June 19, 2000 -- Long the bane of children's dentists, pacifiers could earn some new respect among pediatricians, if a study presented at a recent meeting of specialists in Boston can be verified. It found that babies who sucked on pacifiers had fewer and shorter episodes of gastroesophageal or "acid" reflux, a painful condition in which stomach acid creeps into the throat.
The pacifiers apparently work the same way lozenges and chewing gum do in adults: by stimulating the flow of saliva and downward contractions of the esophagus. Together, these actions help to more quickly move the highly irritating stomach fluid back where it belongs.
But the study's lead researcher says this is not a call to push more pacifiers into the mouths of babes. "We are not advocating use of a pacifier as a treatment option for reflux," says Shahid Sheikh, MD, a pediatric pulmonologist at the Columbus Children's Hospital in Ohio. "Pacifiers do have a lot of problems. This is an observation, and I think many more studies have to be done. We don't want parents to start using pacifiers because we do know their use can have long and short-term complications."
Among the criticisms of pacifiers are that they can cause teeth misalignment and problems with breastfeeding. Still, Sheikh's study presents some compelling evidence that pacifiers, or some similar device, could find a medical use.
Consider this finding from the study: Among the infants who tested positive for reflux, there were three times as many babies who didn't use pacifiers as those who did. And, Sheikh says, when infants who used pacifiers did test positive, their reflux conditions tended to be less severe. So convinced is Sheikh of a relationship that he says infants who are about to undergo testing for reflux should not be allowed to use a pacifier, or the results might get skewed.
And it is important to make a proper diagnosis of reflux, because it can lead to other problems, particularly asthma. "There are a number of studies which show 20-30% of asthmatics have [reflux]," Sheikh says. He also raises the possibility that in infants, stomach acid in the throat could lead to life-threatening apneas, brief episodes in which breathing stops.
But that has not been proven conclusively, says Judith Sondheimer, MD, head of pediatric gastroenterology at the University of Colorado Health Sciences Center. What is known is that reflux in children is common, and it doesn't always require treatment. In many cases, she says, the symptoms disappear as a child grows older.
"Gastroesophageal reflux, as characterized by recurrent spitting and vomiting, occurs in about four out of 10 healthy children," says Sondheimer, who was not involved in the study.
- Gastroesophageal reflux, characterized by recurrent spitting and vomiting, is common in infants and children, but doesn't always require treatment.
- A new study shows that infants who suck on pacifiers have fewer and shorter episodes of reflux, although researchers don't go so far as to encourage the use of pacifiers.
- Pacifiers stimulate the flow of saliva and downward contractions of the esophagus, reducing the time it takes to move the irritating stomach fluid back where it belongs.