Pacifier Cleaning Practices and Risk of Allergy Development

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Infants with a diverse gut microbial flora are less likely to develop eczema and allergy.WHAT THIS STUDY ADDS: Parental sucking of their infant' s pacifier is associated with a reduced risk of allergy development and an altered oral flora in their child. Transfer of oral microbes from parent to infant via the pacifier might be used in primary prevention. abstract OBJECTIVE: Immune stimulation through exposure to commensal microbes may protect against allergy development. Oral microbes may be transferred from parents to infants via pacifiers. We investigated whether pacifier cleaning practices affected the risk of allergy development. METHODS:A birth-cohort of 184 infants was examined for clinical allergy and sensitization to airborne and food allergens at 18 and 36 months of age and, in addition, promptly on occurrence of symptoms. Pacifier use and pacifier cleaning practices were recorded during interviews with the parents when the children were 6 months old. The oral microbiota of the infants was characterized by analysis of saliva samples collected at 4 months of age. RESULTS: Children whose parents "cleaned" their pacifier by sucking it (n = 65) were less likely to have asthma (odds ratio [OR] 0.12; 95% confidence interval [CI] 0.01-0.99), eczema (OR 0.37; 95% CI 0.15-0.91), and sensitization (OR 0.37; 95% CI 0.10-1.27) at 18 months of age than children whose parents did not use this cleaning technique (n = 58). Protection against eczema remained at age 36 months (hazard ratio 0.51; P = .04). Vaginal delivery and parental pacifier sucking yielded independent and additive protective effects against eczema development. The salivary microbiota differed between children whose parents cleaned their pacifier by sucking it and children whose parents did not use this practice.CONCLUSIONS: Parental sucking of their infant' s pacifier may reduce the risk of allergy development, possibly via immune stimulation by microbes transferred to the infant via the parent' s saliva. Pediatrics

Thumb-Sucking, Nail-Biting, and Atopic Sensitization, Asthma, and Hay Fever

“…The findings of this study are consistent with those of the pacifier study by Hesselmar et al, 13 who found that children whose mothers sucked their pacifiers clean were less likely to develop allergies. Although the mechanism and age of exposure are different, both studies suggest that the immune response and risk of allergies may be influenced by exposure to oral bacteria or other microbes.…”

“…The cohort represents the full range of socioeconomic status in the South Island of New Zealand, and the study participants are mostly of New Zealand European ethnicity. Follow-up assessments were completed at ages 3,5,7,9,11,13,15,18,21,26,32, and 38 years. A full description of the study is reported elsewhere.…”

“…A recent study found that infants whose mothers "cleaned" their pacifiers by sucking them clean were less likely to develop asthma and eczema. 13 They concluded that immune stimulation secondary to the exchange of maternal oral bacteria might protect against atopy. We hypothesized that the introduction of microbes by thumb-sucking and nail-biting would influence children's immune responses and reduce the risk of developing allergies.…”

Fat intake and breast milk fatty acid composition in farming and nonfarming women and allergy development in the offspring

“…The children were clinically examined by pediatricians at 1.5 and 3 y of age to diagnose food allergy, eczema, asthma, and allergic rhinoconjunctivitis according to predefined protocols (38). Sensitization against common food (6-mix food) and inhalant allergens (Phadiatop) were assessed by blood tests (Phadia, Uppsala, Sweden).…”

Animal fur and asthma: an indoor farmyard phenomenon?

“…These include parental mouth cleaning of pacifiers [4], hand washing dishes [5], using feather bedding materials [6], having a pet in the house [7], drinking unpasteurised milk [8] and regular visits to animal stables [9]. At first glance, putting an infant on an animal fur ( presumably largely sheepskins) to sleep might be expected to have similar effects to coming into close contact with farm animals.…”