Pacifier Use May Help Prevent SIDS

  1. http://articles.health.msn.com/id/100110866

    Letting your baby suck on a pacifier before bed may help reduce the risk of sudden infant death syndrome (SIDS).
    Hauck and her colleagues reviewed seven studies that looked at the association between pacifier use and SIDS. They concluded that approximately one SIDS death could be prevented for every 2,733 babies who use a pacifier while they sleep.
    That benefit, said Hauck, outweighs any potential risks of pacifier use, including dental problems, a slightly increased risk of ear infections and breast-feeding difficulties.
    "There was a 61 percent reduction in SIDS risk [from pacifier use]," said Hauck.
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  2. 20 Comments

  3. by   Jessy_RN
    How interesting. Thank you for sharing.
  4. by   SmilingBluEyes
    I did not agree that they should put out info like this so soon.......I have problems with "research" having learned that up to 40% it is debunked within months/a year or two. Pacifiers can create more problems than they solve. And these same peds are also advocating NOT to co-sleep in a study linked to this one regarding SIDS. Wonder if they asked dentists how they feel about pacifier use? Once started, it's a HARD habit to break kids of. . I co-slept w/both kids and it saved our sanity more than on one occasion. I think it's all in HOW it's done, myself. It was the best way to breastfeed in the night, and I heard nearly every breath they took, from day one.

    JMO as always.
  5. by   gauge14iv
    So does boob use - and there are studies to support that....
  6. by   Spidey's mom
    Quote from gauge14iv
    So does boob use - and there are studies to support that....
    Woot!!!!!:hatparty:

    Deb, I'm with you . . this study was released too soon and what exactly kind of research information is included? The parents who did not practice safe co-sleeping - were they included? The ones who were not given accurate and safe info and went home and got drunk and slept on their kids?

    I slept with all my kids - they are all still alive to tell the tale.

    steph
  7. by   Roy Fokker
    I made sure I slept with my parents.

    Or so my Mother tells me :chuckle
  8. by   URO-RN
    My kid is still alive. I nursed her in bed. She is still alive. In fact, doing this helped me nurse till she was almost 2. Only had one ear infection, and that happened after enrolling her in daycare.
  9. by   URO-RN
    Okay,

    what I meant to say was this:

    That co-sleeping is good; that it helps promote breast feeding.

    ( can't edit my post the old fashioned way....d/t problems with the posting program)
  10. by   mwbeah
    http://adc.bmjjournals.com/cgi/conte...tract/81/2/112

    you can download the article in pdf format here.

    you have to judge for yourself (statistics.....what did mark twain say, "there are lies, damn lies, and statistics). below is the discussion section of the article.

    [color=#ff1b00]discussion[color=#ff1b00]top
    abstract
    introduction
    methods
    results
    [color=#464c53]discussion
    references

    the similarity between the proportion of victims of sids and control infants reported as sometimes using a pacifier, and the similarity between this figure (68%) and that found in our prospective population study (65%) suggests that there was no systematic under-reporting of pacifier use by parents of victims of sids.1
    our study confirms that there is an association between pacifier use and a reduced risk of sids. in addition, our study confirms the previously reported associations between pacifier use and infant feeding practices, parental smoking, and socioeconomic status, but controlling for these and other relevant factors (such as prone sleeping position) in a multivariate analysis strengthened the apparent protective effect associated with pacifier use. these observations, together with the unique size and the comprehensive nature of the data collected in the cesdi/sudi study, suggest that the protective association is real.
    the observations on pacifier use from new zealand2 preceded the "back to sleep" campaign, yet found a magnitude of effect in a multivariate analysis (or, 0.44; 95% ci, 0.26 to 0.73) that was very similar to ours (or, 0.44; 95% ci, 0.21 to 0.94). in common with our study, the dutch study3 took place after the change in recommendations on sleeping position and found an even stronger univariate association (or, 0.06; 95% ci, 0.01 to 0.25). a recommendation derived from this study, to use a pacifier, has been widely publicised in holland, despite serious reservations expressed by righard.12 a study of routine pacifier use from norway4 found a large difference in routine use between sids infants (10%) and age matched controls (24%). thus, four studies from different countries have shown associations between pacifier use and a reduced risk of sids.
    it is important to emphasise that the association does not necessarily imply that the use of a pacifier is "protective" against sids, although the finding is compatible with this hypothesis. even with a large and careful case control study, we cannot be sure that parents of victims of sids who use a pacifier are not systematically different in some unmeasured way from the controls. the possibility remains that the use of a pacifier may be confounded with some other factor of parental behaviour that has not been identified by the questionnaire but which is the reason for apparent risk reduction. although pacifier sucking has been shown to increase oxygen tensions in preterm infants,13 there are no published physiological data that identify a mechanism by which pacifiers might protect against sids, and no evidence in the epidemiological studies for a "dose response" effect of pacifier use.
    unless or until other corroborative evidence becomes available, it follows that health professionals should be cautious in recommending routine pacifier use on the grounds of protection against sids. the evidence for recommending that all babies should be given pacifiers to reduce the incidence of sids is weaklevel iii at best (us agency for health care policy and research). advice that is given routinely about the care of healthy babies must have at least as strong an evidence base as the treatment of those babies who are ill, because healthy babies are far more common, and the potential for unsuspected harm is relatively great, a lesson already bitterly learned for infant sleeping position.
    it is widely believed that pacifiers have negative effects upon breast feeding, but few studies have considered this conflict in their conclusions, since pacifier use has been associated with both a decrease14 15 and no effect16 on the prevalence and duration of breast feeding. in our study there was a clear association between pacifier use and lower prevalence, as well as shorter duration of breast feeding, a finding compatible with a negative effect of pacifier use on breast feeding.
    pacifier use is associated with an increased incidence of respiratory and gastrointestinal illness.1 that this association may be causal is plausible, given the difficulties of maintaining pacifiers in a hygienic state. there is little hard evidence for other widely held beliefs about harmful effects of pacifiers on tooth growth, palatal anatomy, or speech development.
    the association between pacifier use and a reduced incidence of sids needs to be explored further because of the implications for infant care practices if evidence for a causal link should become strong. this will require knowledge of the physiological effects of pacifier use, awake and during sleep, in health and disease; further epidemiological studies to explore risk factors not identified in the existing studies; and a full evaluation of potential harm as well as potential benefit. no recommendations on pacifier use can be made in the light of present knowledge.
    Last edit by mwbeah on Oct 13, '05
  11. by   Roy Fokker
    Quote from mwbeah
    http://adc.bmjjournals.com/cgi/conte...tract/81/2/112

    You can download the article in pdf format here.

    You have to judge for yourself (statistics.....what did Mark Twain say, "there are lies, damn lies, and statistics). Below is the discussion section of the article.
    Using peer reviewed research work as original citations as a basis for your argument?

    I like yer style

    Now if only I could seduce you to join a MIL-history forum
  12. by   URO-RN
    Quote from mwbeah
    http://adc.bmjjournals.com/cgi/conte...tract/81/2/112

    you can download the article in pdf format here.

    you have to judge for yourself (statistics.....what did mark twain say, "there are lies, damn lies, and statistics). below is the discussion section of the article.

    [color=#ff1b00]discussion[color=#ff1b00]top
    abstract
    introduction
    methods
    results
    [color=#464c53]discussion
    references

    the similarity between the proportion of victims of sids and control infants reported as sometimes using a pacifier, and the similarity between this figure (68%) and that found in our prospective population study (65%) suggests that there was no systematic under-reporting of pacifier use by parents of victims of sids.1
    our study confirms that there is an association between pacifier use and a reduced risk of sids. in addition, our study confirms the previously reported associations between pacifier use and infant feeding practices, parental smoking, and socioeconomic status, but controlling for these and other relevant factors (such as prone sleeping position) in a multivariate analysis strengthened the apparent protective effect associated with pacifier use. these observations, together with the unique size and the comprehensive nature of the data collected in the cesdi/sudi study, suggest that the protective association is real.
    the observations on pacifier use from new zealand2 preceded the "back to sleep" campaign, yet found a magnitude of effect in a multivariate analysis (or, 0.44; 95% ci, 0.26 to 0.73) that was very similar to ours (or, 0.44; 95% ci, 0.21 to 0.94). in common with our study, the dutch study3 took place after the change in recommendations on sleeping position and found an even stronger univariate association (or, 0.06; 95% ci, 0.01 to 0.25). a recommendation derived from this study, to use a pacifier, has been widely publicised in holland, despite serious reservations expressed by righard.12 a study of routine pacifier use from norway4 found a large difference in routine use between sids infants (10%) and age matched controls (24%). thus, four studies from different countries have shown associations between pacifier use and a reduced risk of sids.
    it is important to emphasise that the association does not necessarily imply that the use of a pacifier is "protective" against sids, although the finding is compatible with this hypothesis. even with a large and careful case control study, we cannot be sure that parents of victims of sids who use a pacifier are not systematically different in some unmeasured way from the controls. the possibility remains that the use of a pacifier may be confounded with some other factor of parental behaviour that has not been identified by the questionnaire but which is the reason for apparent risk reduction. although pacifier sucking has been shown to increase oxygen tensions in preterm infants,13 there are no published physiological data that identify a mechanism by which pacifiers might protect against sids, and no evidence in the epidemiological studies for a "dose response" effect of pacifier use.
    unless or until other corroborative evidence becomes available, it follows that health professionals should be cautious in recommending routine pacifier use on the grounds of protection against sids. the evidence for recommending that all babies should be given pacifiers to reduce the incidence of sids is weaklevel iii at best (us agency for health care policy and research). advice that is given routinely about the care of healthy babies must have at least as strong an evidence base as the treatment of those babies who are ill, because healthy babies are far more common, and the potential for unsuspected harm is relatively great, a lesson already bitterly learned for infant sleeping position.
    it is widely believed that pacifiers have negative effects upon breast feeding, but few studies have considered this conflict in their conclusions, since pacifier use has been associated with both a decrease14 15 and no effect16 on the prevalence and duration of breast feeding. in our study there was a clear association between pacifier use and lower prevalence, as well as shorter duration of breast feeding, a finding compatible with a negative effect of pacifier use on breast feeding.
    pacifier use is associated with an increased incidence of respiratory and gastrointestinal illness.1 that this association may be causal is plausible, given the difficulties of maintaining pacifiers in a hygienic state. there is little hard evidence for other widely held beliefs about harmful effects of pacifiers on tooth growth, palatal anatomy, or speech development.
    the association between pacifier use and a reduced incidence of sids needs to be explored further because of the implications for infant care practices if evidence for a causal link should become strong. this will require knowledge of the physiological effects of pacifier use, awake and during sleep, in health and disease; further epidemiological studies to explore risk factors not identified in the existing studies; and a full evaluation of potential harm as well as potential benefit. no recommendations on pacifier use can be made in the light of present knowledge.

    thanks for sharing. very interesting and i will bring a copy of this article to our journal club at work.
  13. by   kitty29
    Quote from SmilingBluEyes
    I did not agree that they should put out info like this so soon.......I have problems with "research" having learned that up to 40% it is debunked within months/a year or two. Pacifiers can create more problems than they solve. And these same peds are also advocating NOT to co-sleep in a study linked to this one regarding SIDS. Wonder if they asked dentists how they feel about pacifier use? Once started, it's a HARD habit to break kids of. . I co-slept w/both kids and it saved our sanity more than on one occasion. I think it's all in HOW it's done, myself. It was the best way to breastfeed in the night, and I heard nearly every breath they took, from day one.

    JMO as always.
    I was wondering many of the things you have just mentioned, and am forewording the article to our CNS to see what she says. I'll get back to ya.
  14. by   gauge14iv
    FOR IMMEDIATE RELEASE

    CONTACT

    United States Breastfeeding Committee
    Chair: Audrey Naylor, MD, PhD
    AJNaylor@aol.com
    619-574-8174
    Vice Chair: Ruth Lawrence, MD
    ruth_lawrence@urmc.rochester.edu
    585-275-4354

    Mixed Credibility of the Revised AAP SIDS Prevention Recommendations

    WASHINGTON, D.C. (October 17, 2005) - The American Academy of Pediatrics
    (AAP) released revised recommendations for Sudden Infant Death Syndrome
    (SIDS) prevention last week, one of which provides valuable new information to help parents protect their infant, while others not only lack a solid scientific basis but also entail some risks.

    The AAP now recommends that infants sleep in the same room as their parents because this is associated with a reduced risk of SIDS. While studies have consistently found that isolating infants for sleep (in a separate bedroom) is associated with a higher risk of SIDS, this information has not previously been widely disseminated. Sleeping near one's infant has also been shown to increase maternal responsiveness to the infant's nighttime physiologic signals and to make it easier for mother to succeed with breastfeeding. Breastfeeding, in turn, is linked to a reduced risk of many acute and chronic illnesses, including a 21% lower all-cause infant mortality rate in an analysis by the National Institutes of Health, and to a reduced risk of SIDS in a number of studies.

    Two recommendations in the new AAP statement have stirred particular
    concern: to give babies pacifiers and to remove the infant from the parental bed prior to sleep. Both recommendations are problematic in a number of ways, including that they lack a clear scientific basis, constrain parental choice, complicate the potentially challenging process of putting infants to sleep, and impair breastfeeding.

    Because early pacifier use reduces breastfeeding duration, the AAP SIDS statement recommends waiting until one month of age (to allow breastfeeding to get off to a good start) before starting pacifiers in breastfed infants.
    Even beyond this period pacifiers entail health risks, however, and may undermine breastfeeding success.

    A number of studies (but not all) have found an association between pacifier use and lower rates of SIDS. But these studies cannot determine if the relationship is causal, and therefore whether pacifier use can reduce the risk of SIDS. Nevertheless, even if the oral stimulation of sucking were protective, only those infants lacking the natural source of nighttime suckling, breastfeeding, would be likely to benefit from an artificial pacifier source of such stimulation. Only in such "at risk" groups might it make sense to assume the health risks of pacifier use which include yeast infections, oral malocclusion, and ear infections.

    Data are also lacking to justify telling parents whether or not they should sleep with their infants-beyond informing them of the protective effect of sleeping in the same room as their baby. In the best controlled studies, infant safety is not associated with whether the baby sleeps in the parents'
    bed per se, but on specific environmental factors that warrant attention whether the baby is in a bed, a crib, or other sleeping surface. For example, SIDS has been associated with prone sleep position, maternal smoking, soft mattresses, and bedding near the baby that could cover the head. Avoidable exceptions in which bedsharing itself has been associated with an increased risk of SIDS include the use of particularly unsafe furniture (e.g., couches, which are associated with a 25-fold increased risk of SIDS) and parent smoking or incapacitation due to alcohol or drug use, or exhaustion.

    The United States Breastfeeding Committee recommends caution before advising pacifiers for breastfeeding infants even after one month of age. It also emphasizes the importance of closeness to one's infant and supports the statement of the Section on Breastfeeding of the AAP that mother and infant sleep in close proximity.

    The United States Breastfeeding Committee is a national committee made up of over 30 organizations that promote, protect, and support breastfeeding.

    1. AAP Task Force on Sudden Infant Death Syndrome. The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding Sleeping Environment, and New Variables to Consider in Reducing Risk. Pediatrics November 2005; 116(5):1245-1255

    2. American Academy of Pediatrics, Section on Breastfeeding, PolicyStatement: Breastfeeding and the Use of Human Milk. Pediatrics 2005;115(2):496-506

    3. Chen A, Rogan WJ. Breastfeeding and the Risk of Postneonatal Death in the United States. Pediatrics 2004; 113:e435-439
    URL: http://www.pediatrics.org/cgi/content/full/113/5/e435

    4. McKenna JJ, McDade T. Why babies should never sleep alone: A Review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding. Pediatric Respiratory Reviews 2005; 6:134-152 (available on line at www.sciencedirect.com)

    United States Breastfeeding Committee (USBC)
    2025 M Street, NW, Suite 800
    Washington, DC 20036
    General: (202) 367-1132
    Fax: (202) 367-2132
    office@usbreastfeeding.org
    www.usbreastfeeding.org

    The USBC is an organization of organizations. Opinions expressed by the USBC are not necessarily the position of all member organizations and opinions expressed by USBC representatives are not necessarily the position of the USBC.
    Last edit by gauge14iv on Oct 18, '05

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