Breastfeeding was defined as a form of feeding where the child is fed human milk (directly from the breast or expressed) regardless of other foods; in bottle-feeding, the child ingests any kind of liquid or semisolid food from a bottle. In the absence of a single clinical PLX4032 protocol for the diagnosis of mouth breathing, two methods were used. The first was a written history, as

established by Abreu et al.,13 which advocates the following clinical manifestations as major signs: snoring, mouth open while sleeping, drool on the pillow, stuffy nose every day. The following are considered as minor signs: itchy nose; occasional congested nose; difficulty breathing at night or restless sleep; irritability or drowsiness during the day; difficulty or delayed food swallowing; episodes of throat infection, ear infection or sinusitis; and difficulty in school or grade repetition. The occurrence of two major signs or two minor signs in the patient’s history is compatible with mouth breathing. The second method used was established by observation and palpation of the mentalis

muscle. The relationship of the upper and lower lips to the resting position of the tongue was evaluated, and breath analysis of the child was performed while he/she was in a more relaxed position, according to the method established by Moyers.18 The test was indicative of mouth breathing if the child showed a lack of lip seal. With these two diagnostic methods, the child’s breathing pattern type was determined; children who presented characteristics compatible with mouth breathing in both methods were considered as AZD2281 mouse mouth breathers. A pre-test questionnaire was administered to 20 mothers who did not participate in the study, in an attempt to make the necessary adjustments for a better MycoClean Mycoplasma Removal Kit understanding of the addressed factors. The legal guardians signed the consent form, according to the recommendations of Resolution 196/96

of the Ministry of Health and the Declaration of Helsinki. The study was approved by the Ethics in Research Committee of UFPI (Opinion No. CAAE 0039.0.045.000-10). The data were processed and analyzed using Stata, version 11.0 (Stata Corporation – College Station, TX, USA). To assess the association between variables, the chi-squared test was used. The multivariate analysis included variables with p < 0.20 in the bivariate analysis, using Poisson regression in order to verify the independent variables associated with the presence of oral breathing, controlled for possible confusion factors (adjusted prevalence ratios [PR]). The results were presented as PRs, and the 95% confidence interval and associations were verified by the Wald’s test. The results with p < 0.05 were considered statistically significant. The study population was composed of 139 male children (55.2%) and 113 female children (44.