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 May 07, 2013
The best way to clean a dirty soother? Put it in your mouth

 The best way to clean a pacifier after it has fallen on the ground, according to a Swedish study, is to pop it in your own mouth and then give it back to your baby.

While the practice may seem unsanitary to germophobic North Americans, the research suggests it may reduce the risk of allergy symptoms in babies as young as 18 months.

In the study, published online Monday in the journal Pediatrics, children whose parents sucked on their pacifiers to clean them had one-third the risk of developing eczema -- the most common early manifestation of allergies -- at 18 months of age, compared to children whose parents sterilized pacifiers with boiling water or rinsed them under tap water. By 36 months, the babies whose parents had used their mouths to clean their pacifiers had half the incidence of allergy symptoms.

"We think parents' saliva stimulates the immune system in babies," said lead author Dr. Bill Hesselmar, a physician at Queen Silvia Children's Hospital in Gothenburg, Sweden.

The new research is part of a larger investigation of the hygiene hypothesis -- the notion that increased rates of allergies and asthma in children are due to overly clean living environments.

Children with allergies typically have eczema at a young age. Later, they may develop asthma and allergic reactions to pets, animal dander, pollen and other allergens, Hesselmar said. "When they are very young, eczema is a good marker of allergies to study," he explained.

Pacifiers coated with parents' saliva may be an early delivery system of microbes that contribute to intestinal flora, he said. "We know from previous studies that you need to have a very diverse bacterial flora in the intestine to become tolerant to allergens," Hesselmar said.

Other feeding practices, such as sharing a baby's spoon, do not expose babies to a parent's saliva until about six months of age, he said. With the pacifier method, however, "we found the difference in the flora in the mouth already at four months of age."

Canadian dentists caution parents against sharing a baby's spoon or toothbrush because of the risk of transmitting micro-organisms such as streptococcus mutans, which have been linked to early childhood caries, or tooth decay.

But according to Hesselmar, the evidence that exposure to a parent's saliva increases the risk of caries has not been conclusive. Some studies have shown that when parents and small children have very close oral contact, the children have fewer caries, he noted. The increased risk of caries "has to be examined," he said.

In the meantime, North American parents should consider getting over the "ick" factor of sucking on a baby's dirty soother.

"It's a very common practice in Sweden," Hesselmar said, and "so far, I haven't seen any parents become ill from it."