Pacifier use and sudden infant death syndrome: results from the CESDI/SUDI case control study
- Peter J Fleminga,
- Peter S Blaira,
- Katie Pollarda,
- Martin Ward Plattb,
- Charlotte Leacha,
- Iain Smithc,
- P J Berrya,
- Jean Goldinga,
- the CESDI SUDI Research Team
- aFSID Unit, Department of Child Health, Developmental Physiology, Royal Hospital for Children, St Michael’s Hill, Bristol BS2 8BJ, UK, bNewcastle Neonatal Service, Ward 35, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK, cNuffield Institute for Health, 71–75 Clarendon Road, Leeds LS2 9PL, UK
- Professor Fleming. email:
- Accepted 29 March 1999
OBJECTIVES To investigate the relation between pacifier use and sudden infant death syndrome (SIDS).
DESIGN Three year population based, case control study with parental interviews for each death and four age matched controls.
SETTING Five regions in England (population > 17 million).
SUBJECTS 325 infants who had died from SIDS and 1300 control infants.
RESULTS Significantly fewer SIDS infants (40%) than controls (51%) used a pacifier for the last/reference sleep (univariate odds ratio (OR), 0.62; 95% confidence interval (CI), 0.46 to 0.83) and the difference increased when controlled for other factors (multivariate OR, 0.41; 95% CI, 0.22 to 0.77). However, the proportion of infants who had ever used a pacifier for day (66% SIDS v 66% controls) or night sleeps (61% SIDS v 61% controls) was identical. The association of a risk for SIDS infants who routinely used a pacifier but did not do so for the last sleep became non-significant when controlled for socioeconomic status (bivariate OR, 1.39 (0.93 to 2.07)).
CONCLUSIONS Further epidemiological evidence and physiological studies are needed before pacifier use can be recommended as a measure to reduce the risk of SIDS.
There was no difference between victims of SIDS and control infants in routine use of a pacifier (“dummy” or “soother”) for day or night sleeps
The use of a pacifier was associated with a lower prevalence and shorter duration of breast feeding, lower socioeconomic status, and mothers who smoked more heavily
There was no association between pacifier use and sleeping position
More control infants used a pacifier for the last/reference sleep, giving an apparent “protective” effect against SIDS; the significance of this association increased when controlled for other factors
Further epidemiological evidence and physiological studies are needed before we can recommend pacifier use as protective against SIDS