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Advice for the mouths of babes

March 03, 2003|Dianne Partie Lange | Special to The Times

The common caution not to give a breast-feeding newborn a pacifier has proved to be true. Hold off for at least four weeks, conclude the authors of a study comparing how long babies nursed if given a pacifier early (before they were 5 days old) or later (at 1 month old).

More than 700 pregnant women who planned to breast-feed were recruited by University of Rochester (N.Y.) researchers and randomly assigned to one of four groups. Information about nursing patterns was regularly collected from birth to 1 year, and researchers compared the effects of early and late introduction of a pacifier -- as well as the use of cups or bottles for supplementary meals.

The group given the pacifier at 1 month nursed for six months on average. The group given the pacifier at five days nursed for an average of five months. And both cup and bottle methods of supplementing breast-feeding shortened the duration of breast-feeding.

The researchers say more studies are needed to determine why early pacifier use interferes with nursing. They don't think, however, that babies are confused by the different nipples, a common theory because the mechanics of sucking at the breast and on an artificial nipple are different.

"If it was nipple confusion, we would have seen differences in weight gain or difficulties attaching to the breast for feeding. But we saw no difference. Maybe babies using the pacifier are staying on the breast for less time," says lead author Dr. Cynthia Howard, pediatric director of the mother-baby unit at Rochester General Hospital in New York.

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For MS treatment, interferons only modestly effective, analysis suggests

People with the most common type of multiple sclerosis -- relapsing-remitting MS -- often are prescribed drugs called interferons to slow the progress of the disease. But improvement in those taking the drugs, compared with a placebo, is "modest," during at least the first year of treatment, an analysis has found. Beyond a year, the authors report, the drugs' effectiveness is uncertain.

Researchers from the National Neurological Institute in Milan, Italy, analyzed data from seven interferon studies conducted over the last decade, finding that most of them had major weaknesses. Many people dropped out of the studies, they found, making the available data difficult to interpret. "New trials are needed to assess [the drugs'] long-term effectiveness and side effects," the authors said.

Dr. Aaron Miller, chief medical officer for the National MS Society, agrees that better studies are needed, but he is critical of the report, published in the Feb. 15 issue of the Lancet. "In my view it is quite misleading." For one thing, he says, the analysis combined data from studies using different types of interferon at different doses. And Miller points out that the large number of "dropouts" included people from a study that was ended early because the drug was working.

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Smoking, weight may be factors in hot flashes

A woman approaching menopause may be able to get the upper hand on hot flashes if she's willing to stop smoking and lose weight.

The first large study of hot flashes in more than 1,000 women found that those who smoke more than a pack a day were 2.5 times more likely to report moderate to severe hot flashes than those who never smoked. Women who smoked a pack or less a day had a lower risk, but it still was greater than those who never had smoked.

Smoking probably affects estrogen levels, report the University of Maryland researchers who conducted the study, perhaps because an enzyme that breaks down cigarette smoke also is involved in the metabolism of estrogen.

Being too heavy also increased the risk of hot flashes in women approaching menopause. Those who were 50 or younger and were obese had twice the risk of hot flashes as those of normal weight, according to lead author Maura K. Whiteman.

The study was published in the February issue of Obstetrics and Gynecology.

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