Lest we be accused of not being afraid of wading into controversial topics, a recent article in the Wall Street Journal caught our eye. Not that it had anything to do with dentistry per say, but the title “Can You Sleep Train Your Baby At 2 Months” was tantalizing none the less.
The article centered on the sleep philosophy of a prominent pediatric group in Tribeca (that would be a neighborhood in the center of the universe, otherwise known as Manhattan) which advocated ‘ferberizing’ infants at 2 months of age so as to improve their nightly sleeping habits.
The Ferber method, or Feberization, is a technique invented by Dr. Ferber who promoted the idea of letting babies ‘cry it out’ and develop the ability to self-soothe and fall asleep on their own.
The basic idea is to leave the baby in the room, leave, and return at progressively increasing intervals to comfort the crying baby (without picking him or her up). With each night, these intervals increase until the baby is asleep. Dr. Ferber felt that by age 6 months of age, this technique is appropriate as most babies are capable of sleeping through the night by that age and don’t need night feeding.
The WSJ article profiled a practice that goes one step further, and their recommendation is to sleep train babies at age 2 months. Of course, in the interest of a balanced informed article, both advocates and detractors of this method discussed the pluses and minuses of sleep training at so young an age. This is a highly emotionally charged issue with both sides accusing the other of being absolutely wrong. I suspect this debate will go on for the foreseeable future.
So why was this article on how to put your baby to sleep of interest to a pediatric dentist? Simply put, we face a similar conundrum on a daily basis at our practice and that is the issue of pacifier use. Pacifiers certainly have their place in soothing very young infants, and parents (myself included) would be quick to say that they work well in getting that fussy baby of yours to calm down, even fall asleep. However, pacifiers do become a problem when used for too long, especially once baby teeth start growing in. Long term use of a pacifier can cause significant malocclusion, specifically distorting the position of the front teeth, causing large overbites, failure of the front teeth to be able to close, and even impeding in the widening of the palate – all ingredients for orthodontics at an early age.
Most children be getting weaned off the pacifier starting by age 2, and our recommendations is that they stop by age 4. Anything beyond can cause the developmental problems listed above.
The takeaway from the WSJ article for this pediatric dentist is that one CAN train your child be it to fall asleep or stop using the pacifier. The basic technique(similar to that of Dr. Ferber) is that of being consistent and over time decrease the amount of time your child is allowed to use the pacifier. Our thought is that the earlier one starts (or if you never start at all!), the easier the pacifier removal will be. Clearly if some parents can train their 2 month old to sleep through the night, pacifier removal should be a cinch!
Is cleaning your child’s pacifier by sucking on it a wise idea?
A new study being released this week in the journal Pediatrics (the official journal of the American Academy of Pediatrics), looks at the role of pacifier cleaning and the risk of developing allergies.
(Click here for a news report : http://thechart.blogs.cnn.com/2013/05/06/study-finds-your-babys-spit-cleaned-pacifier-is-ok/)
This Swedish study, which looked at 184 infants between the ages of 18 and 36 months, reports that infants whose parents sucked on their pacifiers to clean them developed fewer allergies than children whose parents typically rinsed or boiled them. They also had lower rates of eczema, fewer signs of asthma and smaller amounts of a type of white blood cell that rises in response to allergies and other disorders. The author’s hypothesize that the presence of bacteria, be it from the parent’s mouth, or from the environment, helps promote the development of a healthy immune system, which does not over react to trivial allergens. Our bodies over reaction to ‘trivial’ allergens such as pollen and peanuts is what leads to allergies.
As pediatric dentists, we have always recommended that parents NOT clean their infants pacifiers by sucking on them. Our concern, which has been demonstrated in many scientific studies, is that the bacteria known to cause cavities, streptococcus mutans, can be passed from a caregivers mouth to the child’s mouth. This can be done through the sharing of utensils, toothbrushes and the cleaning of pacifiers through sucking. The rule of thumb is that ‘cavities’ can be passed on from a parent to a child through the exchange of saliva.
So what should one make of this new Swedish study? Well, it’s only one study, and though it presents an intriguing premise, further additional studies need to be done to confirm it’s findings. The study does lead into the more interesting general question that society’s overall phobia against germs may be doing us some harm, and that the proliferation of anti-bacterial soaps, purell etc… is leading to changes in our immune system. What comes of this study remains to be seen.
For now, I think we’ll continue to recommend that the only person sucking on a pacifier should be your infant.