Andretta P.1; Settimi E.2 1Logopedista Magistrale, Servizio di Foniatria e Logopedia ASL 3 Bassano del Grappa; docente al corso di Laurea in Logopedia dell’Università degli Studi di Padova. 2Logopedista, Libero Professionista; Master di I° Livello Disturbi della Deglutizione.

Email: paki43@inwind.it elysettimi@libero.it

International SYMPOSIUM on OROFACIAL MYOFUNCTIONAL Therapy

FEEDING IN CHILDHOOD AND DEVELOPMENT CRANIUM-OROFACIAL

INTRODUCTION

METHOD

DISCUSSION

Swallowing is a neuromuscular mechanism that follows a physiological maturation represented by passage from childhood to adulthood swallowing. Alterations in the growth and development of the stomatognathic cause dysfunction in the performance of all oral functions (breathing, eating, verbal articulation, mime activities, sensory and kinesthetic) (P. Andretta 2005) and the development cranio-orofacial causing “Squilibrio Muscolare Orofacciale" (SMO). The main causes are divided into physiological factors (adenotonsillar hypertrophy, abnormal skeletal growth of the face, dysfunctions of the central nervous system affecting the face, tongue ankylosis, muscle orofacial injuries or diseases) and environmental factors (nutrition wrong, parafunctional habits, use of muscle relaxant drugs, interventions dental incomplete or incorrect, oral habits, buccal overprotection).

The study is based on a survey conducted through an anonymous questionnaire completed by parents of 162 children aged between 12 and 36 months with the exception of children affected by disease. For data analysis the children were divided into two age groups: 12-24 and 25-36 months. The preparation of the questionnaire was carried out in accordance with the recommendations published in the "Notebooks of the Ministry of Health" (January-February 2011), the LG of "American Academy of Pediatric Dentistry" (2013) and the studies found in the international literature of the last 10 years. Questionnaires were completed, for the most part, by parents, the remainder were compiled with the support of educators, adequately trained both for the administration and for the compilation. The purpose of the study is in order to confirm the hypothesis of significant relationships between type of breastfeeding, duration and the presence of oral habits and differences between the various modes of feeding in infancy.

Keywords: Non nutritive sucking and malocclusion; Non nutritive sucking; Oral habits; Breastfeeding and bottle feeding; Pacifier and digit sucking.

Analysis of the data showed that children breastfed are less likely to develop oral habits and non-nutritive sucking habits (73.68%); oral habits are more prevalent in children bottle-feeding (90.91%) or with mixed-mode (90%).

Type of nursing NO oral habits Oral habits

Breastfeeding 26,32% 73,68%

Bottle feeding 9,09% 90,91%

Mixed feeding 10,00% 90,00%

Breastfeeding and

then bottle feeding

14,29% 85,71%

(Breastfeeding and no oral habits) (Bottle feeding

and non nutritive sucking)

The duration of breastfeeding is a very important parameter because protects the children by the development of oral habits; then, early weaning could be an incentive to develop these habits.

The data obtained from the literature review indicate that ideal time for weaning from breastfeeding between 6 and 12 months; in the group of children examined the 18.82% of breastfeeding were weaned early and 81,18% were weaned over 6 months. In the group with early weaning a large number of children of non-nutritive sucking habits has over 24 months (71.43% bottle, pacifier and some 42.86% both modes), compared to the number of children with weaning over 6 months (35.48% bottle, pacifier 19,35%, 19,35% oral defects). Analysis of the data shows that in the current society a significant amount of children of non-nutritive sucking habits beyond 24 months: 52.05% bottle, pacifier 46.58%.

CONCLUSION The American Academy of Pediatric Dentistry in recommendations on oral habits (2013) argues that the welfare of an infant, a child or adolescent may be influenced by the oral habits and invites health professionals to take an individualized approach in the management of these habits (interdisciplinary approach). From the data obtained from a study we can draw the following conclusions and recommendations that are also relevant in national and international literature: - Breastfeeding protects children from development of oral habits and non-nutritive sucking habits. - The weaning from breastfeeding beyond six months reduces the likelihood of developing oral habits and non-nutritive sucking habits. - Non-nutritive sucking habits should be deleted within 24 months and no later than 36 (LG 2011) to encourage a good cranio-orofacial development. - It is essential to provide more information on the problems caused by prolonged use of pacifiers and bottles.

Conflict of interest statement The authors have no other funding, financial relationships, or conflicts of interest to disclose.