Sunday, October 16, 2005

Back to Babies

Have you heard that about this week’s new recommendations from the American Academy of Pediatrics (AAP’s)? Here they are:

1. Babies should sleep on their backs, and should not be placed to sleep on their sides.
2. Babies should sleep with pacifiers from the time they’re one month old.
3. Babies should not sleep in one bed with their parents

And why all this? To prevent SIDS (Sudden Infant Death Syndrome).

So first I must digress. How can Sudden Death be a Syndrome? Isn’t that an oxymoron? Isn’t a syndrome by definition a set of symptoms as opposed to just one? And isn’t sudden death just one? How about calling it just plain SID? I need an explanation

But back to the main subject. When my daughter was born, my 70 year old neighbour told me a little anecdote about his mother. She used to say that pediatricians drove her crazy. She had given birth to 11 children. When her first baby was born, bananas were the best food for babies. When the second appeared – bananas were an absolute no no, sure to bring dire consequences. When baby number three was born, bananas were back in favor, but by the time baby number five showed up, they were in disgrace. You get the idea.

When my daughter was born the recommendation was to put babies to sleep on their sides, and the hospital took great pains to teach us how to do this (it’s not easy). We had just been coming out of an era when it was recommended to lay babies on their stomachs. Pacifiers were a bad thing. Sleeping in bed with the parents – well, I think that recommendation has remained consistent…

Let’s focus a bit on pacifiers. My daughter loved pacifiers from the day she was born. There was a natural bond between her and her pacifier. My son, in contrast, never could stand a pacifier. Never. I could never convince him to take one. I can’t explain it.

Now was it bad for my daughter to suck a pacifier? At the time a lot of American parents considered it a sin and an abomination. Well, here I’ll get on my high horse and say that aversion to pacifiers is just one more way that American parents make life difficult on themselves. In my opinion, pacifiers are good in every way. They calm the baby, and make the baby more alert. Instead of listening to his own inner angst, the baby seems to relax and take in the world. And perhaps most important of all, pacifiers help prevent thumb-sucking. Babies that take a pacifier very rarely start sucking their thumbs.

But when my daughter was young, pacifiers were considered a taboo in the U.S. A sign of a negligent parent. I always loved to compare it to Israel, where people have much more children, and generally seem to enjoy them more. In Israel pacifiers came in three sizes, small (for infants), medium (for toddlers), and large. The large ones were about the size of an orange – even adults have a tough time sticking them into their mouths, but 3-4 year olds seemed to love them. By the time kids got to first grade of course none of them would go around with pacifiers. And guess what. They wouldn’t suck their thumbs either. Thumb-sucking is almost exclusive to kids who don’t take, or were denied pacifiers, and it’s actually is a big problem. If you decide to lose your pacifier, which kids do as they get older, you just throw it out. If you get used to sleeping with your thumb in your mouth, it’s a very tough habit to break. And if children continue sucking their thumbs past age 6 or 7, it causes permanent deformation of the mouth, with upper teeth sticking out. Then it provides plenty of income for orthodontists (I know, I was married to one…).

But why did the AAP recommend that pacifier use start only after age one month? Why not from birth? Because the breastfeeding lobby is claiming that giving a pacifier to a newborn interferes with breastfeeding. Do any of you believe that? How can a pacifier interfere with breastfeeding? There’s no nutrition involved. Babies have a primal need (as do we all) to eat. If they’re offered a breast and a pacifier, as opposed to only a breast, does that mean they won’t nurse? No, it just means that they may not use the breast as a pacifier – a good outcome in my opinion…

I don’t think the AAP thought the pacifier would interfere with breastfeeding either. I give enough credit to their basic sense of reason. However, the breastfeeding lobby is a different story altogether, and has power to make or break pediatricians’ practices. So when they say so, the AAP jumps. And that’s how you get this funny statement that pacifier use should start only after the first month…

Bottom line, I don’t have any problem with the new recommendations of the AAP, and in any case, for anyone who isn’t happy with them, I can assure you that these too will change.


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