Several people have asked me to ref. the comments I made about Japanese
research on thumb sucking, from which I had made some extrapolations about
pacifiers and a connection with SIDs.
I pulled it off the Internet while doing a search for ankyloglossia. The
article is titled:
Respiration while thumb sucking and without thumb sucking," Mukai,S.
Mukai,C, and Nagasugi,S. Dept. of Otorhinolaryngology, Mukai Clinic, Mukai
Research Institute of Biology. Yamatominami 2-8-9, Yamoto, Kanagawa, 242
Japan.
"Abstract: In our studies of ankyloglossia with deviation of the epiglottis
and larynx (ADEL) there were many babies who slept only while thumb sucking.
Babies with ADEL have respiratory insufficiency. We supposed that thumb
sucking was related to respiration. To test this hypothesis we monitored
respiration during sleep with and without thumb sucking. Chest and eye
movements, arterial blood saturation rate (SaO2) and pulse rate were
monitored in ten babies from tour to ten weeks as they slept while thumb
sucking and abstaining from thumb sucking. We compared apnea, respiratory
frequency and minimum level of SaO2 during three minute periods before and
after we pulled out fingers from babies. Two out of ten subjects presented
apnea three times in three minutes during thumb sucking. When not sucking
eight out of ten presented apnea an average of 10.2 times in three minutes.
The average number of apnea episodes whilelthumb sucking and without thumb
sucking was 1.0 and 5.9 respectively. The average respiratory frequency was
8.0/10 sec. during thumb sucking and 6.8/10 sec without sucking. The
average lowest level of SaO2 was 98.3 and 90.7, respectively. Ther were
significant differences between respiratory frequency (p=0.0075), length of
apnea (p=0.0047) and minimum SaO2 (p=0.030) during sleep with and without
thumb sucking. We concluded that thumb sucking caused relief from
respiratory insufficiency."
Key words: Ankyloglossia, thumb sucking, Apnea
The article states: "From fifty to eighty percent of babies and from twenty
to forty-five percent infants exhibit thumb sucking in Japan (they ref.
these numbers). Why so many children have the habit of thumb sucking has
puzzled scientists as well as mothers for centuries."
They give theories for this behavior and then declare these theories lack
scientific proof. "In our studies of ankyloglossia with deviation of the
epiglottis and larynx (ADEL), there were many babies who slept only when
they were thumb sucking...."
Discussion:
"Thumb sucking is nonnutritive sucking. Koenig et al reported that
nontutitive sucking did not interrupt breathing or decrease minute
ventilation. Ardran et al confirmed that during sucking, the lower jaw is
alernately raised and lowered...The movements during thumb sucking may be
the same as the Ardran et al reported for teat sucking. Timms et al
suggested that the control of muscles of deglutition may pass to the
respiratory center. Our study showed that the average respiratory frequency
while thumb sucking was more than without thumb sucking. Apnea and SaO2
levels were greatly reduced during thumb sucking. This evidence suggests
that there is a sleeping respiratory center and a feeding respiratory
center. As the sleeping respiratory center is not fully mature in young
infants, apena and a decrease of SaO2 occurred during sleep. On the other
hand, the feeding respiratory center matures in early infancy making it
possible for the infants to maintain constant respiratory rhythm and
ventilation. By this reasoning we concluded that thumb sucking compensates
for respiratory insufficiency and is not merely a habit that provides
comfort but is in fact an intrinsic survival reflex."
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html
-----Original Message-----
From: Linda J. Smith <[log in to unmask]>
To: 'Barbara Wilson-Clay' <[log in to unmask]>
Date: Friday, May 14, 1999 01:29 PM
Subject: RE: pacifiers and SIDS
>Which article are you referring to here?
>
>Linda J. Smith, BSE, FACCE, IBCLC
>Bright Future Lactation Resource Centre
>Dayton, OH USA
>http://www.bflrc.com
>
>
>-----Original Message-----
>From: Barbara Wilson-Clay [mailto:[log in to unmask]]
>Sent: Tuesday, May 11, 1999 12:53 AM
>Subject: pacifiers and SIDS
>
>The Japanese have research which discusses the fact that there are two
>centers in the brain which control respiration. They hypothesize that in
>some infants, when the main respiratory control center is depressed, the
>baby may switch over to the center which controls respiration during
>FEEDING. Therefore, if they can maintain non-nutritive sucking during
>sleep,
>they avoid apnea episodes. What appears to be strongly habituated thumb,
>digit and pacifier sucking behavior in those infants may be an attempt by
>the baby to protect their respiratory status during sleep ie a survival
>strategy.
>
> It may be that the withdrawal of pacifiers is a risk in this group of
>infants, but would
>not esp. matter to otherwise normal infants, who wouldn't be (I suspect) as
>interested in sleeping with something in their mouths anyway. It just goes
>to show that
>there are no absolutes and that often it is hard to tell what the hell is
>going on. It also suggests that there is usually a reason underlying all
>behavior -- even if we can't figure it out because our prejudices get in
the
>way of critical observation.
>
>Barbara Wilson-Clay, BSEd, IBCLC
>Austin Lactation Associates, Austin, Texas
>http://www.jump.net/~bwc/lactnews.html
>
>
>
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