title: Pacifier cleaning practices and risk of allergy development.
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.
authors: Queen Silvia Children's Hospital, Gothenburg, Sweden. bill.hesselmar@vgregion.se
authors: Bill
authors: B
authors: Hesselmar
authors: Fei
authors: F
authors: Sjöberg
authors: Robert
authors: R
authors: Saalman
authors: Nils
authors: N
authors: Aberg
authors: Ingegerd
authors: I
authors: Adlerberth
authors: Agnes E
authors: AE
authors: Wold
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000517:prevention & control; D004485:Eczema / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D015438:Health Behavior; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000517:prevention & control; D007114:Immunization; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D054892:Metagenome; D009055:Mouth / Q000382:microbiology*; D041361:Pacifiers / Q000382:microbiology*; D011247:Pregnancy; D015980:Public Health Practice; D012307:Risk Factors
keywords: allergy; asthma; child; eczema; infant; microbiota; pacifiers; sensitization