Parents and Pacifiers

We've all seen it happen: a child who's sucking on a pacifier drops it on the floor, and the person who's minding the child retrieves the device, pops it into his or her own mouth and squishes it around, then places it back into the mouth of the waiting child.  Hmmm.  A bit disgusting when you stop to think about it, but as any parent knows, also the most expedient way to make sure an infant or toddler can be kept under control in public. Hardly seems like the stuff of scientific scrutiny, does it?  Yet as Rick and I discuss on PodMed this week, there it is- a study in Pediatrics examining the benefits, yes, that's right, the benefits, of such a practice.  What exactly did this study do?

A birth cohort of 184 infants in Sweden were followed for up to 36 months.  The children were assessed for clinical allergy and sensitization to both foodborne and airborne allergens with development of asthma, eczema, or sensitization as demonstrated by IgE levels by a pediatric allergist at 18 and 36 months of age.  Parents kept a diary of data relative to the infant, including characteristics of the home, presence of siblings, animals, when the child was weaned, when solid food was introduced, and symptoms suggestive of developing allergic conditions.  These data were gathered from the parents by means of a structured telephone interview at 6 months.  Also queried was the method of cleaning the child's pacifier: boiling, tap water, or parental sucking.  Respondents could choose more than one option, and as Rick quips in the podcast, those of us who are parents of more than one child likely would have said boiling for our firstborn, followed by tap water rinses for the second child, and finally, a third child would be fortunate to have any method of cleaning employed at all!

The study found that about half of these parents admitted to using the sucking method to clean their child's pacifier, and those children were significantly less likely to develop asthma, allergy or IgE sensitization, or eczema at 18 months, and protection against eczema remained at 36 months of age. Moreover, an assessment of oral flora revealed that those children whose parents did not use sucking to clean their pacifiers had markedly different flora than their parents, which the authors suggest may be one mechanism of protection: parental flora would broaden the exposure of the infant's developing immune system and perhaps inoculate against inappropriate allergy development.

Last week in both this blog and on PodMed, we discussed a study related to immigrant children and their allergy status.  Both this study and that one seem to lend more support to the hygiene hypothesis, that idea that early exposure to a host of allergens somehow prevents the immune system from responding to things like ragweed later on in life.  While the evidence is accumulating, for now it seems okay for parents to continue sucking their children's pacifiers, and for those of us who may look askance at the practice to simply look the other way.

Other topics this week include a lack of benefit seen with some supplements with regard to managing macular degeneration in JAMA, and in the same journal a look at preventing inappropriate shocks with implanted defibrillators.  We also discuss the lung cancer screening guidelines in Chest.  Now, as promised in the podcast, here's a look at a wonderful, faithful listener who's of great help to Rick and me every week and his crew in Canada: thank you, Tom, for all you do- your students are lucky to have you:  Until next week, y'all live well.

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Parents and Pacifiers | jhublogs
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