Data Support Use of Pacifiers to Lower Sids Risk

NEW YORK (Reuters Health) - An analysis of seven published studies demonstrates a significantly reduced risk of sudden infant death syndrome (SIDS) with pacifier use, particularly when used at bedtime.

Based on their finding, the authors recommend that pacifiers be offered to infants up to 1 year of age, which includes the peak ages for SIDS risk, when they are being placed for daytime naps and sleep at night.

While pacifier use has been shown to lower the risk of SIDS, most countries, including the US, have been reluctant to recommend their use because of concerns about possible harmful effects, Dr. Fern R. Hauck from the University of Virginia in Charlottesville and colleagues explain in the latest issue of the online edition of Pediatrics. These concerns have focused mainly on breastfeeding difficulties and increased risk of ear and other infections, and dental problems.

For the studies included, the risk of SIDS was decreased by up to 30 percent with "usual pacifier" use, according to the team. Pacifier use during sleep decreased the risk of SIDS by up to 61 percent.

"Encouraging pacifier use is likely to be beneficial on a population-wide basis," the authors also note, pointing out that one SIDS death could be prevented for every 2,733 infants who use a pacifier when put in for a nap or at bedtime.

For breastfed infants, it's best to introduce the pacifier after breastfeeding is well established, the investigators suggest.

Based on the data, it's likely that the "consistent and large" beneficial effects of pacifiers up to the age of 12 months outweigh any potential negative effects, the researchers advise.

Pacifiers should not be used after 12 months of age, "because (ear infection) risk is higher, whereas SIDS risk declines considerably after this age," Hauck's group notes. To help minimize the risk of ear infection, parents should clean pacifiers frequently and replace them when damaged.

SOURCE: Pediatrics 2005.