SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
"Pacifier polydactyly" is defined in babies with a large edematous postaxial duplication attached by soft-tissue stalks that contain neurovascular elements. These serve in utero as pacifiers. Imminent ischemic necrosis was induced in all three by local trauma. Simple excision is the treatment of choice.
Each of 5 collaborating laboratories determined volatile N-nitrosamines in 3 blind quadruplicate sets of latex rubber infant pacifier samples, using a gas chromatographic-thermal energy analysis (GC-TEA) method. Volatile N-nitrosamines are extracted from cut-up pacifier nipples with CH2Cl2. The extract is concentrated and subjected to high temperature purge and trap, and the nitrosamines are eluted from the trap and determined by GC-TEA. N-Nitrosodibutylamine (NDBA) was the only nitrosamine found in sufficient concentration to allow analysis. NDBA concentrations of the 3 sets of samples were 82.6, 21.0, and 7.12 ng/g rubber. The repeatability relative standard deviations ranged from 7.46 to 24.0% and the reproducibility relative standard deviations from 7.46 to 29.2%. The minimum detectable level of NDBA by this method is 3.6 ng/g rubber. The method has been adopted official first action.
A case is presented of an infant who aspirated the nipple from a makeshift pacifier. The use of makeshift pacifiers is widely practiced at hospital nurseries throughout the United States and should stop immediately.
Behavioral state, heart rate, and respiration were monitored during heelstick procedures in samples of healthy, term neonates (N = 48) and preterm neonates treated in minimal care (N = 48) and intensive care (N = 48) nurseries. The treated infants who were given pacifiers spent significantly less time fussing and crying during and following the heelstick procedures. Physiologic arousal was monitored in both preterm groups but was attenuated only in the preterm infants who received pacifiers (minimal care group). As similar amounts of sucking were observed in both preterm groups, the inconsistency in treatment effects on behavioral and physiologic arousal was interpreted as a lack of cardiac-somatic coupling in the neonate in intensive care. Results suggest that nonnutritive sucking during heelstick procedures may attenuate behavioral distress in all neonates and physiologic arousal in neonates with less severe postnatal complications.
Within the past 5 years there has been an increase of premature infants surviving in the neonatal intensive care unit as well as an increasing cost for each day the infant is kept there. It is important for the premature infant to acquire the feeding skills necessary for weight gain, which lead to discharge from the hospital, and recent advancements have indicated the effectiveness in using contingent music to teach sucking skills to premature infants. The purpose of the first analysis in this study was to determine the effects of Pacifier Activated Lullaby (PAL) trials on weight gain of premature infants. During a 2-year time period, 62 infants from a sample of 188 met criteria for analysis. A one-way analysis of variance showed no significance in daily weight gain for the number of PAL trials completed. The mean weight gains for infants with 1 PAL trial = 13.85 grams, 2 trials = 26.67, 3 trials = 29.64, and 4 or more = 22.89. The Pearson product-moment correlation between the mean percent of music earned via nonnutritive sucking (NNS) and mean weight gain of all trials approached significance (p = .077, r = 0.18). In a second analysis, weight gained prior to use of PAL, during use of PAL, and post use of PAL was analyzed. Results indicated no significant difference between weight gain 1 day prior to use of PAL, the day of PAL trial, and 1 day post use of PAL. Mean weight gain for those infants who participated in 1 PAL trial was 8.49 grams for 1 day prior to use of PAL, 18.73 the day of PAL trial, and 24.81 for 1 day post use of PAL. Mean weight gain for 3 days prior to using the PAL was 10.78, 11.30 on the day of PAL trial, and 24.78 grams for 3 days post PAL use. The analyses show definite trends of greater weight gain with PAL use; however, individual variability within groups was greater than group differences leading to no significance in statistical analysis. In the third analysis the effect of proximity between premature infants' feeding schedule and PAL trial on amount of time the infant received contingent music via NNS was examined; the infants' feeding and sleep schedules were divided into 5 blocks of time. Results indicated no statistical significance among the amount of time premature infants sucked/received music according to their schedule, although there were noticeable differences in the average percent of music reinforcement received according to assigned block. Infants who participated in PAL trials 30 minutes prior to feeding scored the highest average at 77.25 %, followed by 71% for infants who participated in PAL trials during feeding. Other times, primarily after the infants' feeding, resulted in averages of 59% and 54.5%; these infants often fell asleep after their feeding and did not complete the full 15-minute trial. Based on this research and previous research on NNS, it seems beneficial for premature infants to participate in PAL opportunities 30 minutes prior to feeding.
OBJECTIVES: To examine the association between use of a dummy (pacifier) during sleep and the risk of sudden infant death syndrome (SIDS) in relation to other risk factors. DESIGN: Population based case-control study. SETTING: Eleven counties in California. PARTICIPANTS: Mothers or carers of 185 infants whose deaths were attributed to SIDS and 312 randomly selected controls matched for race or ethnicity and age. MAIN OUTCOME MEASURE: Use of a dummy during sleep determined through interviews. RESULTS: The adjusted odds ratio for SIDS associated with using a dummy during the last sleep was 0.08 (95% confidence interval 0.03 to 0.21). Use was associated with a reduction in risk in every category of sociodemographic characteristics and risk factors examined. The reduced risk associated with use seemed to be greater with adverse sleep conditions (such as sleeping prone or on side and sleeping with a mother who smoked), although the observed interactions were not significant. In addition, use of a dummy may reduce the impact of other risk factors for SIDS, especially those related to adverse sleep environment. For example, infants who did not use a dummy and slept prone or on their sides (v on their back) had an increased risk of SIDS (2.61, 1.56 to 4.38). In infants who used dummies, there was no increased risk associated with sleeping position (0.66, 0.12 to 3.59). While cosleeping with a mother who smoked was also associated with increased risk of SIDS among infants who did not use a dummy (4.5, 1.3 to 15.1), there was no such association among those who did (1.1, 0.1 to 13.4). CONCLUSIONS: Use of a dummy seems to reduce the risk of SIDS and possibly reduces the influence of known risk factors in the sleep environment.
OBJECTIVE: The case of a child with a repaired cleft palate and a pacifier habit is presented. The influence of both the cleft and the habit on the malocclusion is discussed. The malocclusion disappeared as the habit ceased.
OBJECTIVE: To assess the effectiveness of oral sucrose via a nipple compared with no treatment and dorsal penile nerve block (DPNB) for alleviating pain in neonatal circumcision. DESIGN: Randomized control trial. Data analysis performed by investigators blinded to the 3 treatment groups. SETTING: University teaching hospital, General Care Nursery. PATIENTS: One hundred nineteen full-term male, normal birth weight neonates, 12 hours old or older. INTERVENTIONS: No treatment (our standard care), DPNB, or oral sucrose prior to circumcision. MAIN OUTCOME MEASURES: Differences between groups in heart rate and oxygen saturation changes from baseline during specified intervals of the circumcision procedure. Differences between groups in loss of data due to episodes of excessive motion. RESULTS: Sucrose gave significant (P < .001) pain relief compared with the no treatment control throughout most of the circumcision and particularly in the early stages of the procedure. Overall, the average difference in the elevation of heart rates during the circumcision operative procedure among the 3 groups and the 95% confidence intervals (CIs) were as follows: control vs DPNB, 27.1 beats/min (17.6, 36.6) and control vs sucrose, 9.7 beats/min (0.1, 19.3). Furthermore, newborns who received either DPNB or sucrose had less loss of oxygen saturation data due to excessive motion during the procedure than the no-treatment controls. The total percentages of lost data due to excessive motion in the 3 groups were 31% for control, 10% for DPNB, and 8% for sucrose. Relative risk and 95% CIs were: DPNB vs control, 0.32 (0.23, 0.43); sucrose vs control, 0.26 (0.18, 0.36). Differences in oxygen saturation among the 3 groups during the circumcision operative procedure were statistically (P < .001), but perhaps not clinically, significant. However, the analysis did not include missing data due to excessive motion, which occurred predominantly in the no-treatment control group. CONCLUSION: Sucrose on a pacifier is an inexpensive and effective method for pain relief in neonatal circumcision when DPNB is not desirable.
Empirical data for functional measurements of the infant oral cavity under stimulated sucking conditions are presented. The data may serve as a basis for the design of nourishing and nipple-shaped pacifiers. Casts of the oral cavity during sucking show a sagittal flattening. The length of the nipple-head influences sucking capacity.
Rubber nipples and pacifiers were analysed for volatile N-nitrosamines using gas chromatography-thermal energy analysis after extraction with 'artificial saliva'. All of the 17 samples tested were found to contain at least two of the following: N-nitrosodimethylamine, N-nitrosodiethylamine, N-nitrosodibutylamine and N-nitrosopiperidine. Total volatile N-nitrosamine levels up to 19.7 micrograms/kg rubber were found, with a mean content of 7.3 micrograms/kg. Nitrosatable compounds, measured as N-nitrosamines after nitrosation, were detected in 15 of the 17 samples to total levels up to 13.7 mg/kg, the mean being 5.0 mg/kg.
A method is described for the determination of non-volatile N-nitrosamines in baby bottle rubber nipples and pacifiers. It consists of extraction of the sample with dichloromethane in the presence of ascorbyl palmitate (an inhibitor of artifactual formation of nitrosamines), clean-up on silica or basic alumina, and final analysis by high-performance liquid chromatography-thermal energy analysis, a technique which is highly specific for N-nitroso compounds. The method worked well for the determination of four rubber-related non-volatile nitrosamines, namely, N-nitrosomethylphenylamine, N-nitrosoethylphenylamine, N-nitrosodicyclohexylamine, and N-nitrosodibenzylamine (recoveries from spiked samples greater than 80%; detection limit, ca. 5 micrograms/kg for each). Eighteen out of twenty four samples analyzed were found to contain varying levels (mean, 41 micrograms/kg; range, 8-146 micrograms/kg) of N-nitrosodibenzylamine. The identity of the compound was confirmed by gas chromatography-thermal energy analysis as well as by gas chromatography-mass spectrometry analyses.
Latency to soothe by a pacifier in the neonatal period was assessed for 107 full-term infants. When the infants were 9 and 12 months old, their mothers rated their temperament on standardized questionnaires. Correlations were computed between the neonatal latencies to soothe and the temperament ratings. When compared with neonates who soothed more quickly, neonates who took longer to soothe were likely to be rated at 9 months as more active, more rhythmic, more approachful to new situations, and more adaptable; and at 12 months as more approachful, more pleasant in mood, and more The results are discussed in terms of developmental stages and individual variability in maturation, a shared underlying dimension of behavior for motor activity and emotionality, and a link across time between objective ratings of behavior and maternal views of infant temperament.
Samples of rubber baby bottle teats and pacifiers available in New Zealand were analyzed for nitrosamines by HPLC-TEA. These products, which were manufactured in the USA, Singapore, West Germany, England, and Japan contained one to three nitrosamines. All but one product, which was made of synthetic polyisoprene rubber complied with the US Food and Drug Administration regulatory limit of 60 ng/g. The mean level of total nitrosamines in 11 of the 12 products was 34 ng/g with a range from 9-63 ng/g. The twelfth product recorded a level of 190 ng/g total nitrosamines.
A longitudinal study was conducted to evaluate the hypothesis that a healthy mother-infant relationship is a prerequisite for the development of a child's attachment to a blanket or other soft object. Security of attachment to mother was measured at 12 months with the Strange Situation Test and at 30 months with the Attachment Q-Sort. Most of the children with soft object attachments were rated as securely attached to their mothers at both ages. Children with pacifier attachments, on the other hand, were less often rated as securely attached and were more likely to show changes in security classification between 12 and 30 months. The results are discussed in terms of necessary, but not sufficient, conditions for the development of attachments to inanimate objects.
PURPOSE: To determine whether nonnutritive sucking (NNS) in preterm infants influences selected outcome variables. DESIGN: A systematic review, based on the Cochrane Collaboration format, of trials utilizing experimental or quasi-experimental designs in which NNS (by pacifier) was compared to no provision of NNS; related to naso/orogastric tube feedings, bottle feedings, or not associated with feeding. SAMPLE: All infants born at < 37 weeks gestation. This review consisted of 19 studies; 13 were randomized controlled trials. Sample sizes ranged from 10 to 59 infants and totaled 518 infants. MAIN OUTCOME VARIABLE: Weight gain, energy intake, heart rate, oxygen saturation, length of hospital stay, intestinal transit time, and postconceptional age at full oral feedings. RESULTS: NNS significantly decreased the length of hospital stay in preterm infants. The review did not reveal a consistent benefit of NNS with respect to other major clinical variables. No negative outcomes were reported in any of the studies.
The case of an infant who developed intestinal obstruction following ingestion of a pacifier is reported. Progression of this foreign body in the intestinal lumen was extremely slow because of the deformability of the material and laparotomy was required. The authors point out that this is a difficult diagnosis and that regulations on manufacturing standards should be enforced in order to avoid such accidents.
Use of the baby pacifier or sucker has been the subject of controversy, due to the serious consequences that such habit may bring upon the infant. Different theoretical points of view have been set forth as to why should a child need such an object. Methods used by parents in an attempt to make the baby stop sucking a comforter go from passive suggestion to aggressive menace, sometimes carried out in reality.
A method is described for determining volatile nitrosamines in baby bottle rubber nipples and pacifiers. The method consists of overnight soaking of the sample with dichloromethane in the presence of propyl gallate, an inhibitor for artifactual formation of nitrosamines; extraction with dichloromethane using an ambient temperature column procedure; distillation from aqueous alkali; extraction of the aqueous distillate with dichloromethane and concentration of the extract using a Kuderna-Danish concentrator; and final analysis by gas chromatography with detection by thermal energy analyzer. Major improvements over other published methods include a simpler extraction, a more efficient distillation and concentration to minimize losses, and incorporation of propyl gallate inhibitor as well as of a test to detect unsuitable dichloromethane solvent that otherwise might lead to artifactual formation. The method is highly accurate (approximately 90% recovery) and precise (av. CV = 4.7% at greater than 9 ppb levels) and is applicable to determination of nitrosamines in both rubber- and plastic-based products.