Chemically Sterilized Pacifiers Tied To Increased Risk Of Food Allergy

Pacifiers (also known as dummies or soothers) are one of the sources of microbial exposure in early life. Despite most infant pacifiers being cleaned in some way, no previous work has finely classified pacifier use in the context of the associated cleaning method (sanitization), nor has challenge-proven FA been examined. Therefore, Dr Anne-LouisePonsonby and her team conducted a study to investigate whether infant pacifier use during the first postnatal year, with further consideration of sanitization, alters the risk of food allergy by age 1 year.

The Barwon Infant Study (BIS) was a population-based birth cohort study of 1074 infants. The researchers recruited pregnant mothers at under 28 weeks gestation in southeast Australia, with 894 families followed up when infants turned one year. They collected the data through questionnaires at recruitment and infant ages 1, 6, and 12 months, included pacifier use and pacifier sanitization (defined as the joint exposure of a pacifier and cleaning methods). They assessed the challenge-proven food allergy at 12 months.

Key findings of the study were:

• Upon evaluation, the researchers found that any pacifier use was associated with food allergy (adjusted odds ratio, 1.94) at six months of age, but not with other ages.
• They noted that this overall association was driven by the joint exposure of pacifier-antiseptic use (adjusted odds ratio, 4.83) compared with no pacifier use.
• They also noted that using pacifiers without antiseptic at six months was not associated with food allergy.
• They reported that antiseptic cleaning was still associated with food allergy (adjusted odds ratio, 3.56) compared with no antiseptic use among pacifier users.
• Also, they mentioned that persistent and repeated antiseptic use over the first six months was associated with higher food allergy risk.

The authors concluded, "This is the first report of a pacifier-antiseptic combination being associated with a higher risk of subsequent food allergy. Future work should investigate underlying biological pathways."

For further information:

DOI: https://doi.org/10.1016/j.jaci.2021.01.032