Taking comfort: great dummy debate rages on

Published Jun 23, 2006

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Few issues provoke fiercer debate among new parents than whether babies should be given a dummy to stop them crying. It is a more critical battleground than which baby foods to buy and more urgent than which school to choose.

Health professionals disagree. Some back their use for fractious infants - to protect parents' sanity - others reject them for developmental, hygienic or aesthetic reasons.

Now an authoritative study in a medical journal has examined the evidence and concluded that dummies are bad for babies and parents should be advised against them.

The review of research published in Nursing Standard analysed the results of 20 studies conducted around the world over the past decade.

It found babies who used dummies were less likely to breastfeed or were breast fed for a shorter period. Breast feeding is known to be beneficial for babies.

This disadvantage was partly outweighed by the finding that babies who used a dummy were less likely to suffer a cot death or Sids - sudden infancy death syndrome.

However, the authors from the Joanna Briggs Institute in Australia, concluded: "As breast feeding confers an important advantage on all children and the incidence of Sids is very low, it is recommended that health professionals generally advise parents against pacifier use."

The researchers say the use of a dummy may reduce a baby's desire to suck, which is necessary to stimulate the supply of milk, leading to diminishing interest in the breast. By contrast a bottle provides a ready supply of milk from the first suck.

There is widespread concern that dummies damage babies' teeth or increase infection but the researchers found none of the studies were of sufficient quality to reach firm conclusions on these risks.

A straw poll conducted by Independent Newspapers found parents divided. Supporters of dummies said they prevented thumb sucking, which continues for longer and poses a greater risk to developing teeth. Nearly half of thumb-suckers still have the habit at the age of nine when their adult teeth are coming through.

Opponents said they were unnecessary, ugly and could pose problems later on.

A spokesperson for the British Dental Association said: "Beyond the age of six when second teeth start to come through, thumb sucking can displace teeth. It may be better for children to suck a dummy because they give it up earlier."

Penny Gibson, a consultant community paediatrician in Guildford and spokesperson for the Royal College of Paediatrics said she knew of no evidence that the use of a dummy reduced thumb sucking.

"Personally I would not favour giving a dummy at any age. I did offer my first child a dummy when he was screaming but, thankfully, he spat it out."

She said anything that reduced the chances of breast feeding was bad for babies.

"To stimulate and maintain breast feeding you need a certain amount of sucking. It is completely different from a bottle when you get a lot of milk very easily."

There were also hygienic reasons for avoiding dummies, she said.

"You see a dummy dropped on the floor picked up and sucked clean by the parents - or not, which is probably worse - and popped back in the baby's mouth."

William Yule, professor of applied child psychology at the Institute of Psychiatry said: "If parents come to me and say their child is being fractious a lot of the time, I'd recommend using a dummy. It won't harm the child, and it's certainly worth a try. Most babies either take to them straight away or reject them from the start, in which case you have to think of something else to quell their cries."

The use of dummies stretches back centuries with reports of infants sucking objects in the late 15th century. Soothers and comforters consisting of small linen bags filled with bread, milk and sugar were used to nourish and comfort children in the late 19th century.

The first patent on an India rubber nipple similar to the present day dummy was recorded in 1845. Today's dummies are made of latex or silicone and come in different shapes and sizes - long or short with a ball shaped or flattened end - backed by a plastic shield to prevent swallowing or choking.

Fiona Smith, children's nursing adviser at the Royal College of Nursing, said the use of dummies varied widely between cultures, societies and communities.

"It is not just about changing professional practice, it is also about changing cultural views. Many parents use dummies to calm children when they are upset. We would recommend alternatives, such as a comfort blanket or a toy." - The Independent

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