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Dummies,
Pacifiers, Soothers, what's in a name?
The
humble pacifier, the giver of peace, the instrument of tranquillity and
mothers savoir, all of these names do not do justice to the power of this
little piece of plastic and rubber. The sanity of many long gone mothers has been
saved by this little piece of magic!
Over the years the pacifier has taken on a general standard
appearance, e.g. teat, mouth shield and handle, but in reality the
pacifier can be anything that soothes the baby. Indeed the pacifier
of today, evolved from the teething soothers of yesteryear
Illustrated below is an advert from Sears Roebuck & Co
catalogue dated
1902. It was
around this time that the pacifier took on the shape that we all recognise
today. It is true to say the pacifier we are all familiar with today
evolved directly from the early teething rings.
Many of the early teething rings/dummies were manufactured
with a choice of black, maroon or white rubber. The harmless looking white
rubber of the day contained a certain amount of lead!
Below shows the selection available in there 1908
catalogue

Centuries Of Soothers
-
If 21st century soothers can be hard on
a child’s teeth, imagine what the 17th century version did. Parents in
the 1600s used white candy sticks as pacifiers for their children.
-
A couple of hundred years later, the
expression “born with a silver spoon in his mouth” could be taken
literally. If you were an upper-crust mom in the 1800s, you probably
gave baby a pacifier made of silver. And if you were taking her out for
a special occasion, you probably broke out the high-end sucky, the one
made from mother-of-pearl or the one made of coral which was thought to
ward off sickness and the evil eye.
-
A less elaborate pacifier, still in use
last century, was properly known as a “sugar tit.” This was made by
tying cloth or gauze around a small amount of sugar and soaking it, then
giving it to baby to suck.
-
A mere five or six years ago, soothers
surfaced in the world of fashion. In the mid-’90s, it was a teen trend
to wear pacifiers as accessories.
-
Meanwhile, Maggie from The Simpsons is
rarely separated from her pacifier, and her constant “suck, suck, suck”
sound has been the audio backdrop for virtually every episode.
1971 South African Medical Journal
S. LEVlN, M.B. (RAND), VLR.C.P. (EDNN.), D.C.H.,
Johannesburg;
'suck, and be satisfied'
Isaiah 66 : 1 1
A dummy, the dictionary tells us, is a counterfeit
object. So what is the genuine article? If a bottle and teat is a dummy
wet-nurse, what corresponds to the counterfeit object stuffed into a
baby's mouth?
The Americans have supplied a hint by calling dummies
pacifiers, comforters, soothers; and what is a pacifier and comforter?
Food, and, within the context of primitive life, specifically breast milk,
and the object from which the food issues, the nipple. A dummy is a
counterfeit nipple, but a wet nipple, and a sweet one, for breast milk is
distinctly sweet.
Babies enjoy chewing and tugging at a nipple while
psychologists enjoy puzzling over why this should be so. Babies also enjoy
mouthing a dummy and a thumb and doctors may wonder why the thumb is so
often preferred to the dummy. In the context of a substitute moist nipple,
the dummy has had a tortuous history and it is difficult to conceive of
future developments considering that there has been virtually no change in
the evolution of the dummy since the turn of the century.
In the medical literature the first mention of
dummies was ca. 1500 in Germany; in fact, almost everything written on
dummies before 1900 is in German. Dummies are recorded ‘in der
medizinischen Literatur zum ersten Male bei Metlinger im Jahre 1473 und
bei Rosslin im Jahre 1513’. The first representation of a dummy is in a
painting of Madonna and Child by Albrecht Durer at the beginning of the
16th century (Fig. 1).
But dummies certainly have a far more venerable
lineage, and we can guess, with some certainty, that sweetened dummies
were used thousands of years ago to sweeten the temper or fractious
infants. Ancient records concerning milk and honey refer more to
pacification and comforting of babies than to a formula of cow's milk.
Excavations of ancient infant burials have uncovered clay dummies
analogous to the `dinky feeders' available today.
Small clay animals-horses, frogs have been excavated
from graves in Italy and Cyprus. These 2000- or 3000year-old specimens
possessed handles and were evidently meant to be hung around the neck. A
single large opening permitted the insertion of some viscous material
perhaps honey-while small orifices at the animal's mouth permitted the
infant to suck out the honey. Such feeding dummies were made in Europe
until the Middle Ages.
The physicians Soranus (2nd century) and Oribasius
(4th century) mention the use of honey during the newborn period. Not
only was it sweet but it was credited with all sorts of healing virtues, a
view still common today among the thousands of mothers who prefer to add
honey rather than sugar to the baby's bottle of milk.
RAG BAGS
Perhaps these feeding dummies-dinky feeders-were not
true dummies if we can define the primary function

Fig. l. Madonna and
Child: Albrecht Diirer, 1506. Courtesy Staatliche Museen Berlin Dahlem.
Notwithstanding its large size, the rag bag is a dummy.
of a dummy as supplying sucking comfort, and sweet
moisture or liquid as but a secondary phenomenon. True dummies can never
be turned up by the spade of the archaeologist for they must have been
made of linen and it is these linen bags which feature in the comments of
Metlinger and Rosslin and the painting of Durer.
A strip of rag or cloth could be knotted, this knot
being dipped in honey and placed within an infant's mouth. It thus acted
as an effective dummy, in some situations more effective than the modern
rubber equivalent. Anyone who has observed an infant crying during a
ritual circumcision can readily gauge that in this situation a rubber
dummy could never be as comforting as a piece of knotted gauze dipped in
sugared water. The infant sucks frantically on the gauze dummy which
remains sweet and moist for perhaps half-a-minute whereas the moisture on
the surface of a rubber dummy would be sucked off within a second or two.
The strips of rag were usually knotted to enclose
various foodstuffs within the bag and these rag bags contained pieces of
bread, grain, meat or fish. Such were known to have been used throughout
Europe and in Russia where, some sources claimed, they were employed only
during the neonatal period, an unlikely end-point. Among the Finns and
Lapps the rag bags contained pieces of fat. The various foodstuffs were
moistened by means of the infant's saliva but other liquids were also used
including honeyed milk, brandy and laudanum, or else poppy seeds. In this
context the term pacifier is especially appropriate. A piece of sponge
within the bag might have been used, better to retain liquid. There were
occasional observations that babies became intoxicated from sucking on
dummies. These rag bags were tied to the crib or blanket rather than to
the baby's clothing, as is more usual today.
During the 19th century Afrikaner mothers used a rag
bag called a poppie or poppetjie. This consisted of a piece of sponge cake
(suikerbrood) tied within a square of muslin, the knot being large enough
to prevent the whole being swallowed. The long ends of the muslin were
left dangling.
Medical comments on the sucking rags were generally
highly critical, but these dummies must have been valuable and must have
enjoyed widespread popularity in order to elicit the condemnation of the
medically eminent during the 1800s. Some, like the Swedish physician Nils
Rosen von Rosenstein, wrote (about 1764) that it was sufficient to use the
honeyed sucking rag only for the first few days during which it was
thought desirable to rid the infant's bowel of meconium by means of the
honey.
About 1800 Christian August Struve wrote (translated
from the German) 'One of the most revolting practices is the sucking rag
with which one tries to feed or quieten the child. Many a poor mother
makes a rag from an old shirt or cloth which was picked up somewhere,
possibly in the street- and contained vermin or even the remains of
venereal poisons. One dips this rag into lukewarm water, the child throws
it on the ground, and it is put back in his mouth in an even dirtier
condition. Many flies sit on it, when the child is not observed, flies
which a little earlier had been sitting on some poisonous matter in the
room.' He also mentioned the possibility of suffocation. So did Jacob
Christian Gottlieb Shaffer (about 1800) who advised that the rag bag
should be removed during sleep. Christoph Jakob Meltin (about 1800)
claimed that the sucking rag produced a large mouth and thick lips. It was
also objected that these dummies were moistened within the mouths of
mothers and nurses and might thereby pass on venereal diseases.
GUM STICKS
Dummies were not only used as nipple substitutes but
also functioned as comforters and pacifiers for teething infants. In
earlier times teething was credited with causing far more disabilities
than at present. London Bills of Mortality during the 1600s list teething
as a leading cause of infantile deaths.' As recently as 1905 the Returns
of the Registrar-General in Britain listed more than 2000 children as
having died from teething.' Teething as a cause of trouble might have been
invoked-as it still is today-from the earliest months of life, so that a
dummy had a dual function for earlier folk: to soothe a fractious infant,
and to relieve the distress of teething.
We thus find a harder type of dummy also available,
primarily for the gums to bite on rather than for the tongue to suck on.
These dummies were called `gum sticks' or `gum rings' and were generally
made of the bones and teeth of animals. A wolf's tooth mounted in a
holder, or else a piece of ivory, or a string of vertebrae from a snake.
During the 17th century a piece of red coral was popular. There was also a
measure of magic attached to these gum sticks, coral in particular being a
traditional amulet against witchcraft. Wax candles were also popular as
gumsticks, and also sticks of liquorice dipped in honey.
In the late 18th century the English physicians
George Armstrong and William Buchan urged the use of breadcrust as a
teething dummy and such advice survives to this day in the form of the
finger-biscuit often introduced when an infant is some 4 - 5 months old.
Buchan derided 'hard metal or impenetrable coral . . . a crust of bread is
the best gum stick'.'
RUBBER
During the mid-1800s we find gum rings also being
made from elastic, and during the rest of this century rubber ousted
coral, ivory, bone and bread-crusts as gum rings and gum sticks. The
British company, Maws, has a catalogue from 1839 featuring elastic gum
rings at 6d each. These sticks and rings gradually expanded into flat.
broad devices for the baby to bite on and these, now called `soothing
pads', feature in the 1882 catalogue.' Some of them already had rings and
guards attached.
By this time rubber teats were ubiquitous and the
flat soothing pads again contracted into teat-like structures sold as
`solid Indian rubber nipples' and made of hard; black, smelly rubber. Few
had guards or rings attached. By 1900 the guard and ring were standard
attachments and were fashioned from bone, ivory and aluminium as well as
rubber. Sometimes small tinkling bells were attached. During World War I
the usual price of a dummy was 6d.
As the rubber dummy took on the modern shape its
earlier function as a gum stick or gum ring did not die out but
proliferated into various other shapes and is now clearly designated as a
`teething ring' with a function quite distinct from that of a dummy.
Teething rings are now generally made of rubber, hard plastic or soft
plastic entrapping a few ml of cold fluid.
Also, as the rubber dummy took on the modern shape,
the rag bag, which persisted until 1900, rapidly died out. From time to
time minor modifications of dummy shape appear, but are of no great
consequence; though admittedly there are babies who emphatically prefer
one sort of dummy to another. One deficiency of rubber dummies has not
been rectified, They cannot be impregnated so as to ooze a supply of
pleasant liquid (I have made and used dummies cut from plastic sponge
rubber but they are too soft and babies reject them). A dinky-feeder is a
cross between a dummy and a bottle, a modern version of the ancient clay
dummies.. but these feeders are rapidly emptied. are ungainly and commonly
fall out of the baby's mouth. If used when teeth are already present the
sugary liquid produces rampant dental caries. The modern dummy is usually
dipped in gripe water or a solution of honey which is almost immediately
sucked off and the infant must then be left to enjoy his own saliva. A rag
bag still has its advantages.
DUMMIES: MODERN OPINIONS
It is hard to know what modern paediatricians think
of dummies because they do not write about the subject. Dummies are not
even mentioned in large textbooks such as those edited by Brennemann,
Nelson, Holt, Gaisford and Lightwood and others. Even in earlier decades
they are barely mentioned, and the 8-volume Abt's Pediatrics (1923) has
almost nothing on dummies.
Dentists also have little to say on the subject
though there are views that long teats (and presumably dummies) tend to
produce tongue thrust and anterior open bite though the evidence for this
is inconclusive.' In any event dummy sucking usually ceases years before
the permanent dentition begins to erupt.
In an extensive account (in German) of the history of
dummies Nlahler' briefly considers possible orthodontic sequelae and draws
attention to the Freudian sexual theory of dummies. Spock, in his famous
book' grants dummies a psychological significance (sucking
gratification), but other psychologists' find no evidence that babies
need sucking to gratify their psyches.
Where experts don't know the ignorant do, and mothers
have determinedly continued to use dummies-and this against the advice of
experts in earlier decades. It presents little difficulty to find `baby
books' published during the 1930s, 1940s and even more recently, which
condemn dummies out of hand as dirty, a menace to health, a cause of mouth
disfigurement, of thrush and sundry digestive disturbances. There is
commonly advice that the best method of dealing with the dummy habit is
simply to remove the dummy.
Feelings on dummies in earlier decades ran high. As
recently as 1926 Professor Pinard, in France, succeeded in carrying a
motion in the Chamber of Deputies prohibiting the sale of the sucerte.
Such vehement feelings still persist among some doctors, some nurses
concerned with infant care and among the laity. Nevertheless most mothers
have ignored the professors, nurses and politicians and continued to
dummy their babies. The experience of the ignorant has routed the wisdom
of the learned.
As a result, the learned have had to alter the nature
of their wisdom--in the manner of the politician who declaimed `and those,
ladies and gentlemen, are my principles, and if you don't like them, I'm
prepared to change them'.' So we find that Spock,' in the most recent
edition of his book, adopts almost a benign attitude to dummies, or at
least an attitude of positive neutrality. Perhaps an even warmer welcome
awaits in the future.
CURRENT PRACTICE
An attempt was made to bring historical insights up
to date by investigating current opinion and practices with regard to
dummies. A detailed questionnaire was sent to mothers with 3 or more
children and 108 replies were sufficiently clear to permit analysis. A
total of 358 children were accounted for within the 108 families. These
families were Whites, middle- or upper-middle-class, living in
Johannesburg's northern suburbs.
Family Pattern in the Use of Dummies
There were 67 families in which a majority of
children sucked dummies plus another 10 in which half the children (there
being a total of 4 or 6 in these instances) sucked dummies. There were 11
families in which a majority of the children sucked their thumbs
(occasionally 2 fingers or an arm preferred) and a further 6 in which
half the children sucked their thumbs. In 20 families a majority of
children (plus 4 in which half the children within the family) declined to
suck either dummy or thumb.
Relationship between Breast-Feeding and Dummy
Sucking
Nursing patterns were classified on the basis of
lasting less than one month, 1 - 3 months and over 3 months. On this basis
64 mothers had roughly the same nursing experience for their 3 or more
babies. Of the 44 mothers whose patterns altered, in 37 there was a
progressive decrease (`failure') in the duration of nursing in subsequent
babies while in 7 there was an improvement.
On an individual basis, babies with different nursing
patterns were classified as shown in Table I.
TABLE I. NURSING PATTERNS
|
|
Dummy
suckers |
Thumb
suckers |
Neither |
|
Group 0-bottle-fed |
69 (65%) |
15 (13%) |
24 (22 |
|
Group A-breast-fed |
|
|
|
|
<1 month |
29 (63%) |
5 (13%) |
11 (24%) |
|
Group B-breast-fed |
|
|
|
|
1 - 3 months |
57(62%) |
16 (18 %) |
17(20%) |
|
Group C-breast-fed |
|
|
|
|
>3 months |
5 8 (51%) |
25(22%) |
31 (273;) |
The numbers are perhaps too small to draw significant
conclusions but possibly one can point to a curious trend: the longer the
baby is breast-fed, the more the likelihood that he will prefer his thumb.
True enough, the great majority will still be sucking dummies but
comparatively many will have discarded the dummy in favour of a thumb when
nursing is successful and plentiful. This trend does not support Spock's
opinion:' 'I have the impression that a breast-fed baby is less apt to be
a thumb sucker.'
Conversely, babies on the bottle will prefer the same
rubber as on the teat. Comparatively fewer enjoy the thumb.
Parenthetically, it should be noted that nearly
one-third of babies are completely bottle-fed, and if to this group is
added those who are nursed for less than a month, then nearly half of all
babies get little or no breast-feeding. About one-third of babies are
breast-fed for more than 3 months.
It does not follow that one-third of mothers do not
even try to nurse. Many of the failures are isolated instances in families
where other siblings were breast-fed for a period. Of the 108 mothers in
the study, 15 made no attempt to nurse any of their children while a
further 5 made a perfunctory attempt (group A) in one instance.
Effect of Extended Breast-Feeding on Use of
Dummies or Thumbs
This is unknown, because extended breast-feeding does
not occur. There were very few mothers nursing after
7 - 8 months, while dummy and thumb sucking are most
established in the second year of life.
Factors Responsible for Final Cessation of Dummy
Sucking
Dummy sucking ceases at any time from the age of a
few weeks to 6 - 7 years but is mostly ended by 3 - 4 years. Thumb sucking
can continue much longer and one participant father, a one-time contender
for the `Mr South Africa' body-building title, is a thumb sucker, at the
age of 33 years!
In general terms, if the dummy is discarded within
the first year of life it will be because the baby spat it out rather than
because the mother took it away. With increasing age the cessation of
dummy use is more likely to be related to maternal compulsion, perhaps
compounded by maternal suggestions that a big boy (girl) no longer needs
such a baby thing.
During the first 2 years twice as many children
voluntarily gave up their dummies as compared with dummy loss by
coercion. At the age of 3 years, the same applied: 18 children gave up the
habit on their own and 7 were compelled to do so. But at 4 years the
picture changes, with 8 giving up the dummy voluntarily while 11 were
compelled to do so.
Materials Used for Moistening the Dummy
Gripe water is the massive favourite. Honey comes a
poor second while water, Vidaylin and Virol get occasional mention. One
mother wondered whether honey on the dummy rots the teeth.
What Mothers Think of Dummies .
A great majority of mothers (88) were in favour of
dummies; 8 were opposed to their use, while 12 were uncertain, equivocal
or gave no opinion.
Among those favouring the use of dummies, opinions
varied from mild approval to comments like `the most wonderful invention
in the world', `worth their weight in gold', `the man who invented the
dummy should be knighted', `long live the dummy' and `I couldn't have
survived without dummies'.
Most mothers drew attention to the value of dummies
as comforters, soothers, pacifiers and useful for establishing routines,
e.g. time to sleep. Two mothers thought the dummy good for teething and
one for colic and bedwetting.
Virtually no mothers worried about dummies deforming
the jaws and teeth. Two commented that their dentists
had said that dummies make the teeth protrude but
that they did not believe this. On the other hand, many considered thumb
sucking to be a cause of protruding jaws and teeth and many attempted to
give the dummy-often unsuccessfully-in the hope of preventing thumb
sucking. It was mentioned several times that one can throw away a dummy
but cannot throw away a thumb.
Of the 88 in favour, 16 expressed mild reservations
and these related to possible orthodontic troubles (doubted), to dummies
being unhygienic, to their being a nuisance if forgotten when out
visiting and especially to the need for getting up at night to replace the
dummy. One mentioned that the discs on the dummies were too small and the
whole thing could easily get inside a baby's mouth.
A few children demanded a large supply of dummies for
sucking, tickling the nose and playing. Four babies were only satisfied
with the relatively expensive Nuk dummy.
Surprisingly few mothers (only 8) were opposed to
their use, and 4 of these gave no good reasons, complaining about `dirty
filthy habit', `ugly', `the whole idea displeasing', `they become too
dependent on it'. Two complained that the need to get up at night to
replace the dummy vitiated any beneficial effects and two said it deformed
the teeth. Curiously, one of these was a mother whose 3 children did not
use dummy or thumb but 2 of them are having orthodontic treatment!
SUMMARY
Dummies have a venerable history although mentioned
for the first time in medical literature only during the sixteenth
century. Until the advent of rubber in the last century, cloth bags
enclosing a sweet food served as dummies.
Dummies also evolved into teething sticks and rings.
Medical and nursing opinion has generally been opposed to the use of
dummies but mothers have persevered nevertheless, and in an investigation
among Whites in Johannesburg more than 80% of mothers found them useful.
REFERENCES
1. Levin, S. (1963): A Philosophy of Infant Feeding.
Springfield, Ill.: Charles C. Thomas.
2. Bruning, H. (1908): Geschichte der Methodik der
KunstLichen SBuglingsernfihrung. Stuttgart: Ferdinand Enke.
3. Rendle-Short, J. (1955): Proc. Roy. Soc. Med., 48,
132.
4. Buchan, W. (1826): Domestic Medicine, or A
Treatise on the Prevention and Cure of Diseases. London.
S. Skinner, L. J. (Maws' Pharmacy Supplies, England)
(1957,`,; Personal communication.
6. Levin, S. (1969): S. Afr. Med. 7., 43, 31.
7. Mahler, B. (1966): Beitrage zur Geschichte des
Schnullers', MD. dissertation, Dusseldorf.
8. Spock, B. (1969): Baby, and Child Care. New York:
Pocket Books.
9. Blau, T. H. and-Blau, L. R. (1955): J. Abnorm.
Soc. Psychol., 51 123.
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