We actually discussed the SIDs and pacifier connection some time ago and I
imagine the archives would reveal info from all those who commented then.  I
shared then and will repeat, a theory that the Japanese ENTs have published.
They state that they think that there are two respiratory centers in the
brain.  They theorize that the main center may be dysfunctional in some
babies who suffer repeat episodes of apnea and have poor re-arousal from
apeniac states.  They think the secondary brain control for respiration is
connected with feeding.  Obviously, infants have to have the
suck-swallow-breathe coordination going for normal feeding, and it seems
biologically plausible that there would be a center for control of
respiration while feeding.  The Japanese speculate that some infants who
have depressed main respiratory control will switch over to the respiration
while eating control center as a survival strategy.  Therefore, they are
very attracted to pacifier use and thumb sucking because so long as they are
sucking, this secondary respiratory center stays switched on and they have
fewer apeaic episodes.  The Japanese describe this behavior (constant desire
to have something in the mouth) as having nothing to do with habituation but
is an important way these babies protect respiratory status.  Their papers
on this are interesting, and I include one citations below.  This research
dovetails with Flemmings study that documented SIDS deaths increasing AFTER
withdrawal of pacifiers.  I wonder if those breastfeeding babies who can't
sleep without a breast in their mouths are utilizing the same protective
strategy?  Linda Smith has read a lot about this issue and I recall she
chimed in on the last go-around of this discussion.  Sounds like this new
paper is just adding new credence to the theory that some infants who are
very attached to pacifiers may need (not want) them.  While we certainly
have attitudes towards pacifiers with regards to interference with
breastfeeding, we need to keep open minds to new research that helps explain
behavior.

Mukai S,  Muka C. and  Nagasugi S. RESPIRATION WHILE THUMB SUCKING AND
WITHOUT THUMB SUCKING, Department of Otorhinolaryngology, Mukai Clinic and
Mukai Research Institute of Biology (Yamatominami 2-8-9, Yamato, Kanagawa,
242 Japan)  The full text of this paper appears on-line (view Medline:
Pediatric Surgery Update, Vol 06, 1996.)




Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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