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Pacifiers and SIDS

12/10/2005

Dear Friends,

Articles hit the news the past couple of weeks regarding pacifiers and SIDS. The news refers to a study funded by the National Institute of Child Health and Human Development (NICHD) and National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, contract N01-HD-5- 3227. More information follows.

We have received many e-mail messages asking for more information. The public has been on an information roller coaster, the result of an explosion of medical reports, each heralding a "breakthrough in SIDS research." We need to help people separate myth from fact and risk factor from cause. We will post information as it becomes available to us.

Please keep the following in mind:

  • When it comes to media coverage of SIDS, we often feel a sense of frustration in being confronted with misleading headlines, announcements of so-called breakthroughs and statements taken out of context.
  • Please read the article, "Mass Media's" Role in SIDS Education, at <http://sids-network.org/media.htm>.
  • This study does not claim that pacifier use prevents SIDS.
  • This study's observations confirm several previous reports.
  • The study concludes that, "Use of a dummy seems to reduce the risk of SIDS and possibly reduces the influence of known risk factors in the sleep environment."
  • There was a discussion of statistical results that mention, "After adjustment for known confounders, the odds ratio for SIDS in infants who used a dummy during the last sleep was 0.08 (0.03 to 0.21), which translates to a more than 90% reduction of risk in this study compared with infants who did not use a dummy during the sleep."
  • There was a discussion of the limitations for the study including small sample size, low participation rate, and deliberate under-reporting.
  • There was a discussion that "potential underlying mechanisms of our observed association should not be confused with the “certainty” of a causal effect between use of dummies and risk of SIDS. The findings from our study and others will collectively provide support for the protective effect of dummies, but they are not “proof” of a causal effect by themselves."

You can read the study published in the British Medical Journal here (pdf 80 Kb). (BMJ, doi:10.1136/bmj.38671.640475.55 (published 9 December 2005)).

We are currently gathering more information about this specific research and will keep you updated. Thanks!

Chuck Mihalko
Executive Manager
SIDS Network

5/10/99

There are now four published, well-designed studies which support a substantially lower incidence of Sudden Infant Death Syndrome in infants who use pacifiers compared to those who do not. According to the current data, the use of pacifiers appears to halve the risk. Two other studies, published in abstract form, report similar results. A review of the recent scientific literature demonstrating an apparent protective association between pacifier use and SIDS was presented by John Brooks, MD*, at the SIDS Alliance National Conference in Atlanta on April 9, 1999. Read more here.

5/3/98

Pacifiers cut risk of crib death, study finds

Copyright (c) 1998 Nando.net
Copyright (c) 1998 Reuters News Service

UTRECHT, Netherlands (March 25, 1998 5:19 p.m. EST http://www.nando.net) - Giving a baby a pacifier at night radically reduces the risk of crib death, according to a Dutch study published Tuesday.

The study, which surveyed 219 babies over a period of 18 months, found babies who were habitually put to bed with a pacifier were 20 times less likely to fall victim to Sudden Infant Death Syndrome (SIDS).

"Once we had corrected for all other factors, we were surprised to find that putting your baby to bed with a pacifier reduced the risk of crib death by a factor of 20," said Monique l'Hoir, who led the research at Utrecht's Wilhelmina children's hospital.

Studies in New Zealand and elsewhere earlier indicated pacifiers might be an aid to preventing crib death, but the Dutch study put forward convincing evidence, L'Hoir told Reuters.

She said the incidence of crib death in the Netherlands was relatively low at one in 4,000 infants (0.26 per 1,000), mainly due to a late 1980s community health drive which taught 90 percent of Dutch parents to lay babies to sleep on their backs.

The Dutch figure compares with an incidence of 1.05 crib deaths per 1,000 babies in the United States and 1.59 per 1,000 in France, according to the latest available data from the World Health Organization (WHO).

Earlier studies have indicated that laying babies to sleep on their stomachs heightens the risk of crib death, as do the use of duvets, wrapping infants too warmly and parental smoking.

The study surveyed 73 Dutch babies who died of unexplained causes, comparing the data with a control group of 146.

Parents in both groups were asked how they had prepared their children for the night and how they were found the next morning.

Non-SIDS parents were far more likely to put their child to bed with a pacifier than parents who had lost their child, L'Hoir said.

She said that while researchers were still unclear about why using a pacifier reduced SIDS, it was thought that pacifier-sucking children were less likely to change their sleeping position to lie nose and mouth down.

"Another explanation could be that babies who are given pacifiers learn very young to keep the breathing passage -- the nose -- open," L'Hoir added.

She said babies at least risk from SIDS were breast-fed infants, partly because mother's milk offered greater protection against infection.

In addition the superior oral ability of breast-fed children was thought to play a role, she said.

"For this reason we would counsel pacifiers for bottle-fed babies, while breast-fed babies should only be given a pacifier when breast-feeding is well-established to prevent nipple confusion," L'Hoir said.

The Utrecht research forms part of a European-wide study into preventing crib death, the European Concerted Action on SIDS (ECAS).

Results of the ECAS study are due to be published this spring in leading British-based medical journal The Lancet.

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