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<title>Dummy/pacifier use and speech development</title>
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<p class=MsoNormal><tt><font size=2 color=black face="Lucida Sans Typewriter"><span
style='font-size:10.0pt'>Baker, E. (2002). The pros and cons of dummies: What a
speech pathologist</span></font></tt><font size=2 color=black
face="Lucida Sans Typewriter"><span style='font-size:10.0pt;font-family:"Lucida Sans Typewriter";
color:black'><br>
<tt><font color=black face="Lucida Sans Typewriter">should know. ACQuiring
Knowledge in Speech, Language and Hearing, 4(3),</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">134-136.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Key points raised in the
review were as follows.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">THE PROS OF USING A DUMMY /
PACIFIER / COMFORTER</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">1. They (dummies) MAY help
settle agitated, fretting babies (evidence is</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">equivocal)</font></tt><br>
<br>
<o:p></o:p></span></font></p>
<p class=MsoNormal><tt><font size=2 color=black face="Lucida Sans Typewriter"><span
style='font-size:10.0pt'>2. They are thought to facilitate sucking in premature
infants (conflicting</span></font></tt><font size=2 color=black
face="Lucida Sans Typewriter"><span style='font-size:10.0pt;font-family:"Lucida Sans Typewriter";
color:black'><br>
<tt><font color=black face="Lucida Sans Typewriter">evidence)</font></tt><br>
<br>
<o:p></o:p></span></font></p>
<p class=MsoNormal><tt><font size=2 color=black face="Lucida Sans Typewriter"><span
style='font-size:10.0pt'>3. They are thought to help infants with GORD
(research failed to support</span></font></tt><font size=2 color=black
face="Lucida Sans Typewriter"><span style='font-size:10.0pt;font-family:"Lucida Sans Typewriter";
color:black'><br>
<tt><font color=black face="Lucida Sans Typewriter">this)</font></tt><br>
<br>
<o:p></o:p></span></font></p>
<p class=MsoNormal><tt><font size=2 color=black face="Lucida Sans Typewriter"><span
style='font-size:10.0pt'>4. There is thought to be something
"protective" about dummy sucking in</span></font></tt><font size=2
color=black face="Lucida Sans Typewriter"><span style='font-size:10.0pt;
font-family:"Lucida Sans Typewriter";color:black'><br>
<tt><font color=black face="Lucida Sans Typewriter">terms of preventing SIDS in
babies 1 to 12 months (evidence is inconclusive)</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">THE CONS OF USING A DUMMY /
PACIFIER / COMFORTER</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">1. Increased risk of GI
infections.</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">2. Increased risk of Otitis
Media (with all that that implies) in babies who</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">use a dummy >5 hours a
day. (interesting studies cited research surrounding</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">the importance of this)</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">3. Increased incidence of
dental caries and malocclusion.</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">4. Association with nipple
confusion.</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">5. "Other" -
latex allergy, choking (these are rare).</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">SPEECH DEVELOPMENT AND
DUMMY / PACIFIER / COMFORTER USE</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">The speech-language
pathologist can surmise that:</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">1. Certain sounds are
difficult to produce with something in your mouth.</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">2. Dummy sucking reduces
vocal play.</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">3. Dummy sucking reduces
imitation of facial expressions and mouth movements</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">(interesting studies cited
research surrounding the importance of this)</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">There is very little
research into a possible DIRECT relationship between</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">dummy sucking and language
delay.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">There is a positive
relationship between dummy sucking, dental malocclusion</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">and speech disorder.</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">There is a positive
relationship between dummy sucking, otitis media and</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">speech disorder.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">It is important for SLPs to
be well-informed in order to advise caregivers</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">accurately.</font></tt><br>
<br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">================</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">RELATED ARTICLES</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">================</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Pacifier pros and cons: is
it good or bad to give your baby a binkie?</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">(Healthy Baby)</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter"><a
href="http://www.findarticles.com/cf_dls/m0KFZ/2_9/98576972/p1/article.jhtml">http://www.findarticles.com/cf_dls/m0KFZ/2_9/98576972/p1/article.jhtml</a></font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">"Your baby is crying.
She looks very unhappy: She has her mouth open, her</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">eyes squeezed shut, her
fists clenched. You've tried everything you can</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">think of to calm her
down--breastfeeding, walking her in the stroller,</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">gently rocking her and
singing to her. In your palm you hold what you hope</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">will be the answer--a
pacifier. But before you pop that binkie in her mouth,</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">consider the many ways
using it could affect your baby's health.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">THE PROS</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">A way to soothe > The
amount of time an infant spends crying increases from</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">birth until about 6 weeks,
when a baby cries for an average of three hours a</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">day.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">"That's a lot of
crying stress," says Cynthia R. Howard, M.D., M.P.H.,</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">associate professor of
pediatrics at the University of Rochester School of</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">Medicine and Dentistry in <st1:State
w:st="on"><st1:place w:st="on">New York</st1:place></st1:State>. Sucking
undoubtedly helps calm a baby,</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">she adds, which is why
pacifiers are so popular. According to a 1999 study</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">by Howard published in
Pediatrics, approximately 75 percent of babies are</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">given pacifiers to suck.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Health benefits > The
only proven medical benefits linked to pacifiers have</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">been seen in preterm
babies. Preemies who suck on binkies gain weight</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">faster, according to a 1992
study published in the Swedish journal Acta</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">Pediatrica. Other research
has found that preemies who use pacifiers shortly</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">after birth show earlier
sucking patterns and experience fewer health</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">complications.
"Sucking promotes oral-muscle function and muscle</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">development," says
Nina L. Shapiro, M.D., assistant professor of pediatric</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">otolaryngology at the <st1:PlaceType
w:st="on">University</st1:PlaceType> of <st1:PlaceName w:st="on">California</st1:PlaceName>,
<st1:City w:st="on"><st1:place w:st="on">Los Angeles</st1:place></st1:City>,
School of</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">Medicine.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Reduced risk of SIDS>
Pacifiers are associated with a reduced risk of sudden</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">infant death syndrome
(SIDS), according to four recent studies. But since a</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">cause-and-effect
relationship has not been proven, researchers aren't sure</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">how, or even if, pacifiers
prevent SIDS. In the meantime, the SIDS Alliance</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">refrains from recommending
their use.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">THE CONS</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Ear infections >
Pacifiers were found to he responsible for 25 percent of</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">ear infections in children
under 3 attending day care, according to a study</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">published in Pediatrics in
1995. Restricting pacifier use to just before a</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">child fell asleep, though,
returned the risk to almost normal, a follow-up</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">study in 2000 (also in
Pediatrics) found. Why the link? Pacifier sucking</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">promotes fluid collection
in the ears, which can lead to ear infections,</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">Shapiro says.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Early weaning from the
breast > Offering a pacifier to a full-term baby may</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">keep her from what she
really needs--food. Indeed, several studies have</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">linked pacifier use with
early cessation of breastfeeding. However, a study</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">reported in the Journal vi
the American Medical Association found that</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">pacifiers probably were not
to blame for early weaning. The researchers</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">concluded that their use is
a sign of breastfeeding difficulties or reduced</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">motivation to breastfeed.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">While the
pacifier-breastfeeding connection remains a question, if you do</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">give a binkie, it's best to
wait. "If you want to offer a pacifier, wait</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">until four to six weeks,
when your milk supply is established," Howard says.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Dental, problems>
Children who suck anything--thumb, finger or pacifier--</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">past age 2 have a higher
risk of developing protruding front teeth and/or a</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">crossbite in baby teeth,
according to a study published last year in the</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">Journal v/the American
Dental Association. In some cases, these problems</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">persist when permanent
teeth come in.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">So where does that leave
you and your screaming baby? Prudent use of a</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">pacifier--occasionally and
briefly, after breastfeeding is established and</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">before your child is
2--probably won't cause any harm. So if your baby is</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">soothed by using a pacifier
for short intervals, give it to her guilt-free.</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">Or you could try another
round of feeding, rocking or singing. Either way,</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">your baby eventually will
settle down.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">RELATED ARTICLE: * Do's and
don'ts</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">If you do decide to offer
your baby a pacifier, here are some caveats to</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">remember:</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">* Never give your baby a
pacifier to delay a meal.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">* Offer a binkie; don't
force it.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">* Boil the pacifier or run
it through the dishwasher frequently for the</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">first six months; after six
months, wash the pacifier regularly with hot,</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">soapy water.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">* Never tie a pacifier
around your baby's neck or hand, or to your child's</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">crib or bassinet.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Elizabeth Rusch, mother of
1-year-old Cobi, is the author of Generation Fix:</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">Young Ideas for a Better
World [Beyond Words, 2002]."</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">COPYRIGHT 2002 Weider
Publications</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">COPYRIGHT 2003 Gale Group</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">===========================================</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">Do Pacifiers Discourage
Breastfeeding?</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter"><a
href="http://www.findarticles.com/cf_dls/m0867/1999_April/54450681/p1/article.jhtm">http://www.findarticles.com/cf_dls/m0867/1999_April/54450681/p1/article.jhtm</a></font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">l</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">The majority of babies in
the <st1:country-region w:st="on"><st1:place w:st="on">U.S.</st1:place></st1:country-region>,
whether they are breastfed or not, are</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">given pacifiers. Some
scientists have worried that if a baby gets used to an</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">artificial nipple such as a
pacifier, she might have difficulty suckling at</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">the breast (something
called "nipple confusion"). Indeed, a number of</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">studies have reported that
infants who use pacifiers are less likely to be</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">breastfed as long as
infants who don't. However, there is a lot of debate</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">over whether the pacifier
actually causes the problem.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">In a study of 265
breastfeeding infants from <st1:place w:st="on"><st1:City w:st="on">Rochester</st1:City>,
<st1:State w:st="on">NY</st1:State></st1:place>, researchers</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">interviewed the mothers at
delivery and at regular intervals until</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">breastfeeding ended.
Two-thirds of mothers introduced a pacifier before</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">their baby was 6 weeks old,
and as was found in other studies, infants who</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">used pacifiers didn't
breastfeed for as many months as those who didn't use</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">a pacifier.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">However, the authors of
this study paid careful attention to which came</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">first--the pacifier or
problems with breastfeeding--and they found that when</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">women gave their babies
pacifiers, they already tended to breastfeed fewer</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">times per day and they were
also more likely to report that breastfeeding</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">was inconvenient and that
they had insufficient milk supplies.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">These researchers conclude
that it may be incorrect to blame pacifiers for</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">decreases in breastfeeding.
Rather, they think that mothers who are having</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">problems breastfeeding are
the most likely to give their infants pacifiers,</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">and because of their
problems breastfeeding, these same mothers are more</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">likely than others to stop
breastfeeding early. (Howard CR et al: Pediatrics</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">Mar 1999; e33 [electronic
edition]</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">COMMENT: Many studies have
found that pacifier use is to early stopping of</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">breast feeding, and most
people feel that pacifiers must be the cause of</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">this problem. On that
basis, some parents have been warned not to give their</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">infant a pacifier, for fear
that it will interfere with successful</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">breastfeeding (however,
that doesn't stop babies from sucking on their</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">fingers, thumbs, or toes!)</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">This carefully done study
makes an important point about whether pacifiers</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">are the cause or the effect
of this problem, and we agree with the authors</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">that pacifiers don't seem
to be the cause.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Rather, moms who are having
various difficulties in breastfeeding are more</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">likely to give their
infants pacifiers because the infants cry more as a</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">result of breastfeeding not
going well. Of course, when breastfeeding isn't</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">going well, there's an
increased chance that mothers will stop early.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">What this means, we think,
is that parents should focus more attention on</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">how to breastfeed
successfully and worry less about whether the baby uses a</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">pacifier."</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">COPYRIGHT 1999 Child Health
Alert, Inc.</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">COPYRIGHT 2001 Gale Group</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">========================================</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Pacifier Use And Ear
Infections</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter"><a
href="http://www.findarticles.com/cf_dls/m0867/2000_Oct/66304090/p1/article.jhtml">http://www.findarticles.com/cf_dls/m0867/2000_Oct/66304090/p1/article.jhtml</a></font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">"It's known that
pacifiers can affect the way a child's teeth come in, but</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">with that exception, they
are generally considered harmless, and 75-85% of</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">children in western
countries make a habit of using one. In the last few</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">years, some studies have
raised the question of whether pacifier use might</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">be related to an increase
in ear infections (otitis media), and researchers</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">from <st1:country-region
w:st="on"><st1:place w:st="on">Finland</st1:place></st1:country-region> have
now tried to learn more about the relationship between</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">pacifier use and ear
infections.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">They enrolled 484 infants
from 14 well-baby clinics; on average, the</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">children were 8 months old.
The children under 18 months of age were divided</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">into two groups; in one
group, parents were advised that pacifier use was OK</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">up until age 6 months, but
between 6 and 10 months they were told to limit</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">use to the time just before
their baby was falling asleep, and then to stop</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">all use after the infant
was 10 months old. Parents in the other group were</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">given no advice about
pacifier use. Parents kept daily symptom sheets for a</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">period of three to six
months, and took their children to the doctor</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">whenever they felt it was
necessary.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Overall, the authors found
that about three-quarters of the infants in both</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">groups used a pacifier
before the study began, and by the end of the study,</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">pacifier use had dropped to
about two-thirds in both groups. Even though the</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">intervention didn't reduce
the total number of children using pacifiers, it</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">did appear to reduce the amount
of time infants spent using a</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">pacifier--among the 7-18
month olds, the intervention seemed to reduce heavy</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">pacifier use by 21%.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Along with that reduction
in pacifier use was a 29% reduction in the number</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">of ear infections. The
authors conclude that "pacifier use appeared to be a</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">preventable risk factor for
acute otitis media in children." (Niemela M et</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">al: Pediatrics, September,
2000, pp. 483-488)</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">COMMENT: Pacifier use and
ear infections are both common parts of an</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">infant's life, but there's
been surprisingly few studies focused on whether</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">pacifier use actually
increases the risk of ear infections. The current</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">study offers some
additional evidence that frequent use of pacifiers might</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">be related to a child's
risk of having ear infections, but it doesn't prove</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">that pacifiers actually
cause ear infections.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Until we know for sure,
it's hard to suggest that parents be advised to</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">"pull the plug".
On the other hand, parents who choose to limit pacifier use</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">in an effort to limit their
child's risk of ear infections are probably not</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">going to do their child
much harm."</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">COPYRIGHT 2000 Child Health
Alert, Inc.</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">COPYRIGHT 2001 Gale Group</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">===========================</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Counseling Parents About
Pacifier Use in Infants</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter"><a
href="http://www.findarticles.com/cf_dls/m3225/5_63/71267999/p1/article.jhtml">http://www.findarticles.com/cf_dls/m3225/5_63/71267999/p1/article.jhtml</a></font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">"Pacifier use is
associated with an increased risk of acute otitis media,</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">oral candidiasis and dental
caries. Niemela and associates conducted a</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">randomized, controlled
trial in 14 well-baby clinics in <st1:country-region w:st="on"><st1:place
w:st="on">Finland</st1:place></st1:country-region> to determine</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">if counseling parents about
pacifier use was associated with a decrease in</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">episodes of acute otitis
media in infants.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">Nurses who staffed the
well-baby clinics were instructed about the harmful</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">effects of pacifier use and
asked to share this information with the parents</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">of children 18 months or
younger (see the accompanying table on page 948).</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">Parents were also given a
leaflet summarizing this information. The</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">counseling sessions occurred
at each well-baby visit. Parents of children in</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">the control group (whose
nurses received information about the epidemiology</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">of infectious diseases) did
not receive counseling about pacifier use. All</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">parents were asked to
complete a daily symptom sheet to record symptoms</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">consistent with acute
otitis media.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">The children enrolled in
the trial were followed for three to six months,</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">depending on the date of
recruitment. Information about previous episodes of</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">acute otitis media, type of
day care and signs and symptoms of allergies was</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">also collected. Based on
previous studies of the prevalence of pacifier use,</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">the authors surmised that
one half of the children in the intervention</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">(counseling) group would
develop acute otitis media; they hypothesized that</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">the counseling would
decrease this occurrence by one quarter. The use of</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">pacifiers was classified as
follows: none, only when falling asleep or</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">continuously.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">There were 272 children in
the counseling group and 212 in the control</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">group. The mean age of the
children was eight months. About one third of the</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">children had a history of
acute otitis media. Pacifier use occurred in 79.0</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">percent of the intervention
group and in 74.7 percent of the control group.</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">At the end of the study,
pacifiers were still being used by 68.0 percent of</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">children in the
intervention group and 66.5 percent of children in the</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">control group. However,
children in the intervention group were</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">significantly less likely
to be using the pacifier continuously than were</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">those in the control group
(35 percent versus 48 percent). Among children</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">seven to 18 months of age,
this represented a 21 percent decrease in the</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">continuous use of a
pacifier.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">The incidence of acute
otitis media was reduced by 29 percent in the group</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">that received counseling.
Continuous use of the pacifier was associated with</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">a 33 percent higher rate of
acute otitis media. Most of the parents seemed</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">to appreciate the
counseling about pacifier use, although 11 percent felt</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">anxiety because they had
not known of the adverse effects of pacifier use, 9</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">percent felt guilty and 7
percent were angry about the counseling.</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">The authors conclude that
offering supportive and encouraging</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">recommendations about the
use of pacifiers can reduce the occurrence of</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">acute otitis media.
Pacifier use is one of the easily modifiable risk</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">factors for acute otitis
media (as opposed to anatomic considerations or</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">mode of day care), and
anticipatory guidance of parents about pacifier use</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">should occur."</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">GRACE BROOKE HUFFMAN, M.D.</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">Niemela M, et al. Pacifier
as a risk factor for acute otitis media: a</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">randomized, controlled
trial of parental counseling. Pediatrics</font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">September 2000;106:483-8.</font></tt><br>
<br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">COPYRIGHT 2001 American <st1:place
w:st="on"><st1:PlaceType w:st="on">Academy</st1:PlaceType> of <st1:PlaceName
w:st="on">Family Physicians</st1:PlaceName></st1:place></font></tt><br>
<tt><font color=black face="Lucida Sans Typewriter">COPYRIGHT 2001 Gale Group</font></tt><br>
<br>
<tt><font color=black face="Lucida Sans Typewriter">=================================</font></tt></span></font><font
size=2 color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<div>
<p><st1:PersonName w:st="on"><font size=2 color=navy face="Times New Roman"><span
style='font-size:10.0pt;color:navy'>Caroline Bowen</span></font></st1:PersonName><font
size=2 color=navy><span style='font-size:10.0pt;color:navy'> PhD<br>
Speech Language Pathologist<br>
<st1:Street w:st="on"><st1:address w:st="on">9 Hillcrest Road</st1:address></st1:Street><br>
Wentworth Falls NSW 2782<br>
<st1:country-region w:st="on"><st1:place w:st="on">Australia</st1:place></st1:country-region><br>
e: cbowen@ihug.com.au<br>
i: <a href="http://www.slpsite.com">http://www.slpsite.com</a><br>
t: 61 2 4757 1136</span></font><o:p></o:p></p>
</div>
<div>
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face="Times New Roman"><span style='font-size:12.0pt'>
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</span></font></div>
<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
info-childes@mail.talkbank.org [mailto:info-childes@mail.talkbank.org] <b><span
style='font-weight:bold'>On Behalf Of </span></b>Alcock, Katherine<br>
<b><span style='font-weight:bold'>Sent:</span></b> Monday, 17 October 2005 7:20
PM<br>
<b><span style='font-weight:bold'>To:</span></b> info-childes@mail.talkbank.org;
dev-europe@lboro.ac.uk<br>
<b><span style='font-weight:bold'>Subject:</span></b> Dummy/pacifier use and
speech development</span></font><o:p></o:p></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p><font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>There
has been a new recommendation out recently that infants be offered pacifiers to
put them to sleep, which is supposed to help prevent SIDS. About the
first thing mothers in the UK say to me when they hear I study oral motor
skills and speech is "oh, we never use a dummy" or "my sister
gave hers a dummy, it's very bad for their speech, isn't it?" I
expect this to re-emerge with this new advice, and I've even heard from speech
therapists that they are supposed to be linked to lisps. </span></font><o:p></o:p></p>
<p><font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>I
have heard this much less frequently from US parents than UK parents - I think
using a dummy is much more stigmatised over here, and this makes me suspicious
of un-referenced advice even from health professionals. And I have been
able to find absolutely no evidence one way or the other - Medline and Psycinfo
searches bring up nothing (some work on dental problems - which don't seem to
be linked).</span></font><o:p></o:p></p>
<p><font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Does
anyone know of any studies?</span></font> <o:p></o:p></p>
<p><font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>thanks</span></font>
<o:p></o:p></p>
<p><font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Katie
Alcock</span></font> <o:p></o:p></p>
<p><font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Katie
Alcock, DPhil</span></font> <br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Lecturer</span></font>
<br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Department
of <st1:PlaceName w:st="on">Psychology</st1:PlaceName></span></font> <br>
<st1:PlaceName w:st="on"><font size=2 face=Arial><span lang=EN-GB
style='font-size:10.0pt;font-family:Arial'>Lancaster</span></font></st1:PlaceName><font
size=2 face=Arial><span lang=EN-GB style='font-size:10.0pt;font-family:Arial'> <st1:PlaceType
w:st="on">University</st1:PlaceType></span></font> <br>
<st1:PlaceName w:st="on"><font size=2 face=Arial><span lang=EN-GB
style='font-size:10.0pt;font-family:Arial'>Fylde</span></font></st1:PlaceName><font
size=2 face=Arial><span lang=EN-GB style='font-size:10.0pt;font-family:Arial'> <st1:PlaceType
w:st="on">College</st1:PlaceType></span></font> <br>
<st1:City w:st="on"><st1:place w:st="on"><font size=2 face=Arial><span
lang=EN-GB style='font-size:10.0pt;font-family:Arial'>Lancaster</span></font></st1:place></st1:City><font
size=2 face=Arial><span lang=EN-GB style='font-size:10.0pt;font-family:Arial'>
LA1 4YF</span></font><span lang=EN-GB> </span><o:p></o:p></p>
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