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The relationship of bottle feeding and other sucking behaviors with speech disorder in Patagonian preschoolers

Clarita Barbosa1, Sandra Vasquez1, Mary A Parada2, Juan Carlos Velez Gonzalez1, Chanaye Jackson2, N David Yanez23, Bizu Gelaye2* and Annette L Fitzpatrick24

Author Affiliations

1 Corporacion de Rehabilitacion Club De Leones Cruz Del Sur, Punta Arenas, Chile

2 Multidisciplinary International Research Training Program, University of Washington, School of Public Health, Seattle, Washington, USA

3 Department of Biostatistics, University of Washington, School of Public Health, Seattle, Washington, USA

4 Departments of Epidemiology and Global Health, University of Washington, School of Public Health, Seattle, Washington, USA

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BMC Pediatrics 2009, 9:66  doi:10.1186/1471-2431-9-66

Published: 21 October 2009



Previous studies have shown that children's nonnutritive sucking habits may lead to delayed development of their oral anatomy and functioning. However, these findings were inconsistent. We investigated associations between use of bottles, pacifiers, and other sucking behaviors with speech disorders in children attending three preschools in Punta Arenas (Patagonia), Chile.


Information on infant feeding and sucking behaviors, age starting and stopping breast- and bottle-feeding, pacifier use, and other sucking behaviors, was collected from self-administered questionnaires completed by parents. Evaluation of speech problems was conducted at preschools with subsequent scoring by a licensed speech pathologist using age-normative standards.


A total of 128 three- to five-year olds were assessed, 46% girls and 54% boys. Children were breastfed for an average of 25.2 (SD 9.6) months and used a bottle 24.4 (SD 15.2) months. Fifty-three children (41.7%) had or currently used a pacifier for an average of 11.4 (SD 17.3) months; 23 children (18.3%) were reported to have sucked their fingers. Delayed use of a bottle until after 9 months appeared to be protective for subsequent speech disorders. There was less than a one-third lower relative odds of subsequent speech disorders for children with a delayed use of a bottle compared to children without a delayed use of a bottle (OR: 0.32, 95% CI: 0.10-0.98). A three-fold increase in relative odds of speech disorder was found for finger-sucking behavior (OR: 2.99, 95% CI: 1.10-8.00) and for use of a pacifier for 3 or more years (OR: 3.42, 95% CI: 1.08-10.81).


The results suggest extended use of sucking outside of breastfeeding may have detrimental effects on speech development in young children.