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Re: ‘Association between exclusive maternal breastfeeding during the first 4 months of life and primary enuresis’
Journal of Pediatric Urology (2016) 12, 96
Letter to the Editor
Re: ‘Association between exclusive maternal breastfeeding during the first 4 months of life and primary enuresis’
breastfeed [4]. A study by Barone et al. compared enuretic children with a control group, and showed that duration of breastfeeding longer than 3 months had a protective effect against bedwetting [5]. Therefore, breastfeeding is not a new factor affecting enuresis.
Dear Editor,
We read the article by Oliveira et al. [1] with interest. In their study they reported that the duration of breastfeeding of less than 4 months is strongly associated with primary enuresis. However, we have some comments with regard to this article. 1. The study included non-monosymptomatic enuresis patients with symptoms such as lower urinary tract dysfunction and bowel dysfunction. This situation causes suspicions about the other evaluated factors [2]. 2. The authors chose a cut-off value for breastfeeding of 4 months. As an explanation, they stated the local breastfeeding habits and ease of recall during questioning. In papers published by quality journals there should be a scientific explanation for this ‘arbitrarily’ chosen value. 3. While diabetes, which is rarely seen in the childhood period, is excluded from the study, enuresis-related diseases, such as adenoid hyperplasia and obstructive sleep apneaehypopnea syndrome, were not considered in the study design [3]. 4. In the enuretic group, patients using diuretic medications were excluded from the study. But alarm therapy and desmopressin, which are evidence-based first-line treatments, were not considered in the study design and discussion section. 5. The authors stated that duration of exclusive breastfeeding for less than 4 months was a new factor affecting enuresis. However, previously, Singh et al. investigated the relationship between bedwetting and enuresis, and the authors found higher enuresis prevalence in children fed using a bottle compared with those who were
References [1] de Oliveira DM, Dahan P, Ferreira DF, de Oliveira LF, de Paula LI, de Figueiredo AA, et al. Association between exclusive maternal breastfeeding during the first 4 months of life and primary enuresis. J Pediatr Urol 2016;12(2): 95.e1e6. [2] Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization committee of the International Children’s Continence Society. J Urol 2014;191:1863e5. [3] Van Herzeele C, Evans J, Eggert P, Lottmann H, Norgaard JP, Vande Walle J. Predictive parameters of response to desmopressin in primary nocturnal enuresis. J Pediatr Urol 2015;11(200): 1e8. [4] Singh H, Kaur L, Kataria SP. Enuresis: analysis of 100 cases. Indian Pediatr 1991;28:375e80. [5] Barone JG, Ramasamy R, Farkas A, Lerner E, Creenan E, Salmon D, et al. Breastfeeding during infancy may protect against bed-wetting during childhood. Pediatrics 2006;118:254e9.
Eyup Burak Sancak* Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey Omer Kurt Namık Kemal University, Tekirdag, Turkey *Correspondence to: Eyup Burak Sancak, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey. E-mail address: eyupburaksancak@ comu.edu.tr (E.B. Sancak) 30 November 2015 Available online 18 January 2016
DOI of original article: http://dx.doi.org/10.1016/j.jpurol.2015.07.008. http://dx.doi.org/10.1016/j.jpurol.2015.12.003 1477-5131/ª 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
Letter to the Editor
Re: ‘Association between exclusive maternal breastfeeding during the first 4 months of life and primary enuresis’
breastfeed [4]. A study by Barone et al. compared enuretic children with a control group, and showed that duration of breastfeeding longer than 3 months had a protective effect against bedwetting [5]. Therefore, breastfeeding is not a new factor affecting enuresis.
Dear Editor,
We read the article by Oliveira et al. [1] with interest. In their study they reported that the duration of breastfeeding of less than 4 months is strongly associated with primary enuresis. However, we have some comments with regard to this article. 1. The study included non-monosymptomatic enuresis patients with symptoms such as lower urinary tract dysfunction and bowel dysfunction. This situation causes suspicions about the other evaluated factors [2]. 2. The authors chose a cut-off value for breastfeeding of 4 months. As an explanation, they stated the local breastfeeding habits and ease of recall during questioning. In papers published by quality journals there should be a scientific explanation for this ‘arbitrarily’ chosen value. 3. While diabetes, which is rarely seen in the childhood period, is excluded from the study, enuresis-related diseases, such as adenoid hyperplasia and obstructive sleep apneaehypopnea syndrome, were not considered in the study design [3]. 4. In the enuretic group, patients using diuretic medications were excluded from the study. But alarm therapy and desmopressin, which are evidence-based first-line treatments, were not considered in the study design and discussion section. 5. The authors stated that duration of exclusive breastfeeding for less than 4 months was a new factor affecting enuresis. However, previously, Singh et al. investigated the relationship between bedwetting and enuresis, and the authors found higher enuresis prevalence in children fed using a bottle compared with those who were
References [1] de Oliveira DM, Dahan P, Ferreira DF, de Oliveira LF, de Paula LI, de Figueiredo AA, et al. Association between exclusive maternal breastfeeding during the first 4 months of life and primary enuresis. J Pediatr Urol 2016;12(2): 95.e1e6. [2] Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization committee of the International Children’s Continence Society. J Urol 2014;191:1863e5. [3] Van Herzeele C, Evans J, Eggert P, Lottmann H, Norgaard JP, Vande Walle J. Predictive parameters of response to desmopressin in primary nocturnal enuresis. J Pediatr Urol 2015;11(200): 1e8. [4] Singh H, Kaur L, Kataria SP. Enuresis: analysis of 100 cases. Indian Pediatr 1991;28:375e80. [5] Barone JG, Ramasamy R, Farkas A, Lerner E, Creenan E, Salmon D, et al. Breastfeeding during infancy may protect against bed-wetting during childhood. Pediatrics 2006;118:254e9.
Eyup Burak Sancak* Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey Omer Kurt Namık Kemal University, Tekirdag, Turkey *Correspondence to: Eyup Burak Sancak, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey. E-mail address: eyupburaksancak@ comu.edu.tr (E.B. Sancak) 30 November 2015 Available online 18 January 2016
DOI of original article: http://dx.doi.org/10.1016/j.jpurol.2015.07.008. http://dx.doi.org/10.1016/j.jpurol.2015.12.003 1477-5131/ª 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.