Why sucking your baby's pacifier clean may help

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Sucking your baby's pacifier clean may help them
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For years, parents have been admonished for cleaning off their child’s pacifier in their own mouth because it could spread germs, but a new study finds that spit-cleaning your baby’s binkie may actually help them avoid eczema and asthma.

The study of 184 Swedish babies, published today in the journal Pediatrics, revealed that children whose parents spit-cleaned their pacifiers were less likely to develop allergies than those whose parents rinsed or boiled their pacifiers.

“It was surprising that the effect was so strong,” says pediatric allergist Dr. Bill Hesselmar of Queen Silvia Children’s Hospital in Gothenburg, Sweden, lead author of the study published Monday in the journal Pediatrics.

Researchers of the study believe that children benefit from being exposed to their parents’ microbiomes (germs) because it allows the children’s microbiomes to build up immunity against trivial threats in the future, as trying to shield children from germs can result in a weaker immune system. Put simply, germs can be healthy when they stimulate the immune system.

For the study, a team of scientists led by Dr. Hesselmar in Sweden followed the 184 babies and their parents for several years, interviewing the parents about their pacifier cleaning practices, starting at when their babies were six months old. They then checked and re-checked their babies’ allergy sensitivities at 18 and 36 months respectively.

They found that nearly half of the parents occasionally sucked their children’s pacifiers clean. The research team also found that children whose parents sucked their children’s pacifiers clean had one-third the risk of developing eczema at 18 months of age, compared to children whose parents did not spit-clean their children’s pacifier. Eczema is the most common early manifestation of allergy, and the study found that development of it up to 36 months of age was significantly decreased in kids whose parents spit-cleaned their pacifiers during the first six months of life.

The study did not reveal how the parent’s saliva was protective or even whether it was filtering out germs, but cleaning the pacifier with their own mouths did not have any effect on the child’s risk of developing respiratory illness. In other words, children aren't more likely to come down with a cold or get a flu virus just because their parents put their pacifiers in their mouths.

"Transmission of colds/virus infections are common in a household because of "close contact", independent of if the parent's suck on their child's pacifier or not," Hesselmar says.

When parents clean a pacifier with saliva, they introduce gut microflora – the microscopic organisms (mostly bacteria) that live in the digestive tract.

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“We know that if infants have diverse microflora in the gut, then children will have less allergy and less eczema,” explained Hesselmar. “When parents suck on the pacifier, they are transferring microflora to the child.”

The study also looked at how childbirth factored into the equation. As has long been the school of thought, children birthed vaginally are exposed to beneficial bacteria through the birth canal, whereas those delivered by caesarean section are never exposed to them; thus, resulting in children born by caesarean having higher rates of allergy.

Moreover, researchers found that caesarean babies of parents who always sterilized their pacifiers, had the highest incidence of eczema, which was nearly 55 percent.

“The most exciting result was the eczema,” says Christine Johnson, chair of the public health department at Detroit’s Henry Ford Hospital. “I’m a bit more skeptical about the asthma findings because asthma is hard to measure before a child is five or six years old.”

Regardless, the findings add to growing evidence that some degree of exposure to germs at an early age benefits children, and that microbial deprivation might backfire, preventing the immune system from developing a tolerance to trivial threats.

Even though the study could not prove that the pacifiers laden with parents’ saliva were the direct cause of the reduced allergies, such practice may be a marker for parents who are generally more relaxed about shielding their children from dirt and germs, said Dr. William Schaffner, an infectious diseases expert at Vanderbilt University who was not involved in the research.

“It’s a very interesting study that adds to this idea that a certain kind of interaction with the microbial environment is actually a good thing for infants and children,” he said. “I wonder if the parents that cleaned the pacifiers orally were just more accepting of the old saying that you’ve got to eat a peck of dirt. Maybe they just had a less ‘disinfected’ environment in their homes.”

Whether or not parents clean their baby’s binkie with soap and water or boil it is their decision, but Hesselmar encourages them to lick the pacifier if the child was delivered via caesarean section, as such children are more prone to allergies.

“If they are using a pacifier and those parents think it’s OK to suck on the pacifier, then yes, I would recommend it,” Hesselmar said, adding that parents need not be concerned about picking up nasty germs themselves if they put the pacifier in their own mouths to clean.

“I haven’t heard of anyone getting ill from it,” he says. “There isn’t much bacteria on the floor.”

SOURCE: Pediatrics Volume 131, Number 6, published May 6, 2013 (doi: 10.1542/peds.2012-3345)

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