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 Photo by Roger Werth Cowyn McGrath of Castle Rock finds his pacifier soothing. The 6-month-old boy is the son of Rob and Mara McGrath. |
Binky Basics: Despite a few concerns, pacifiers have long, soothing history
Monday, March 26, 2007 11:41 PM PDT
By Dr. Sue Abell
Printable version
E-mail this articleDear Dr. Sue: For all of us new parents out here, could you tell us something about the origins and history of pacifier use? We hear people worrying that babies will have problems with their teeth, or oral fixations when they grow up, or that they need to learn to calm themselves instead of sucking on a pacifier. What do the "experts" say?
Dear parents: Ahhhh, the pacifier, the binky, the dummy. Evidence of the use of various items to soothe a fussy baby can be found far back in time and in just about every culture. The most obvious (and natural) soother is undoubtedly the mother's breast. In many cultures, infants are carried everywhere that the mother goes and are soothed every time they cry by simply being breast fed. This often continues until the child is 2 or 3 years old, or even older.
Throughout history, mothers have been quite inventive at finding substitutes for the breast to calm a fussy baby.
2000- to 3000-year-old clay animals with handles and a single large opening (presumed to be for sucking a thick material like honey out of the object) have been found in graves in Italyand Cyprus. Similar objects are known to have been made in Europe until the Middle Ages.
A painting of the Madonna and Child in 1506 by Albrecht Durer shows a "rag bag," which was used throughout Europe and in Russia. Strips of rag were knotted around foods like bread, grain, meat or fish (or, in Finlandor Lapland, they might contain pieces of fat). Sometimes these bags were moistened with liquids like milk, brandy or laudanum (an opium and alcohol mixture), or contained poppy seeds (from which opium is made).
As babies got older, and began teething, mothers needed something to help relieve their pain. In fact, teething was often felt to be such a stress to young infants that it could be fatal if not relieved. ("London Bills of Mortality during the 1600s list teething as a leading cause of infantile deaths. As recently as 1905 the Returns of the Registrar-General in Britainlisted more than 2000 children as having died from teething.") 1 Therefore, again probably from the dawn of time, babies have been given hard things to bite on to ease the pain of sore gums. Many of these were made from the bones of animals, or from ivory, or from red coral. Candles, licorice sticks, carrots and of course, crisp bread crusts have all been used. Wealthy mothers eventually used a silver spoon for this purpose.
Medications were also used to pacify the teething infant. Some mothers today still believe that than can safely rub whiskey on their babies gums to reduce teething pain (please don't do that!) In earlier centuries, opium was preferred, and was as readily available as Tylenol is now.
When rubber was developed in the last century, the pacifier as we know it today was born. Early pacifiers were without the safety "skirt," and posed a higher risk of choking. One early model contained a not insignificant amount of lead. Today, pacifiers are available in many shapes and colors, with many different cartoon characters emblazoned on them. One even is advertised as a thermometer, though its accuracy has not been well studied.
As you've pointed out, the pacifier is at the center of a certain degree of controversy at the present time
More than one study has suggested that pacifier use may decrease the risk of SIDS, and in response to this the American Academy of Pediatrics recently released a statement recommending the use of pacifiers at naptime and bedtime through the first year of life (though not until after one month of age in breastfeeding infants).
Several national and international breastfeeding organizations refuse to accept this recommendation, at least for breastfeeding infants. They point out that breastfeeding frequently through the night offers the same sucking/lighter sleep benefit that is believed to be responsible for the reduced risk seen with pacifiers. Breastfeeding, they point out, also offers nutritional benefit and close interaction with another human being.
There have been very few studies looking at actual health risks of pacifier use. Those that have been done suggest that pacifier use is associated with a greater risk of four or more ear infections and a greater number of episodes of diarrhea. Whether pacifier use actually causes these problems or whether frequently ill and fussy babies are more likely to be given pacifiers has not been sorted out yet.
There is some appropriate concern about the effect of pacifiers on teeth, as well. Certainly dipping the pacifier into a sugary substance will cause cavities in any teeth that are emerging. Theoretically, prolonged use of a pacifier (or thumb-sucking) could alter tooth alignment or jaw growth, though the AmericanAcademyof Pediatric Dentistry's policy states that "For most children there is no reason to worry about a sucking habit until the permanent front teeth are ready to come in."
Prolonged and heavy pacifier use can definitely interfere with speech development in older infants and toddlers.
Parents, if you choose to use a pacifier for your baby, I would suggest waiting as long as possible if you have a breastfeeding infant. Never dip the pacifier in anything sweet (and certainly not in honey, which can cause infant botulism). Never tie the pacifier around the babies neck, to avoid strangulation. And never put the pacifier into your own mouth to "clean" it: instead, wash it frequently with soap and water.
The Website of the Feeding Bottle Museum, www.babybottle-museum.co.uk/articles.htm/, including the article by S. Levin, M.B. et al from the 1971 South African Medical Journal.
Other sources: www.en.wikipedia.org
Pacifier Use and Morbidity in the First Six Months of Life, Pediatrics, Vol.
103 No. 3, March 1999, p. e.34.
The AmericanAcademyof Pediatrics, www.aap.org The American Academyof Pediatric Dentistry, www.aapd.org Lamaze International, www.lamaze.org The International Lactation Consultant Association, www.waba.org
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