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Ask Dr. Sue
PACIFIER USE
Dear Dr. Sue,
Just for fun, would you tell us something about the
origins and history of pacifier use? (Submitted by Cathy
Zimmerman, Editor of THIS DAY.)
Dear Cathy,
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 Italy and
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 Finland or 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 Britain listed 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.
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 American
Academy of 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 in 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.
1. 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:
1.
www.en.wikipedia.org
2. Pacifier Use and Morbidity in the First Six Months of
Life, Pediatrics, Vol. 103 No. 3, March 1999, p.
e.34.
3. The American Academy of Pediatrics,
www.aap.org
4. The American Academy of Pediatric Dentistry,
www.aapd.org
5. Lamaze International,
www.lamaze.org
6. The International Lactation Consultant Association,
www.waba.org
 
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