pacifier use, breastfeeding and sudden infant death syndrome. Curr Pediatr Rev. 2012;8(4):285-91. Available from: https://doi.org/10.2174/157339612803307697. | Fel napp-exponering och amningsutfall | |
| Jaafar SH, Ho JJ, Jahanfar S, Angolkar M. Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev. 2016;2016(8). Available from: https://doi.org/10.1002/14651858.CD007202.pub4. | Fel napp-exponering och amningsutfall | |
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