Here is the letter to the editor that I just sent regarding the article on pacifiers in yesterday's Boston Globe. Marsha Walker, RN, IBCLC Weston, MA ----------------------- To the Editor: It is true that there is a lower incidence of SIDS among breastfed babies. However, giving a baby a pacifier at night does not necessarily protect the infant from SIDS, as implied by the American Academy of Pediatrics new recommendations on the prevention of SIDS (A controversy boils about baby's binky," Oct 27). The nature of the studies upon which this recommendation is based does not warrant the blanket statement that all babies be given a pacifier. Pacifiers were associated with SIDS in babies who were dependent upon pacifiers to regulate their breathing and arousal patterns - the pacifier was lost from the mouth or not given to the baby on the night SIDS occurred. These were not prospective studies conducted with a group who received a pacifier and a group that did not. Breastfed babies already rouse more frequently during the night so giving them pacifiers would not confer an advantage for a behavior that already exists. Formula-fed babies sleep more deeply and do not rouse in the same manner as breastfed infants. This is why when such a baby is routinely given a pacifier and becomes dependent on it to regulate breathing and arousal from sleep, the loss of the pacifier at night is what places the baby at risk. The question in my mind is if all babies are given pacifiers, will it create dependency in some babies where none existed before and place a sub-population of infants at risk when not given a pacifier? The studies did not take into account if parents were using any of the sleep training programs that condition a baby to sleep deeply through the night during the time period of highest SIDS risk. Pacifiers are also frequently recalled (311,000 in 2005), mainly because they separate and pose a choking hazard. Parents should be informed of this and be directed to the website of the Consumer Product Safety Commission to check for recalled pacifiers. Pacifier use increases the incidence of ear infections, gastrointestinal disease, candida (thrush), and early breastfeeding problems. Some pacifiers are made of latex which pose an allergy hazard. The differences in the shapes of pacifiers are most significant to babies, as any parent will tell you after buying $50 worth of pacifiers until they find one the baby will accept. The pacifier recommendation is very significant to manufacturers too. With 4 million babies born each year, "requiring" several pacifiers at over $2 apiece, there is a bundle of money to be made. Please check the statement from the Massachusetts Breastfeeding Coalition at _www.massbfc.org_ (http://www.massbfc.org/) . Also, the Academy of Breastfeeding Medicine's statement is at _www.bfmed.org_ (http://www.bfmed.org/) . Their web address was incorrect in the article. *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html