Big Binky Brouhaha
A new study that says pacifiers help prevent crib death reignites an old debate.
Parents and doctors take sides.
By Claudia Kalb (Newsweek)
It’s hard to hate baby pictures, especially your
own, but Janna Bosshardt could never stand
the ones that showed her as a toddler with a
pacifier in her mouth. There she is, 3½ years
old, a piece of plastic where the adorable
smile should be. So when Bosshardt, now 33,
started having her own children, she vowed to
avoid the Binkys. « I didn’t want to get any of
my kids hooked, » she says. Her first two,
Zach and Brad, did fine without them. Then
came Cale, an Olympic-level screamer. « A
pacifier was the only thing that would calm
him down, » says Boss-hardt. « It was for his
sanity and mine. »
It’s a pointed debate, one as old as, well, the
thumb: are pacifiers good or bad for babies?
They certainly aren’t new – generations of
children have sucked on devices made out of
everything from cloth to silver – but they’re
more popular than ever. They’ve earned a
vocabulary of their own (soothers, dummies,
Binkys), spawned a minor fashion industry
(glow-in-the-dark and « mood » pacifiers that
change colors) and even made their way into
pop culture – TV’s Maggie Simpson, the
eternal 1-year-old, has been sucking on hers
for more than a decade. Now the American
Academy of Pediatrics is weighing in, saying
pacifiers may help protect babies against
sudden infant death syndrome. In new
recommendations issued this month, the
AAP advises parents to consider using a
pacifier at naptime and bedtime.
Predictably, the recommendation – which
will likely boost the $50 million-plus
pacifier industry – has lit up online
parenting bulletin boards, where « pacis »
are always a controversial topic. And it has
also provoked consternation from breastfeeding advocates and even some AAP
pediatricians. But the link between pacifier
use and SIDS is compelling, says Dr. John
Kattwinkel, head of the AAP’s task force on
SIDS, and « to not call this to the public’s
attention would be irresponsible. »
Nobody knows precisely what causes SIDS
or why pacifiers might help. Researchers
believe the syndrome, which strikes in the
first six months of life, is connected to a
baby’s ability to arouse himself during times
of stress – when his nose is blocked by a
pillow, for example. Doctors say pacifiers
could work by preventing babies from
falling into dangerous deep sleep. Or,
because the devices push the tongue
forward, they may keep airways more open.
Whatever the reason, pacifiers lower the risk
of SIDS by almost two thirds, says Dr. Fern
Hauck, of the University of Virginia Health
System, who conducted a review of the
literature.
Not everyone is convinced. Dr. Lawrence
Gartner, head of the AAP’s committee on
breast-feeding, questions the strength of the
studies, which are retrospective and rely on
parents’ recall about their past use of
pacifiers. And, he says, there are downsides
to pacifiers. The devices pick up bacteria
from germy surfaces and kids who use them
are more prone to ear and respiratory
infections. And pacifiers can be habit-forming
– message boards are full of advice on how to
use « cold turkey » tactics1 on « paci
junkies. »
Above all, Gartner and others worry that
pacifiers may interfere with breast-feeding,
which has important health benefits for
babies. The AAP advises parents to wait a
month before introducing pacifiers to breastfed babies to be sure babies are used to
nursing. But breast-fed babies, who already
wake frequently during the night to nurse,
don’t need pacifiers, says R.N. Marsha
Walker, of the National Alliance for
Breastfeeding Advocacy, who worries that
the AAP recommendation is unnecessarily
broad.
While the experts argue over the data,
parents like Margo Toledano, who says her
son’s pacifier keeps him calm, quickly learn
what it means to choose sides in the great
Binky debate. One day, a stranger in the
grocery store said, « Cute baby, » then
pulled the pacifier out of her son’s mouth.
« You can take the pacifier out, but I’m
going to put it right back in, » says
Toledano. In the world of modern parenting,
it seems, those are fighting words.
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1. techniques de sevrage brutal.
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