Pacifiers Teem with Staph and Other Germs

Pacifiers—used by up to 85 percent of American babies—can be tainted with millions of harmful germs and fungi, from Staphylococcus aureus and Klebsiella pneumoniae to mold, according to a new study presented at the 2012 American Society for Clinical Pathology Annual Meeting.

“Pacifiers have some benefits—and may reduce risk for sudden infant death syndrome (SIDS)—but the downside is that they may expose babies to alarmingly high levels of dangerous bacteria, including antibiotic resistant Klebsiella, which causes pneumonia, and MRSA,” staph A superbugs that cause hard-to-treat skin and other infections, reports study coauthor R. Tom Glass, DDS, Ph.D., professor of Forensic Sciences, Pathology, and Dental Medicine at Oklahoma State University Center for Health Sciences in Tulsa, Oklahoma.

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Pacifiers Are Soothing But Often Unsanitary

“Parents wouldn’t eat with a dirty fork, but they often think nothing of picking a pacifier up off the floor at a mall and popping it back in their baby’s mouth,” says Dr. Glass. “It’s important for parents to realize pacifiers are easily contaminated—and to do a better job of keeping them clean in order to protect their baby’s health.”

A contaminated pacifier grows a biofilm, a slimy, glue-like coating that makes bacteria become increasingly resistant to both antibiotics and detergent. Once a biofilm forms, it can change the balance of microbes in a baby’s mouth and spark inflammation, boosting risk for ear infections and GI problems, including colic, the researchers report. Some pathogens found on pacifiers in the study have also been linked to heart disease, metabolic syndrome, allergies and asthma.

It’s very difficult to get rid of a biofilm, once it forms, particularly on an oral device, says Dr. Glass, who has also studied dentures, orthodontic retainers, toothbrushes, and athletic mouth guards. “Under a microscope, pacifiers are full of porosities, like a sponge,” which soak up food and water, thus creating an ideal breeding ground for bacteria and fungi to form colonies.

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Bacterial Levels of Up to 100 Million Per Gram

The researchers collected 10 used pacifiers of different designs from healthy babies at a pediatric clinic. The binky nipples and shields were minced and placed in lab dishes designed to grow any bacteria or fungi present on pacifiers, with the cultures examined at 24 and 48 hours. The results were compared to seven new, never-used control pacifiers, minced and cultured in the same manner.

Five pacifiers were lightly contaminated with bacteria and fungi, while the other five were heavily tainted, with levels of up to 100 million colony-forming units (CFUs) per gram. In all, 13 types of fungi and 40 types of bacteria were detected on the used pacifiers. The new binkies had less than 100 CFUs, a level that is deemed sanitary.

“I was shocked at how contaminated some of the pacifiers were: Not only was the bacterial load alarmingly high, but the most heavily contaminated pacifier contained four different types of staph bacteria, including MRSA,” a superbug that is resistant to methicillin and similar antibiotics, says Dr. Glass. Staph A bacteria can cause skin infections, such as boils, impetigo, and cellulitis, or less commonly, burrow deeper into the body to trigger bloodstream, joint, or bone infections, or pneumonia.

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While the bacteria levels found were more than enough to cause serious illness, all of the babies were in good health when the pacifiers were collected. In addition, even healthy people can harbor staph germs on their skin or in their nose without getting sick.

To cause disease, staph bacteria must penetrate the skin or tissue (which could occur through a cut or as a tooth breaks through the gums during teething). And even then, the immune system may be able to fight off infection. However, a child’s immune system isn’t fully developed until age six to 12, points out Dr. Glass, who advises against pacifier use. “After doing the study, I say, ‘Why take a chance when pacifiers can cause illness?’”

Reduced Risk for Sudden Infant Death Syndrome

However, along with soothing colicky babies, pacifiers have one surprising health benefit. If they’re used during sleep, risk for sudden infant death syndrome drops by 90 percent, according to a 2006 study published in British Medical Journal. The reasons aren’t yet understood.

The American Academy of Family Physicians reports that pacifiers may be beneficial during the first six months of life. Along with reducing SIDS risk, pacifiers also relieve pain from minor procedures (like vaccinations). Drawbacks include breastfeeding problems or early weaning, higher risk  for ear infections, and in toddlers, greater likelihood of developing crooked teeth. For more information on pacifier risks and benefits, click here.

What’s the Best Way to Sanitize Pacifiers?

If you choose to use pacifiers, there are easy ways to protect your baby’s health. The researchers advise these precautions:

  • Any time a pacifier pops out of a baby’s mouth, it should be cleaned, no matter where it lands.
  • Wash pacifiers with dish soap and water, then air dry; or soak them in denture-cleaning solution or baking soda solution (one teaspoon of baking soda dissolved in 8 ounces of water).  
  • Bring several pacifiers, stored in a clean baggie, on outings, so you have spares if one is dropped or soiled.
  • Replace pacifiers every 2 weeks, so they don’t grow a disease-causing biofilm.
  • Also replace your baby’s pacifiers after an illness, to avoid reinfection.

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