Hi All, Coach Smith here again.

I'm convinced that Barbara Wilson-Clay is exactly right in her observation
that persistent pacifier users (or thumb-suckers, or all-night-nursers, etc)
probably are meeting some yet-undescribed biological need. The Japanese
research she cites is very persuasive, and I have a personal example to
verify this concept.

Confession time: I was not breastfed, and sucked my thumb until some time
around age 8. I had severe orthodontic problems and wore braces for several
years. (Dr. Brian Palmer's 1996 lecture at ILCA could have been my case
history!) Recently, my right TMJ was painful, popping and clicking, so I
sought help from a good orthodontist. A very extensive set of x-rays was
taken, which show clearly several deviated structures in my oral-nasal area.
My mother said she tried to breastfeed me and I've snored my entire life. I
fully realize that one example does not a theory make, but I've read enough
research on this and related  topics to be confident of connecting some of
these dots.

In working with breastfeeding babies, I've noticed that cranial/facial and
upper-body asymmetry is strongly correlated to suck problems, especially
tongue motion deficits and coordination of suck-swallow-breathe. When you
carefully examine at the internal anatomy of the head and neck, this should
come as no surprise. Just the relatively small space inside the infant
cranium alone should be a huge clue that any slight misalignment of
structures, growth deviation, physical pressures during pregnancy and birth,
or actual insult from instruments used during birth has the potential for
enormous neuromuscular problems for the baby. Sucking, swallowing, and
breathing are very complex neuromuscular sequences. (DUH)

I've been in this work for 30 years, and as the rate of medicated and
instrumental birth has risen, so has the rate of suck problems. Again, I'm
not surprised. Birth is supposed to work without help in the vast majority
of women. The history of birth interventions is rife with examples of
tragedies that were publicized and stopped only AFTER many babies were
damaged or killed by the intervention.

My current position on pacifiers: (1) There are a few limited therapeutic
uses for them, especially if you don't have a breast handy. (2) I agree with
those who argue for specific shapes for specific therapeutic uses. (3) Most
"social" use seems intended to keep the baby away from the breast, which is
an obvious problem. (4) Dental research is clear that oral structures are
changed as a result of persistent use of pacifier or finger sucking. And
finally, (5) I'd like to see more research on WHY some kids latch on to
these devices, and the root causes - which I think are going to point to
problems with the neuromuscular coordination of suck-swallow-breathe and the
structures supporting these muscles and nerves.

Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre
Dayton, OH USA
http://www.bflrc.com

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