title: Advising mothers about breastfeeding and weaning reduced pacifier use in the first year of life: a randomized trial.
abstract: OBJECTIVE
  To assess the effectiveness of home visits for advising mothers about breastfeeding and weaning on pacifier use in the first year of life.
  
  
  METHODS
  A randomized field trial was conducted on mothers who gave birth within the public health system in the Brazilian city of Sao Leopoldo (intervention group = 200; controls = 300). The intervention group received the advice 10 days after the child's birth, monthly up to 6 months, at 8, 10, and 12 months, based on the 'Ten Steps for Healthy Feeding', a Brazilian national health policy for primary care, which follows WHO guidelines. Relative risk (RR) was used to estimate the effects of the intervention on the risk of using a pacifier.
  
  
  RESULTS
  55.4% of the children in the intervention group and 66.1% of the controls used a pacifier in the first year of life. The risk of using a pacifier was 16% lower for the intervention group (RR = 0.84; 95% CI, 0.71-0.99). A multivariable Poisson regression model showed higher adjusted risk of using a pacifier for children who had breastfeeding interrupted in the first month of life (RR = 1.43; 95% CI, 1.21-1.69) and whose mothers presented higher level of depression (RR = 1.40; 95% CI, 1.17-1.66).
  
  
  CONCLUSIONS
  Pacifier use is highly prevalent in the population studied. The home visits for dietary advice appear to help in reducing pacifier use in infants. These findings suggest the need for public health strategies that address early advice on pacifier use to promote child oral and general health.
authors.affiliation: Department of Paediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil. cafeldens@terra.com.br
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Feldens
authors.forename: Thiago Machado
authors.initials: TM
authors.lastname: Ardenghi
authors.forename: Luciane Nascimento
authors.initials: LN
authors.lastname: Cruz
authors.forename: Giovana Pereira da Cunha
authors.initials: GP
authors.lastname: Scalco
authors.forename: Márcia Regina
authors.initials: MR
authors.lastname: Vítolo
mesh_terms: D000328:Adult; D001938:Brazil; D001942:Breast Feeding / Q000379:methods*; D019052:Depression, Postpartum; D037001:Directive Counseling; D005260:Female; D006266:Health Education / Q000379:methods*; D006291:Health Policy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000193:education* / Q000523:psychology; D015999:Multivariate Analysis; D041361:Pacifiers / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014886:Weaning