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Lung aerosol deposition in suckling infants
  1. Israel Amirav1,
  2. Anthony Luder1,
  3. Aidah Chleechel1,
  4. Michael T Newhouse2,
  5. Miguel Gorenberg3
  1. 1Ziv Medical Center and Faculty of Medicine, Bar Ilan University, Safed 13100, Israel
  2. 2Firestone Institute for Respiratory Health, St. Joseph's Hospital, McMaster University, Ontario, Canada
  3. 3Department of Nuclear Medicine, Ziv Medical Center, Safed, Israel
  1. Correspondence to Israel Amirav, Ziv Medical Center and Faculty of Medicine, Bar Ilan University, Safed 13100, Israel; amirav{at}


Introduction Aerosol therapy in infants may be greatly compromised by face mask rejection due to squirming and crying. Lung aerosol deposition in crying infants may thereby be greatly reduced. Since ‘suckling’ on a pacifier calms infants, they should more readily accept a face mask that incorporates a pacifier. However, since infants must breathe nasally while suckling, lung aerosol deposition may be reduced due to impaction in the nose.

The aim of the present pilot study was to compare lung aerosol deposition while suckling on a pacifier incorporated into a mask with that obtained while inhaling from a conventional mask.

Methods Twelve infants <12 months old and who regularly used pacifiers participated as their own controls. Lung aerosol deposition was measured scintigraphically (technetium-99mDTPA-labelled normal saline aerosol, MMAD (Mass Median Aerodynamic Diameter) 3 um and GSD (Geometric Standard Deviation) of 2) via jet nebuliser using a conventional mask versus ‘suckling’ on their pacifier incorporated into a unique mask.

Results Mean lung deposition (±SD) while suckling using a mask with attached pacifier (1.6±0.5% in the right lung) was similar to that with a conventional mask (1.7±0.9%, p=0.81).

Conclusions Lung aerosol deposition during nasal breathing while suckling on a pacifier-equipped mask is similar to that in infants breathing quietly using a conventional mask, and results comparable with previous data in infants and in nasal breathing models of an infant's upper respiratory tract. Using a pacifier during aerosol treatment in infants may be as efficient as conventional treatment without a pacifier.

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  • Competing interests Drs Amirav and Newhouse have patent rights for devices for delivering aerosols to infants and Michael Newhouse is the consulting Chief Medical Officer of InspiRx, developer of the SootherMask. All the other authors have indicated they have no financial relationships relevant to this article to disclose.

  • Ethics approval Approval provided by the local IRB and Ministry of Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.