Why parents keep quiet about dummies Child-care fashions change but guilt over using `comforters' is still powerful, write Christopher Martyn and Catharine Gale

The dummy was considered germ-laden, liable to come into contact with `all sorts of unclean things' and so a source of infection

You spot a friend pushing a trolley down a supermarket aisle. As you approach, she reaches out furtively to the child riding in front of her, and takes a dummy from its mouth. She hides it in a pocket.

Dummies make cowards of us all. They may keep our children quiet, but we don't want to be caught using them. A dummy was the only thing that would pacify the daughter of other friends and they let her suck it constantly. Their embarrassment was plainly signalled by the way they referred to the dummy as "the family shame".

The medical and nursing professions have deeply mistrusted dummies for nearly a century. Yet they date back even longer.

In Durer's 16th-century painting of the madonna and child, the infant Jesus is shown clutching a sucking rag - a piece of cloth knotted into the form of a nipple. The practice was in use for years and some delicacy might have been enclosed within the knot. In 1859, an article in the Englishwoman's Domestic Magazine recommended pork fat, toasted cheese, rabbit brains or oysters for this purpose.

The sucking rag evolved into the modern dummy during the second half of the 19th century. In their 1882 catalogue, Maws, manufacturer of bottle-feeding teats, extolled the effectiveness of their rubber "soothing pad", a flat, broad device with the ring and guard of the contemporary dummy. By 1901, more than 60 types of dummy were in production, ranging in price from one penny to 11 shillings.

These helpful little objects have been valued for a long time, so why is using them such an emotive issue for parents today?

An explanation can be found at the beginning of the century, when infant mortality was high and the birth rate was falling. Supporters of social Darwinism and eugenics expressed concern about the deteriorating quality of the race. At the same time, fearsabout imperial decline were magnified by the recruitment statistics during the Boer war. In Manchester, three out of every five men who had offered to enlist had been rejected as physically unfit, and only one in three of those accepted "attained the moderate standard of muscular power and chest measurement required by the military authorities".

The government set up the Inter-departmental Committee on Physical Deterioration to advise on how best to improve infant and child health. One recommendation in the committee's 1904 report was that more health visiting schemes should be set up, along thelines of those already established in Manchester and Salford, where the employment of female sanitary inspectors advising mothers on feeding, hygiene and infant care had been followed by a reduction in infant mortality.

The subject of dummies figured prominently in health visitors' recommendations for mothers. Medical and child welfare experts were united in viewing this object as a serious hazard to babies' health.

At the start of the 20th century, many babies died from diarrhoea. The cause and its mode of transmission were not yet understood, but medical opinion held that "dirt", whether in soil, in milk or in the home, was somehow responsible.

The dummy was considered to be germ-laden, liable to come into contact with "all sorts of unclean things", and so a source of infection, both of the gastro-intestinal tract and of the ears, throat and chest. Dummies were also held responsible for damaging babies' teeth and jaws.

A propaganda campaign began. The author of Motherhood,published by Cow & Gate in 1920, wrote: "Comforters are an unmixed evil, and should never be allowed in any home." Elsewhere in the literature of the growing infant welfare movement, the dummy was described as "an invention of perverted American ingenuity", an "instrument of torture", and the "curse of babyhood". One writer even credited it with addictive powers: "A baby that has had a dummy is like a tiger that has tasted blood."

The clear message was that giving a baby a dummy was a sign of a bad mother.

In Hertfordshire the local authority went as far as directing health visitors to record whether a baby had used a dummy. The registers into which these health visitors' records were transcribed still exist. They start in 1911 when health visitors noted that more than four out of every 10 babies used a dummy during their first year. Twenty years later, the proportion of babies given a dummy had fallen by half. In his annual report of 1938, the county medical officer wrote with some satisfaction that only 18 per cent of infants were using a dummy.

Recent interviews with some of these mothers who are still alive give a more intimate insight into the campaign's success.

Although these women are in their eighties and nineties, none showed any hesitation in recalling whether their children had sucked dummies. They tended to be rather defensive on the subject but if they admitted giving a child a dummy, they often made the excuse that it had been used only out of necessity, usually at other people's suggestion, and then "only at bedtime" or "only indoors".

But the Hertfordshire data also shows that the intensity of feeling aroused by the dummy was groundless. The vast majority of the babies who sucked dummies remained well. Those who used a dummy were no more likely to suffer from diarrhoea or dental problems than those who did not. We discovered that a few infections, such as bronchitis, pneumonia and whooping cough, occurred slightly more frequently in infants who used a dummy but, since these infections are usually airborne, it is unlikely that suckinga dummy contributed to causing them.

Why did early 20th-century medical and child-care experts persuade themselves that the dummy was so harmful?

At that time, almost all illness was explained by the germ theory of disease. Educating mothers in domestic cleanliness and hygienic methods of baby-care was considered the most effective way of reducing infant mortality and improving child health. The dummy was seen not only as a carrier of dirt and disease but a mark of the type of maternal behaviour that the medical authorities were keen to suppress. Another, perhaps deeper, reason that the dummy aroused so much animosity may have been the belief that it was bad for a baby's character.

Many child-care experts believed that indulging the baby's desires for physical comfort and oral gratification was contrary to the ideals of self-control and discipline. A regimented training was thought best for moulding a child's character. Early psychological conditioning was deemed to play an essential role in this process.

This view runs through the writings of Frederick Truby King, whose child-care books in the Twenties influenced generations of parents. One of his followers, Mabel Liddiard, wrote in her Mothercraft Manual at the end of the decade: "Self-control, obedience, the recognition of authority and, later, respect for elders are all the outcome of the first year's training. The baby who is picked up or fed whenever he cries soon becomes a veritable tyrant, and gives his mother no peace when awake; while, on theo ther hand, the infant who is fed regularly, put to sleep, and played with at definite times soon finds that appeals bring no response, and so learns that most useful of all lessons, self-control, and the recognition of an authority other than his own wishes."

These writers made a clear distinction between a baby's legitimate physical "needs" and its "wants", illegitimate and dangerous desires for pleasure and comfort. Sucking a dummy definitely fell into the latter category.

The rapid decline in dummy-use among Hertfordshire babies in the first part of this century shows that the anti-dummy campaign worked. Fashions in child-rearing have changed since then, but the shame that the dummy can still induce in parents today indicates the enduring power of that early propaganda.

Taken from `Dummies and the Health of Hertfordshire Infants, 1911-30' by Catharine Gale and Christopher Martyn, to be published in the journal `Social History of Medicine' in August. Christopher Martyn is a clinical scientist and Catharine Gale a research student at the Medical Research Council Environmental Epidemiology Unit, Southampton.