Bednar’s Aphthae in Infants in Duhok; A Prospective Cross-Sectional Study

Abstract

Background 
 Bednar’s aphthae are small shallow ulcers at the margin of the palate of newborns. They primarily result from the traumatic action of a bottle teat or the nipple of the mother’s breast during feeding. More recently, an immune process has been hypothesized to explain its pathogenesis.
 Objectives 
 To study the clinical features, the associated factors, and the time of healing of Bednar’s aphthae in Duhok. 
 Patients and Methods
 This study was conducted from January 1st, 2020, to February 1st, 2021. It enrolled 17 newborns and infants diagnosed with Bednar’s aphthae through clinical examination while undergoing routine health checkups. Information about sex, delivery mode, age, birth weight, gestational age, perinatal problems, feeding method, feeding habits, type of milk (formula, breast milk, or both), and using a pacifier or not were obtained from mothers through direct interviews. Through the use of a tongue depressor, the palate was visualized. In addition, parents were educated on how to posture the patient while feeding properly. Four weeks later, a follow-up visit was for the ulcers’ course follow-up.
 Results
 Male is the predominant gender. Vaginal delivery was the most common. All the participants were full-term with normal birth weights. The age at which diagnosis was made ranged from 14 to 60 days. Most of them were formula-fed. In 15 patients (88.23%), feeding was in a horizontal posture; 11 (64.7%%) had weak sucking, 10(58.82%) had prolonged feeding time, and 13(76.47%) used pacifiers. The location is marginal in 12 cases (70.58%). The shape was oval in 13 patients (76.47%), and the healing time ranged from 1 week to 4 weeks. The largest ulcer was 2x2 cm, and the smallest was 0.2x0.3 cm. 
 Conclusion
 Bednar’s aphthae are self-limiting disorders in newborns and infants. Mechanical and immunologic factors can be responsible for their pathogenesis. Health education for mothers can help the healing of the ulcers and prevent their recurrence.