Baby Walker Use and Its Consequences in a Group of Turkish Children

Transkript

1 Çocuk Dergisi 2017; 17(): doi:.222/j.child Araştırma Baby Walker Use ad Its Cosequeces i a Grou of Turkish Childre Melike Mete*, Esra Devecioğlu**, Perra Bora***, Ayli Yetim****, Asilay Pazar***, Gülbi Gökçay***** Baby Walker Use ad Its Cosequeces i a Grou of Turkish Childre Objective: Although ot recommeded, owadays baby walkers (BWs) are commoly used by may arets i the re-walk eriod of childre. Therefore studies are eeded about the use ad effects of BWs o child health ad develomet to rovide evidece based recommedatios to arets. The aim of this study was to determie the frequecy of BW-use, ad related ijuries amog baby walker users, to ivestigate the effect of BW use o gross motor develomet of childre ad the relatioshi betwee BW use ad gait disorders. Material ad Method: 193 childre aged 8-8 moths, bor fullterm without ay chroic disease who were followed u i Outatiet Cliics of Social Pediatrics of Istabul Faculty of Medicie, ad Marmara Uiversity Traiig ad Research Hositals, ad their families were icluded i the study. Iformatio was gathered durig face to face iterviews about sociodemograhic characteristics of the families, their attidues about lays, ad toys, gross motor develomet of the baby, its use of baby walkers, accidets, ad diseases the baby exerieced, ad its maer of walkig. Childre usig BWs for at least 30 miutes er day for more tha a moth were cosidered as s. Results: Of all childre 7, were s. The most frequet reaso asserted by families for ot usig BW was hysicia s recommedatio, ad they used BWs to kee the baby occuied. The frequecy of ijuries was higher amog s tha o-users. This differece was statistically sigificat. Both grous attaied their motor develomet stages at similar ages. Gait disorders were see at a higher rate amog s tha ousers. Ages for the were similar i both grous. Coclusio: As was see baby walkers are revaletly referred by arets. I our ivestigatio we determied that BW use does ot affect the gross motor develomet rocess but the frequecy of gait disturbaces were foud to be higher amog s tha o-users. Further rosective studies are eeded to ivestigate the effect of BW use o toe walkig. Keywords: Baby walker, baby, child, ijuries, gait disorders J Child 2017; 17(): Alıdığı tarih: Kabul tarihi: *İstabul Üiversitesi, Çocuk Sağlığı Estitüsü, Aa Çocuk Sağlığı Yüksek Lisas Öğrecisi **İstabul Üiversitesi İstabul Tı Fakültesi, Sosyal Pediatri Bilim Dalı ***Marmara Üiversitesi Pedik Eğitim ve Araştırma Hastaesi, Sosyal Pediatri Bilim Dalı ****İstabul Üiversitesi İstabul Tı Fakültesi, Çocuk Sağlığı ve Hastalıkları Aa Bilim Dalı *****İstabul Üiversitesi, Çocuk Sağlığı Estitüsü Yazışma adresi: Melike Mete, İstabul Üiversitesi İstabul Tı Fakültesi Hastaesi, Çocuk Sağlığı ve Hastalıkları Aabilim Dalı, Sosyal Pediatri Bilim Dalı, Çocuk Sağlığı Polikliiği, Çaa 3 İstabul e-osta: melikemt@gmail.com Bir Gru Türk Çocuğuda Yürüteç Kullaımı ve Souçları Amaç: Yürüteçler öerilmemesie rağme, güümüzde ek çok ebevey tarafıda çeşitli edelerle yürüme öcesi döemde kullaılmaktadır. Bu edele, ae babalara kaıta dayalı öeriler sumak içi yürüteçleri çocuk sağlığı ve gelişimi üzerideki etkileri hakkıda çalışmalara gereksiim vardır. Bu araştırmada, çocuklarda yürüteç kullaım sıklığıı ve yürüteç kullaalarda kaza geçirme sıklığıı belirlemesi, yürüteç kullaımıı kaba motor gelişim ve yürüyüş bozuklukları üzerie etkisii icelemesi amaçlamıştır. Gereç ve Yötem: Araştırmaya İstabul Tı Fakültesi ve Marmara Üiversitesi Eğitim ve Araştırma Hastaesi Sosyal Pediatri olikliikleride izlee, miadıda doğa, herhagi bir kroik hastalığı olmaya, 8-8 ay arasıdaki 193 bebek ve çocuğu ailesi dahil edildi. Yüz yüze uygulaa aketler ile aileleri sosyodemografik özellikleri, oyu ve oyucak kousudaki tutumları, bebeği kaba motor gelişimi, yürüteç kullama durumu, geçirdiği kazalar ve hastalıklar, yürüyüş biçimi koularıda bilgi toladı. Bir ayda uzu süre ile, güde e az 30 dk. yürüteç kullaalar yürüteç kullaa grubuda değerledirildi. Bulgular: Çocukları 7. ii yürüteç kulladığı satadı. Aileleri yürüteç kullamama edeleri icelediğide e sık doktor öerisi edeiyle kullamadıkları, kullama edeleri icelediğide ise e sık bebeği oyalaması içi kulladıkları satadı. Yürüteç kullaaları kullamayalara göre daha fazla kaza geçirdiği belirledi. Aradaki fark istatistiksel açıda alamlı idi. İki gru arasıda motor gelişimsel basamakları kazama zamaı bezerdi. Yürüteç kullaalarda yürüyüş bozukluklarıı görülme oraı daha yüksek buludu. Souç: Yürüteçleri ebeveyler tarafıda yaygı olarak tercih edildiği görülmüştür. Araştırmamızda yürüteç kullaımıı bebeklerde kaba motor gelişim sürecii etkilemediği fakat yürüyüş bozuklukları ile ilişkili olduğu belirlemiştir. Çocuk gelişimi ve sağlığı açısıda, yürüteç kullaımıı armak ucuda yürüme üzerie etkisii iceleye detaylı araştırmalar yaılması gerekmektedir. Aahtar kelimeler: Yürüteç, bebek, çocuk, kazalar, yürüyüş bozuklukları Çocuk Dergisi 2017; 17(): INTRODUCTION Baby walkers (BWs) are curretly used i the rewalkig stage of childre for various reasos. Several studies have showed that the icidece of BW use is over 0 (1-3). I a study carried out i a urba city of Turkey, the frequecy of BW use was foud to be 7 (1). The reasos why the families refer to use 18

2 M. Mete ve ark., Baby Walker Use ad Its Cosequeces i a Grou of Turkish Childre BWs iclude the exectatio that their babies would develo better, or that BW would rovide distractio for the baby thus decreasig the aret s attedace time (). I this cotext, secifyig the beefits ad harms of BW use are imortat i terms of revetive medicie. Although there are differet oiios o this issue, the literature icludes a small umber of studies examiig the effects of BWs o the develomet ad health of childre. Some studies have reorted that use of BWs had egative imact o motor fuctios of childre, while some others roosed that these devices had o effect o euro-motor develomet (2,3,-9). There are studies that ivestigated the relatio betwee BW use ad accidets/ijuries i childre. The geeral view accordig to the fidigs of these studies is that use of BWs icreases the risk of accidets ad ijuries (2,,-16). A research study demostrated that there is a geetic tedecy about toe walkig but also idicated that there may be ogeetic factors which may cause gait disorders (17). To our kowledge there is o study about the relatio betwee BW use ad gait disorders i the literature. The aim of this study was to determie the frequecy of accidets/ijuries amog s ad to ivestigate the effect of BW use o some develometal milestoes ad gait disorders. MATERIAL ad METHOD The study ecomassed 193 childre aged 8-8 moths ad their arets/caregivers who cosecutively admitted to the well child cliics of Hositals of two Medical Schools i Istabul betwee Jauary ad February 201. Childre bor full term ( 37 gestatioal week), without ay chroic disease were icluded i the study. The study was aroved by the Ethics Committee of Istabul Uiversity School of Medicie (o. 2013/732). I both cliics where the study was coducted, childre were followed u from birth to the age of te years. All families were iformed that they should avoid usig BW for their childre, i case they asked a questio about the use of BW. The iformatio about sociodemograhic characteristics of the families, the status of BW use, the reasos for BW use were collected by a questioaire that alied to oe of the arets. The arets were also asked to rovide iformatio about the gross motor develomet of the child, the history of accidets ad the gait atter of the child. The childre who used BWs for at least 30 miutes er day for more tha a moth costituted the grou of. SPSS versio 18 (Chicago, IL, USA) was used for statistical aalysis. The demograhic roerties were examied by descritive statistical aalysis. Ma-Whitey U test ad chi-square test were used for comarisos. A value <0.0 was cosidered to be statistically sigificat. RESULTS Of all childre 0.2 were female. The frequecy of BW use was 7.. The mea age of oset of BW use was 7.6±1.9 moths. Most babies started to use BW betwee 7 ad 9 moths (6.8). The comarisos betwee the characteristics of, ad o-user childre ad their families are reseted i Table 1. Highly educated fathers ad those workig i the health sector were less likely to use BWs for their childre. The reasos for families for ad agaist BW use are show i Table 2. The most commo reaso for usig BWs was foud to be distractig attetio, ad the most commo reaso for ot usig a BW was because of the recommedatio of their hysicias. Although the time to start usuorted sittig, crawlig ad walkig ideedetly were slightly delayed i the grou, the differece was ot statistically sigificat (Table 3). The frequecy of accidets was higher amog s (13.) tha o-users (3.7) (=0.020). These accidets were ot reorted to be related to the use of BW. The gait disorders ad toe walkig were more commo i the BW- user grou tha i o-users (Table ). 19

3 Çocuk Dergisi 2017; 17(): Table 1. The comariso of the sociodemograhic roerties of the families betwee s ad o-users. (= 111) BW o-user (= 82) Geder of the childre Female Male Caretaker at home Mother Other (father, family elders, child carer, older sister, aut) Mother s occuatio Health sector Self-emloymet Govermet emloyee (teacher, olice officer, govermet officer) t workig Father s occuatio Health sector Self-emloymet Govermet emloyee (teacher, olice officer, govermet officer) Mother s workig status Workig t workig Materal educatio Illiterate 6-11 years years ad above Pateraleducatio Illiterate 6-11 years years ad above Number of childre i family Sigle 2 childre 3 childre ad more <0.0 was cosidered statistically sigificat DISCUSSION BBW is commoly used all aroud the world. More tha half of the arets reorted that they used BWs for their childre i our study. The icidece of BW use was 0 i Eglad,. i Ira, i Irelad, 9 i Kuwait, ad 90 i Sigaore (2,3,9,,18). I a commuity-based study coducted i the caital city of Turkey, three quarter of articiats were foud to use BWs (1). This rate was higher tha our results. This differece may be due to the hosital-based ature of our work ad recommedatios give durig the wellchild visits. I a study coducted i Ira, it was foud that educated arets, ad/or families with a sigle child esecially used BWs at higher rate whe comared with ueducated arets, ad/or families with more childre (2). I our study, o sigificat relatio was foud betwee the mother s educatio level ad the umber of childre i the family ad BW use. However, highly educated fathers ad those workig i the health sector were less likely to use BWs for their childre. I our study, the most commo reaso for ot usig BW was a hysicia s recommedatio, ad the most commo reaso for usig BWs was for 160

4 M. Mete ve ark., Baby Walker Use ad Its Cosequeces i a Grou of Turkish Childre Table 2. The reasos of families for usig ad ot usig a baby walker for their childre. Table 3. The comariso of the time to gai the gross motor skills of the childre betwee s ad o-users. The reasos for usig baby walker To kee the baby occuied To eable a better develomet With recommedatios of eighbors ad relatives To revet the baby s feelig cold o the floor With the recommedatio of a hysicia reaso Total The reasos for ot usig baby walker Age of oset of gross motor skills (moths) Usuortted sittig Crawlig Walkig ideedetly X±S 7.22± ±1.8.7±2. <0.0 was cosidered statistically sigificat X±S 7.1± ±1. 7.2± With the recommedatio of a hysica Because they did ot fid it ecessary Cocer that it may affect the baby s develomet egatively Because the baby did ot wat to use it Lack of fiacial ossibility To be rotected agaist ijuries It may be harmful for the geital orga of the male baby reaso Total distractig the attetio of the baby. Similarly Alessa et al. () reorted that oe of the mai reasos of arets to use BWs was to kee the baby occuied. Cotroversial results have bee reorted i studies which evaluated the effects of BW use o gross motor develomet of childre. Shiva et al. did ot fid ay differece betwee s ad ousers i terms of the age to start walkig (2). Some studies showed that the babies who used BWs were delayed i gaiig the skills of stadig o their feet ad walkig without suort, comared to the babies who did ot use (3,6). I a study from Uited States, the motor ad metal scores resultig from the Bayley Develometal tests were lower i BW user grou tha o-users (). O the other had, i a retrosective study the gross motor skills of babies were evaluated by the Alberta Baby Motor Develometal Scale ad it was foud that BW use had o effect o the time of ideedet walkig (7). I aother study age of ideedet walkig was lower amog s tha o-users (8). I our study although gross motor develomet was slightly delayed i the grou comared to the o-users, the differece was ot statistically sigificat. I our study the frequecy of accidets was higher amog s tha o-users. Although these Table. The comariso of the gait disorders betwee BW users ad o-users. Gait disorders Toe walkig Steig iwardly (= 1 ) <0.0 was cosidered statistically sigificat BW o-user (= 72) accidets were ot related to the use of BW, this fidig lead us to thik that s had a tedecy to the risky behaviours. I may studies, it has bee reorted that BW use may cause accidets ad ijuries (2,,9-16). Alessa et al. () reorted that about 30 of s had some accidets related to BWs. It has bee reorted that use of BWs at home icreased the risk of accidets by 9-fold (13). Morriso et al. (1) showed that BW use was oe of the first three causes of accidets durig ifacy. To our kowledge o study i the literature has ivestigated the relatio betwee BW use ad gait disorders. I a curret review about toe walkig, BW use was ot icluded amog the causes (19). However the curret literature does ot show cosistet data about the frequecy ad causes of idioathic toe walkig (17). Pomario et al. (17) reseted the geetic tedecy of toe walkig esecially amog boys ad cocluded that there may be 161

5 Çocuk Dergisi 2017; 17(): other ogeetic factors. I our study gait disorders were higher amog childre who used BWs tha o-users. BW use may be oe of the causes of gait disorders ad may be ivolved i the etiology. Further studies should be erformed which will ivestigate the relatio betwee gait disorders ad BW use. Oe of the limitatios of our study was that the childre s gait were ot followed u ad the develometal tests were ot alied regularly. Also it was a hosital- based study so the data were ot reresetive for the whole oulatio. However it is the first study that showed a relatio betwee BW use ad gait disorders. Our study sets the questio of whether BW use may cause gait disorders amog the childre. Commuity- based rosective studies usig develometal tests should be coducted o this issue Ackowledgemets We thak Haka Kürşat, who was a studet i the 6th grade at Istabul Uiversity, Istabul Medical School, for cotributig to the collectio of the data, Dr. Hayriye Ertem for cotributig to statistical aalysis of the study, ad the families who articiated i this study. Fudig: The authors have o fiacial suort to declare. Coflict of iterest: The authors declare that they have o coflict of iterest. REFERENCES 1. Doga DG, Bilici M, Yilmaz AE, Catal F, Keles N. Baby walkers: a ersective from Turkey. Acta Paediatr 2009;98: htts://doi.org/.1111/j x 2. Shiva F, Ghotbi F, Yavari SF. The use of baby walkers i Iraia ifats. Sigaore Med J 20;1: Garrett M, McElroy AM, Staies A. Locomotor milestoes ad babywalkers: Cross sectioal study. BMJ 2002;32:19. htts://doi.org/.1136/bmj Al-uri L, Al-Isami S. Baby walker ijuries. A Tro Paediatr 2006;26: htts://doi.org/.1179/ x Siegel AC, Burto RV. Effects of baby walkers o motor ad metal develomet i huma ifats. J Dev Behav Pediatr 1999;20:3-61. htts://doi.org/.97/ Talebia A, Hoarishe A, Taghavi A, Fakharia E, Parsa M, Mousavi GA. Do ifats usig baby walkers suffer develometal delays i acquisitio of motor skills? Ira J Child Neurology 2008;2; Chagas PS, Macii MC, Tirado MG, Megale L, Samaio RF. Beliefs about the use of baby walkers. Rev Bras Fisioter 2011;1: htts://doi.org/.190/s Çöl N, Perk P, Özçelik AA. Possible role of BWs usage time oset of walkig without suort i healty ifats? 1st İteratioal Develometal Pediatrics Cogress Book of Abstracts 2016; PP 076, Thei MM, Lee J, Tay V, Lig SL. Ifat walker use, ijuries, ad motor develomet. Ij Prev 1997;3:63-6. htts://doi.org/.1136/i Alessa M, Humoud M, Qabadi WA. Paretal attitudes toward the use of baby walkers. It J Health Sci (Qassim) 201;3():9-13. htts://doi.org/.160/ijhs.v3a 11. Dedoukou X, Syridooulos T, Kedikoglou S, Alexe DM, Dessyris N, Petridou E. Icidece ad risk factors of fall ijuries amog ifats: a study i Greece. Arch Pediatr Adolesc Med 200;18:02-6. htts://doi.org/.01/archedi Coats TJ, Alle M. Baby walker related ijuries--a cotiuig roblem. Arch Emerg Med 1991;8:2-. htts://doi.org/.1136/emj LeBlac JC, et al. Home safety measures ad the risk of uitetioal ijury amog youg childre: a multicetre case-cotrol study. CMAJ 2006;17: htts://doi.org/.103/cmaj Morriso L, Chalmers DJ, Parry ML ad Wright CS. Ifat-furiture-related ijuries amog reschool childre i New Zealad, J Paediatr Child Health 2002;38: htts://doi.org/.6/j x 1. America Academy of Pediatrics. Ijuries associated with ifat walkers. Pediatrics 2001;8: Shields BJ, Smith GA. Success i the revetio of ifat walker-related ijuries: a aalysis of atioal data, Pediatrics 2006;117:2-9. htts://doi.org/./eds Pomario D, Ramirez-Llamas J, Pomario A. Idioathic toe walkig: Family redisositio ad geder distributio. Foot Akle Sec 2016;9: htts://doi.org/.1177/ Kedrick D, et al. Promotig child safety i rimary care: a cluster radomised cotrolled trial to reduce baby walker use. Br J Ge Pract 200;(17): Sivaramakrisha S, Seal A. Fiftee-miute cosultatio: A child with toe walkig. Arch Dis Child Educ Pract Ed 201;0: htts://doi.org/.1136/archdischild