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Sunday, May 18, 2008

Give that baby a pacifier!
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OK you blogsters, you want real controversy, people coming to blows, marriages in shambles, World War III? Let's talk pacifiers.

Here's my contention:
Every human infant on the planet should be offered a pacifier.

Aside from my copious stock options in binky companies, here's why:

There is pretty good (but perhaps not quite definitive) research to show that infants who suck on a pacifier have a significantly lower risk (perhaps as much as 45-90% less, depending on the study) of dying from Sudden Infant Death Syndrome (SIDS). (Yes, thumb-sucking also had a protective effect in at least one study, perhaps a 50% decrease).

The reasons for this association are not clear (especially since we really don't know what causes SIDS in the first place). Some wonder if the pacifier changes the airway in an important way, perhaps by moving the tongue forward or keeping the mouth open. Others speculate the sucking reflex stimulates the brain so it doesn't 'forget' to breathe or to sleep too deeply.

Who knows? (Really, who cares if it does the job?)

But them's fighting words. There are vociferous opponents - haters, really - of pacifiers, mostly because of the concern that their use will interfere with the initiation of breast feeding (although studies generally do not support this) or hasten weaning (which a few studies do suggest). Also pacifier use is associated with a small increase in ear infections in the first year.

**********************
Soooooo, let's take stock: on the one hand, potentially less time breast feeding and/or ear infections, on the other decreased risk of DEATH. Really, is this a tough call?

Even the conservative American Academy of Pediatrics recommends the use of pacifiers for the first 12 months or so, with the following provisos:

  • A bottle-fed baby can be offered a pacifier right away.
  • Wait until breast feeding is well established to offer the pacifier (remember peak of SIDS is not until 2-4 months of age).
  • Use it for all sleep and nap times.
  • No need to keep putting it back in the mouth should it fall out.
  • Don't use sweeteners on the nipple.
  • Keep them clean!

The nice things about a pacifier (which the British call a "dummy", perhaps because it was first used only by the lower classes) is that you can get rid of it whenever you want (unlike the thumb). Since dental misalignment is not a concern for 4-5 years, you have plenty of time to decide when you are ready to face your infant/toddler's wrath at its banishment.

I only wish there were other as simple, effective, inexpensive and relatively risk-free public health interventions! Maggie Simpson has got it right. Power to the Pacie!

******************************************

Articles cited:
Do pacifiers reduce the risk of sudden infant death syndrome? A meta-analysis.
Hauk F, et al. Pediatrics, October 10, 2005.


Use of a dummy (pacifier) during sleep and risk of sudden infant death syndrome:
population-based case-control study.
Li D, et al. British Medical Journal. December, 2005.



Related Topics: Nutrition During Breastfeeding, Infant Formula, Parkinson's Tie Probed

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Posted by: Dr. Parker at 5/18/2008 11:39:00 PM

19 Comments:

Blogger Flea said...

You trying to be controversial? You can do better than that! No arguments here.

Flea

Jun 19, 2006 4:44:00 PM  
Blogger Clark Bartram said...

I second that. A better way to start a riot is to speak out against co-bedding. I even know of a popular neonatologist blogger who is for it. Not me though(waiting for Mommy swat team to crash through my windows).

Jun 20, 2006 12:12:00 AM  
Anonymous Anonymous said...

I'm all for anything that reduces SIDS yet sorry folks I'm the mother of 2 paci rejectors yes they both nurse and yes particularly for my daughter who stayed in the hospital for 3 weeks every time a nurse came she crammed the thing in her mouth. try finding out why your baby's crying to begin w. My big problem is I have friends who 21/2 yr old still uses it they are obsessed w it where abouts. Also had a friend whos daughter had to give it up for Kindergarden. If you must use it don't be a binky slave.

Jun 28, 2006 1:10:00 AM  
Anonymous angel said...

I agree on using the pacifier. My first child (now pregnant with my second)was breastfeed and I had to utilize a pacifier in order to have him sleep peacefully. He would fall asleep while nursing and as soon as I took him off he would wake up. So it is great to hear that it has a medical benefit.

Jun 28, 2006 12:12:00 PM  
Anonymous Anonymous said...

What I find interesting is that the doctor says the a pacifier reduces SIDS perhaps because the sucking reminds the baby to breath. Breastfeeding babies also have a lower risk of SIDS perhaps for the same reason. If DEATH is the con of nonpacifier use, than it is also the con of formula feeding babies.

Jun 28, 2006 4:00:00 PM  
Blogger Alison Ashwell said...

'Dummy' has nothing to do with the lower classes- it is a dummy becuase it's short for a 'dummy tit' ie false nipple

Jul 4, 2006 12:13:00 PM  
Anonymous Anonymous said...

When should my 71/2 month old be able to put her pacifier in by herself at night? She wakes up multiple times during the night screaming until I put her pacifier in her mouth for her. I have tried handing it to her, keeping many in her crib, and showing her where it is, but nothing is working. Once I put the pacifier in her mouth, she goes back to sleep on her own.

Jul 22, 2006 11:05:00 AM  
Blogger MOMMIEOF4 said...

ALL FOUR OF MY BABIES WERE NURSED AND THREE OF THE FOUR TOOK NUKS. ALL THAT TOOK NUKS ARE BOYS! THE NUKS NEVER MADE NURSING DIFFICULT. ALL I KNOW IS THAT THE NUKS GAVE THEM SOME COMFORT AND ME A WE BIT MORE SLEEP!!!

Jul 22, 2006 10:10:00 PM  
Anonymous Anonymous said...

What ever happened to breastfeeding babies and allowing the babies to keep sucking until they were done sucking? Neither of my two ever used a pacifier OR sucked their thumbs!

Jul 25, 2006 11:19:00 PM  
Anonymous Anonymous said...

I nursed my 2 year old for 12 months - she started using her "binky" before we took her home from the hospital. The nurses had asked if it was OK to give her one, and I agreed (to buy me a few more minutes of sleep). No one had ever mentioned it could pose a problem with nursing. It never did interfere with her nursing. I think it helped her accept the bottle of expressed milk that my husband gave to her every night. (bonding time for them, break for me) She didn't have the nipple confusion many bf babies seem to experience. I limited the paci use to nap and bedtime. (I can't stand seeing preschoolers walking around trying to talk with pacifiers) She still uses them, and I'm not sure how to wean her. She knows they are only for sleeping, and our rule is that she must take it out of her mouth to speak - so I'm not too worried yet, (she just turned 2) but I'd like to be done with them soon.

Jul 31, 2006 1:42:00 PM  
Anonymous Anonymous said...

Who has the luxury of having time to let a bf baby suck until he's done sucking? My baby would've been latched on all day! Especially when it's not your first child... Also - the binky was offered when first putting baby to bed, after several nights of getting up to put it back in when it fell out of her mouth, we let her cry. It was hard for a few nights, but she learned how to fall back asleep without it.

Jul 31, 2006 1:53:00 PM  
Anonymous Anonymous said...

the research that suggests babies with pacifiers are less likely to die from SIDS is sort of true, but if you look closer you'll find that the babies in the study were regular pacifier users but for some reason were without their pacifier the night they died. So if you use one then use it until you're definitely out of the sids danger zone i guess

Aug 12, 2007 6:47:00 AM  
Anonymous Anonymous said...

my baby is 1 month and a week now at what age should i start to give him the pacifier?

Sep 4, 2008 5:44:00 PM  
Anonymous Anonymous said...

Not a mom, but I babysat for a 20 month old girl for the past few months who was allowed to have her bink whenever her parents were home. It would drive me crazy when I got there in the morning and she would try to talk around her bink to tell me what she wanted for breakfast. I started taking it away when I gave her breakfast, giving it to her for nap, taking it away immediately after, and she usually didn't get it back until her parents got home and gave it to her. She didn't really fuss about it too much, even though it was a new routine, and I know she ate and talked more without it. Glad to hear they have medical benefits, and I will probably use it on a limited basis (naps, bed, etc) with my children, but after the age of 1 or so, I think children just look silly.

Dec 31, 2008 4:48:00 PM  
Anonymous Anonymous said...

I love the binkie. Both my girls used it until 3 years old (selfishly for my benefit, but also by that age, they started to comprehend good and negative intentions and just gave it up). I also nursed my 2nd baby for 2 years!... night only. Yup she had teeth and all, but the milk always came in as I settled her for bed, and it was the most special bond I'll always take pride in. Bottle feeding was always done during the day by daddy or grandma. I have no regrets and will try my best to do the same routine when my new bundle of joy arrives soon :)

Jan 3, 2009 1:55:00 AM  
Anonymous Anonymous said...

What people need to realize is that children are each different and need different things. People who have had several children usually come to this conclusion themselves. All babies need to suck but some have a much higher need than others. I'm talking about the babies here, not the preschoolers. That's a different subject. I've read some of the research about it reducing the incidence of SIDS..significantly. If your child doesn't want one, then don't force the issue. IMO, if your baby is comforted by a binkie, BY ALL MEANS GIVE IT TO THEM! It may indeed at times reduce the time the baby wants to breastfeed. In the event that this might happen, it is months and months down the road. During the critical first few months of your babies lives, they'll be getting the comfort (and apparent safety increase) they need from the binkie, and the nutrition and comfort they need from the breastfeeding if the mother is fortunate enough to be able to do that. I've seen nurses (I'm a nurse) sharply criticise a parent for wanting a baby to have a binkie after birth. Even if the baby is latching on and feeding well. It makes me sad how judgemental people can be without taking every aspect into account. I certainly have my moments too (not a fan of watching a 6 year old lift his moms shirt to nurse at the mall). I also tend to get on a high horse when watching people with bad parenting skills, but I try not to judge to quickly. In giving advice, for the sake of someone who might listen to you, I think we're all well advised to research our position before we do so. Take into account the fact that someone else's child and their experiences with their child are very different from the experiences you've had with your own.

Jan 3, 2009 2:44:00 AM  
Anonymous Anonymous said...

I'm for both, it really depends on what the child wants. My first son, rejected his paci for his thumb when he was 3 weeks old. He quit sucking his thumb on his own when he turned 5, except for when he slept. My second son who is 4 months old really likes his paci, I wish he would start sucking his thumb but he doesn't seem to want to and I'm ok with that, and the only problem that I have with toddlers and pacis, is when the child is talking with a paci in his mouth because he won't take it out. I don't see the harm in either of them.

Jan 13, 2009 1:39:00 PM  
Blogger Michelle said...

I offered my son a pacifier when he was one week old just to see whether he would take it. He's a very quiet baby so I didn't give it to him just to shut him up. I just thought it might be soothing to him. He took to it immediately and it's never caused a problem. He's 4 months old now, he's never had a single drop of formula, and he's never seemed confused about the bottle vs the breast vs the pacifier. Also I don't buy in to the argument that giving a child a pacifier is lazy parenting either. In the beginning he would cry and I would try everything to try to soothe him. I would change his diaper, try to nurse him, give him more stimulation, less stimulation, etc. but sometimes all he wanted was his binky. So what's the harm in giving your child what he or she needs to feel comfortable? I think the bottom line is that every child is different and you have to do what is right for that child. If your child wants to nurse, let them nurse...if they want to be rocked, rock them...and for God's sake give them a pacifier if that makes them happy.

Jan 19, 2009 8:30:00 AM  
Anonymous Anonymous said...

It came time for my son to loose his pacifier. A friend gave me a free site that had a great method; worked like a champ. It is bye-bye-binky.com. They just make money on advertisements, definately worth a look!

Feb 6, 2009 6:41:00 PM  

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