Сложности грудного вскармливания при затрудненном носовом дыхании у ребенка: альтернативные методы докорма

В статье освещаются особенности грудного вскармливания (ГВ) при затрудненном носовом дыхании у младенцев. Особенное внимание уделено несосательному (альтернативному) бутылочному методу докорма сцеженным грудным молоком, который является актуальным на тот период, когда невозможно ГВ или необходим докорм смесью как дополнение к нему.
Дыхание через рот считается патологической адаптацией вследствие затруднения носового дыхания и связано с развитием многих патологических состояний. Доказано, что длительное ГВ связано с устоявшимся носовым дыханием в более старшем возрасте, а также с правильным формированием прикуса. Анатомо-физиологические особенности строения верхних дыхательных путей у младенцев обуславливают более частое появление затрудненного носового дыхания по сравнению со взрослыми, что вызывает сложности при ГВ вплоть до отказа ребенка от груди. В связи с этим знание современных методов докорма сцеженным грудным молоком наряду с осведомленностью в области эффективной и безопасной терапии заложенности носа у младенцев поможет врачам и родителям преодолеть трудный период заболевания и сохранить ГВ как можно дольше, что особенно важно в свете современных представлений о влиянии этого метода кормления на последующую жизнь матери и ребенка.
Основным методом лечения заложенности носа различной этиологии является ирригационно-элиминационная терапия. Согласно научным данным, назальный аспиратор обладает хорошей переносимостью и не имеет побочных эффектов, применение лекарственного средства особенно эффективно совместно с изотоническим солевым раствором.

1. Basheer B., Hegde K.S., Bhat S.S., Umar D., Baroudi K. Influence of mouth breathing on the dentofacial growth of children: a cephalometric study. J Int Oral Health. 2014;6(6):50–55. Available at: https://pubmed.ncbi.nlm.nih.gov/25628484/.

2. Garde J.B., Suryavanshi R.K., Jawale B.A., Deshmukh V., Dadhe D.P., Suryavanshi M.K. An epidemiological study to know the prevalence of deleterious oral habits among 6 to 12 years old children. J Int Oral Health. 2014;6(1):39–43. Available at: https://pubmed.ncbi.nlm.nih.gov/24653601/.

3. Sharma S., Bansal A., Asopa K. Prevalence of oral habits among eleven to thirteen years old children in Jaipur. Int J Clin Pediatr Dent. 2015;8(3):208–210. https://doi.org/10.5005/jp-journals-10005-1314.

4. Lopes T.S.P., Moura L.F.A.D., Lima M.C.M.P. Association between breastfeeding and breathing pattern in children: a sectional study. J Pediatr (Rio J). 2014;90(4):396–402. https://doi.org/10.1016/j.jped.2013.12.011.

5. Felcar J.M., Bueno I.R., Massan A.C.S., Torezan R.P., Cardoso J.R. Prevalence of mouth breathing in children from an elementary school. Cien Saude Colet. 2010;15(2):437–444. https://doi.org/10.1590/S1413-81232010000200020.

6. Campanha S.M.A., Fontes M.J.F., Camargos P.A.M., Freire L.M.S. The impact of speech therapy on asthma and allergic rhinitis control in mouth breathing children and adolescents. J Pediatr (Rio J). 2010;86(3):202–208. http://doi.org/10.2223/JPED.1995.

7. Chambi-Rocha A., Cabrera-Domínguez M.E., Domínguez-Reyes A. Breathing mode influence on craniofacial development and head posture. J Pediatr (Rio J). 2018;94(2):123–130. https://doi.org/10.1016/j.jped.2017.05.007.

8. Saitoh I., Inada E., Kaihara Y., Nogami Y., Murakami D., Kubota N. et al. An exploratory study of the factors related to mouth breathing syndrome in primary school children. Arch Oral Biol. 2018;92:57–61. https://doi.org/10.1016/j.archoralbio.2018.03.012.

9. Ballikaya E., Dogan B.G., Onay O., Tekcicek M.U. Oral health status of children with mouth breathing due to adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol. 2018;113:11–15. https://doi.org/10.1016/j.ijporl.2018.07.018.

10. Hitos S.F., Arakaki R., Solé D., Weckx L.L.M. Oral breathing and speech disorders in children. J Pediatr (Rio J). 2013;89(4):361–365. https://doi.org/10.1016/j.jped.2012.12.007.

11. Mizutani S., Ekuni D., Tomofuji T., Azuma T., Kataoka K., Yamane M., Iwasaki Y., Morita M. Relationship between xerostomia and gingival condition in young adults. J Periodontal Res. 2015;50(1):74–79. https://doi.org/10.1111/jre.12183.

12. Demir U.L., Cetinkaya B., Karaca S., Sigirli D. The impacts of adenotonsillar hypertrophy on periodontal health in children: a prospective controlled pilot study. Am J Otolaryngol. 2013;34(5):501–504. https://doi.org/10.1016/j.amjoto.2013.04.013.

13. Ribeiro G.C.A., Santos I.D.D., Santos A.C.N., Paranhos L.R., César C.P.H.A.R. Influence of the breathing pattern on the learning process: a systematic review of literature. Braz J Otorhinolaryngol. 2016;82(4):466–478. https://doi.org/10.1016/j.bjorl.2015.08.026.

14. Harari D., Redlich M., Miri S., Hamud T., Gross M. The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. Laryngoscope. 2010;120(10):2089–2093. https://doi.org/10.1002/lary.20991.

15. de Menezes V.A., Cavalcanti L.L., de Albuquerque T.C., Garcia A.F.G., Leal R.B. Mouth breathing within a multidisciplinary approach: perception of orthodontists in the city of Recife, Brazil. Dental Press J Orthod. 2011;16(6):84–92. https://doi.org/10.1590/S2176-94512011000600014.

16. Limeira A.B., Aguiar C.M., de Lima Bezerra N.S., Câmara A.C. Association between breastfeeding and the development of breathing patterns in children. Eur J Pediatr. 2013;172(4):519–524. https://doi.org/10.1007/s00431-012-1919-x.

17. Lopes T.S.P., Moura L.F.A.D., Lima M.C.M.P. Association between breastfeeding and breathing pattern in children: a sectional study. J Pediatr (Rio J). 2014;90(4):396–402. https://doi.org/10.1016/j.jped.2013.12.011.

18. Park E.H., Kim J.-G., Yang Y.-M., Jeon J.-G., Yoo J.-I., Kim J.-K., Lee D.-W. Association Between Breastfeeding and Childhood Breathing Patterns: a Systematic Review and Meta-Analysis. Breastfeed Med. 2018;13(4):240–247. https://doi.org/10.1089/bfm.2017.0222.

19. Savian C.M., Bolsson G.B., Botton G., Antoniazzi R.P., de Oliveira Rocha R., Zanatta F.B., Santos B.Z. Do breastfed children have a lower chance of developing mouth breathing? a systematic review and meta-analysis. Clin Oral Investig. 2021;25(4):1641–1654. https://doi.org/10.1007/s00784-021-03791-1.

20. Victora C.G., Bahl R., Barros A.J.D., França G.V.A., Horton S., Krasevec J. et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475–490. https://doi.org/10.1016/S0140-6736(15)01024-7.

21. Brahm P., Valdés V. The benefits of breastfeeding and associated risks of replacement with baby formulas. Rev Chil Pediatr. 2017;88(1):7–14. https://doi.org/10.4067/S0370-41062017000100001.

22. Neumann R.P., von Ungern-Sternberg B.S. The neonatal lung – Physiology and ventilation. Paediatr Anaesth. 2014;24(1):10–21. https://doi.org/10.1111/pan.12280.

23. El Taoum K.K., Xi J., Kim J.W., Berlinski A. In vitro evaluation of aerosols delivered via the nasal route. Respir Care. 2015;60(7):1015–1025. https://doi.org/10.4187/respcare.03606.

24. Бойкова Н.Э., Гаращенко Т.И. Ирригационная терапия у детей младшего возраста. Медицинский совет. 2016;(16):74–78. https://doi.org/10.21518/2079-701X-2016-16-74-78.

25. Xi J., Si X., Zhou Y., Kim J., Berlinski A. Growth of nasal and laryngeal airways in children: implications in breathing and inhaled aerosol dynamics. Respir Care. 2014;59(2):263–273. https://doi.org/10.4187/respcare.02568.

26. Nayyeri F., Raji F., Haghnazarian E., Shariat M., Dalili H. Frequency of “nursing strike” among 6-month-old infants, at east Tehran health center and contributing factors. J Family Reprod Health. 2015;9(3):137–140. Available at: https://pubmed.ncbi.nlm.nih.gov/26622313/.

27. Jalali F., Kamiab Z., Khademalhosseini M., Daeizadeh F., Bazmandegan G. Nursing strikes among infants and its affecting factors in Rafsanjan city. J Med Life. 2021;14(1):56–60. https://doi.org/10.25122/jml-2020-0118.

28. Ardran G.M., Kemp F.H., Lind J. A cineradiographic study of bottle feeding. Br J Radiol. 1958;31(361):11–22. https://doi.org/10.1259/0007-1285-31-361-11.

29. Woolridge M.W. The “anatomy” of infant sucking. Midwifery. 1986;2(4):164–171. https://doi.org/10.1016/S0266-6138(86)80041-9.

30. Lawrence R.A., Lawrence R.M. Breastfeeding. A guide for the Medical Professional. 8th ed. Philadelphia: Elsevier; 2016. 992 p. Available at: https://iums.ac.ir/files/vch/files/laranc.pdf.

31. Walker M. Breastfeeding management for the clinician: Using the evidence. 2nd ed. Massachusetts: Jones and Bartlett Publishers; 2010. 550 p. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6860729/.

32. Nowak A.J., Smith W.L., Erenberg A. Imaging evaluation of artificial nipples during bottle feeding. Arch Pediatr Adolesc Med. 1994;148(1):40–42. https://doi.org/10.1001/archpedi.1994.02170010042008.

33. Geddes D.T., Langton D.B., Gollow I., Jacobs L.A., Hartmann P.E., Simmer K. Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and sucking mechanism as imaged by ultrasound. Pediatrics. 2008;122(1):e188–e194. https://doi.org/10.1542/peds.2007-2553.

34. Gomes C.F., Trezza E.M.C., Murade E.C.M., Padovani C.R. Surface electromyography of facial muscles during natural and artificial feeding of infants. J Pediatr (Rio J). 2006;82(2):103–109. Available at: https://pubmed.ncbi.nlm.nih.gov/16614763/.

35. Wambach K., Riordan J. Breastfeeding and Human Lactation. 5th ed. Canada: Jones and Barlett Publishers; 2005. 912 p. Available at: https://books.google.nr/books?id=pj1DDwAAQBAJ&printsec=frontcover#v=onepage&q&f=false

36. Infant and Young Child Feeding: Model Chapter for Textbooks for Medical Students and Allied Health Professionals. Geneva: World Health Organization; 2009. Available at: https://www.ncbi.nlm.nih.gov/books/NBK148965/.

37. Mizuno K., Ueda A. Changes in sucking performance from nonnutritive sucking to nutritive sucking during breast- and bottle-feeding. Pediatr Res. 2006;59(5):728–731. https://doi.org/10.1203/01.pdr.0000214993.82214.1c.

38. Batista C.L.C., Ribeiro V.S., Nascimento M.D.S.B., Rodrigues V.P. Association between pacifier use and bottle-feeding and unfavorable behaviors during breastfeeding. J Pediatr (Rio J). 2018;94(6):596–601. https://doi.org/10.1016/j.jped.2017.10.005.

39. McKinney C.M., Balakrishnan U., Ninan B., Glass R., Cunningham M., Murthy J. A Comparative Study of Two Infant Feeding Tools: The Nifty Cup and The Paladai. Indian J Pediatr. 2020;87(7):505–511. https://doi.org/10.1007/s12098-020-03237-8.

40. Fredeen R.C. Cup feeding of newborn infants. Pediatrics. 1948;2(5):544–548. Available at: https://pubmed.ncbi.nlm.nih.gov/18893011/.

41. Musoke R.N. Breastfeeding promotion: Feeding the low birth weight infant. Int J Gynecol Obstet. 1990;31 Suppl 1:57–59. https://doi.org/10.1016/0020-7292(90)90077-X.

42. Marinelli K.A., Burke G.S., Dodd V.L. A comparison of the safety of cupfeedings and bottlefeedings in premature infants whose mothers intend to breastfeed. J Perinatol. 2001;21(6):350–355. https://doi.org/10.1038/sj.jp.7210539.

43. França E.C.L., Sousa C.B., Aragão L.C., Costa L.R. Electromyographic analysis of masseter muscle in newborns during suction in breast, bottle or cup feeding. BMC Pregnancy Childbirth. 2014;14:154. https://doi.org/10.1186/1471-2393-14-154.

44. Penny F., Judge M., Brownell E., McGrath J.M. Cup Feeding as a Supplemental, Alternative Feeding Method for Preterm Breastfed Infants: An Integrative Review. Matern Child Health J. 2018;22(11):1568–1579. https://doi.org/10.1007/s10995-018-2632-9.

45. Wilson-Clay B., Hoover K.L. The breastfeeding Atlas. 6th ed. Lactnews Press; 2017. 206 p.

46. Aytekin A., Albayrak E.B., Küçükoğlu S., Caner İ. The effect of feeding with spoon and bottle on the time of switching to full breastfeeding and sucking success in preterm babies. Turk Pediatri Ars. 2014;49(4):307–313. https://doi.org/10.5152/tpa.2014.1904.

47. Buldur E., Baltaci N.Y., Terek D., Yalaz M., Koroglu O.A., Akisu M., Kultursay N. Comparison of the Finger Feeding Method Versus Syringe Feeding Method in Supporting Sucking Skills of Preterm Babies. Breastfeed Med. 2020;15(11):703–708. https://doi.org/10.1089/bfm.2020.0043.

48. Nunes J. de A., Bianchini E.M.G., Cunha M.C. Oxygen saturation and heart rate in premature: comparison between cup and finger feeding techniques. Codas. 2019;31(6):e20180221. https://doi.org/10.1590/2317-1782/20192018221.

49. Moreira C.M.D., Cavalcante-Silva R.P.G.V., Fujinaga C.I., Marson F. Comparison of the finger-feeding versus cup feeding methods in the transition from gastric to oral feeding in preterm infants. J Pediatr (Rio J). 2017;93(6):585–591. https://doi.org/10.1016/j.jped.2016.12.008.

50. Gribble K.D. Adoptive breastfeeding. Breastfeed Rev. 2005;13(3):6. Available at: https://pubmed.ncbi.nlm.nih.gov/16342406/.

51. Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #3: Hospital Guidelines for the Use of Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2009. Breastfeed Med. 2009;4(3):175–182. https://doi.org/10.1089/bfm.2009.9991.

52. Borucki L.C. Breastfeeding mothers’ experiences using a supplemental feeding tube device: finding an alternative. J Hum Lact. 2005;21(4):429–438. https://doi.org/10.1177/0890334405277822.

53. Rocha N.M.N., Martinez F.E., Jorge S.M. Cup or bottle for preterm infants: effects on oxygen saturation, weight gain, and breastfeeding. J Hum Lact. 2002;18(2):132–138. https://doi.org/10.1177/089033440201800204.

54. Penny F., Judge M., Brownell E., McGrath J.M. What Is the Evidence for Use of a Supplemental Feeding Tube Device as an Alternative Supplemental Feeding Method for Breastfed Infants? Adv Neonatal Care. 2018;18(1):31–37. https://doi.org/10.1097/ANC.0000000000000446.

55. Gallant J.-N., Basem J.I., Turner J.H., Shannon C.N., Virgin F.W. Nasal saline irrigation in pediatric rhinosinusitis: a systematic review. Int J Pediatr Otorhinolaryngol. 2018;108:155–162. https://doi.org/10.1016/j.ijporl.2018.03.001.

56. Fokkens W.J., Lund V.J., Hopkins C., Hellings P.W., Kern R., Reitsma S. et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl S29):1–464. https://doi.org/10.4193/Rhin20.600.

57. Spinato G., Fabbris C., Costantini G., Conte F., Scotton P.G., Cinetto F. et al. The Effect of Isotonic Saline Nasal Lavages in Improving Symptoms in SARS-CoV-2 Infection: a Case-Control Study. Front Neurol. 2021;12:794471. https://doi.org/10.3389/fneur.2021.794471.

58. de Gabory L., Kérimian M., Sagardoy T., Verdaguer A., Gauchez H. Paediatric nasal irrigation: The “fencing” method. Eur Ann Otorhinolaryngol Head Neck Dis. 2021;138(2):107–113. https://doi.org/10.1016/j.anorl.2020.08.004.

59. Chirico G., Quartarone G., Mallefet P. Nasal congestion in infants and children: a literature review on efficacy and safety of non-pharmacological treatments. Minerva Pediatr. 2014;66(6):549–557. Available at: https://pubmed.ncbi.nlm.nih.gov/25336097/.

60. Пайганова Н.Э., Зайцев В.М. Уход за полостью носа при насморке у новорожденных и детей первых лет жизни – современные тенденции. Медицинский совет. 2019;(17):116–121. https://doi.org/10.21518/2079-701X-2019-17-116-121.

61. Tschiderer L., Seekircher L., Kunutsor S.K., Peters S.A.E., O’Keeffe L.M., Willeit P. Breastfeeding Is Associated With a Reduced Maternal Cardiovascular Risk: Systematic Review and Meta-Analysis Involving Data From 8 Studies and 1 192 700 Parous Women. J Am Heart Assoc. 2022;11(2):e022746. https://doi.org/10.1161/JAHA.121.022746.