Pacifier? Or, Killer?

This horrible happening was known to occur when I began my practice in 1960 and still happens today, in 2010. The cause is unrecognized. Some have blamed suffocation, following the use of pacifiers.

Early in the sixties, I had two such deaths: The first was a three-month old baby from Washington Township. I made an emergency house call to the home and found a dead baby in its crib. That baby had four or five pacifiers in the crib, and one was still hanging from the baby's mouth. There was some nasal discharge as well.

Stuffed Orca

I examined the pacifiers. Each pacifier -- nipple, flange and handle -- was made of rubber. The nipples appeared to have elongated, likely secondary to boiling with hot water.

Pacifier? Or, Killer?

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In my view, this was a baby who had a cold that clogged the nose, used a pacifier with a nipple long enough to reach and obstruct the opening at the back of the throat, and could not release the pacifier because there were no air holes in the rubber, lip-sealing flange. I believed that suffocation was the cause of death.

Until fairly recently, pacifiers were made in that way. Further, if an infant happened to have a cold, and the nose was stuffed, there would be no way for air to reach the lungs.

That design hadn't changed when I began my pediatric practice in the sixties; crib deaths were far more frequent then, than they are today.

Because of the first crib death experience, I began to warn mothers in the practice to avoid the use of pacifiers. One mother became incensed and left the office in anger. It was that mother, who weeks later, screamed for a house call.

Her baby was dead in its crib -- but with no pacifier within sight. I simply said, "What happened to the pacifiers?" Mom answered angrily, "I took them out, but they had nothing to do with this!"

And finally, it may be of importance that, in the following forty years of practice, with warnings to parents on the use of pacifiers, and changes in the construction of pacifiers, I never again witnessed a "crib death."

Times have changed. Now let us describe the vastly improved design of a modern pacifier: It has a short nipple and large air openings in the flange, so that the pacifier cannot readily seal the lips -- causing the baby with a stuffed nose to suffocate!

Pacifier? Or, Killer?

Doctor Feinberg's writings and views are his own and do not necessarily represent the opinions of other physicians or of the facilities with which he is or has been associated. Parents should always consult with their own physician for medical advice and treatment. Copyright Sheldon N. Feinberg MD FAAP.

Doctor Feinberg served as a Clinical Assistant Professor of Pediatrics at the University of Medicine and Dentistry of New Jersey. He is the immediate past president of the New Jersey Pediatric Society and is the author of "Looking Back - And Sharing a Wondrous Life with You -" His book is available at [http://www.lifesbestbooks.com].