Vanilla and Lemon Flavoring??

jennylee321 · Apr 3, 2017

Haha I've never heard of this, babies like breastmilk why not put that on the pacifier

KKEGS, MSN, RN · Apr 3, 2017

We use sucrose or breastmilk. I've never heard of anyone using anything else!

Those kinds of questions remind me of when I was studying for the NCLEX and all of the orthopedic questions. I have a friend who is an orthopedic doctor and she laughed and said, "No one even does that anymore!" to some of the positioning and equipment questions.

vanilla bean · Apr 4, 2017

Do you have access to a speech therapist at your facility? When I used to work as an RT and had to assist with swallow studies (for trached adults), I would occasionally see the ST use lemon swabs as part of her assessment. I've not seen it in the NICU, but a ST might be able to explain the function and rationale.

adventure_rn, MSN, NP · Apr 4, 2017

Do you have access to a speech therapist at your facility? When I used to work as an RT and had to assist with swallow studies (for trached adults), I would occasionally see the ST use lemon swabs as part of her assessment. I've not seen it in the NICU, but a ST might be able to explain the function and rationale.

That's an interesting thought. Unfortunately we don't see them at all on night shift, but I'll have to see if one of my AM colleagues can pass the question along. Will update if I get some answers.

amoLucia · Apr 4, 2017

Do you have access to a speech therapist at your facility? When I used to work as an RT and had to assist with swallow studies (for trached adults), I would occasionally see the ST use lemon swabs as part of her assessment. I've not seen it in the NICU, but a ST might be able to explain the function and rationale.

Our SLPs sometimes used lemon ice for dysphagia pts in ltc. Was pucker-power! And strong tasting - while not being terribly nasty. So it stimulated their 'mouthing' response.

llg, PhD, RN · Apr 4, 2017

There used to be lemon-flavored swabs designed for oral care on adult patients -- to clean the mouth and leave a sweet lemon flavor without vigorously brushing. I remember using them in the NICU for babies who were irritable and wanted to such on something for comfort -- and do clean the "gunk" out of their mouths.

I suspect that the practice stopped because units didn't want to keep paying for the swabs when the mouths could be cleaned with plain water -- and the babies couldn't complain about not having something sweet to suck on.

amoLucia · Apr 4, 2017

Had any of you ever tried those lemon swabs? I thought they were just plain nasty yuck. Left an after-taste and my mouth used to have a feeling of being 'coated'. JMO. I used to dip them in water first for pt use.

I always wondered if the glycerine-y coating in the mouth was a harbor for some kind of growth. Probably not because they were FDA-intended for cleaning the mouth.

adventure_rn, MSN, NP · Apr 9, 2017

So I've been asking some old timers and here's what I've learned:

Some units used to (and still do) use vanilla-flavored mouth swabs like the ones we have for adults who aren't allowed to brush their teeth; in adults, I think I remember them being like big pink round sponges that looked like a lollipop on a stick. Nowadays it seems like most neonatal mouth care is done with an unflavored swab (basically a q-tip shaped sponge) and some colostrum or sterile water.

Also, fun fact, apparently pacifiers can be scented/flavored, primarily with vanilla. I checked our pacifier packaging on my unit, and sure enough they all said 'Unscented' prominently on the packaging--who knew? I'm warming up to the idea of vanilla scented pacis to provide positive oral stimulation for oral aversion kids, though I don't know if that's ever done in healthcare.

No word on why the heck you'd use lemon flavoring, although my RNC book also claims that lemon glycerin swabs are also used for kids going home on supplemental oxygen to alleviate dry mouth. I did find more cute babies eating lemons videos...poor babies.