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Selections from Journal Watch Pediatrics and Adolescent Medicine Copyright © 2006 Massachusetts Medical Society. All rights reserved.

Do pacifiers prevent SIDS?

▸ Use of pacifiers during sleep has been associated with reduced risk for sudden infant death syndrome (SIDS). To quantify this association, investigators in Virginia conducted a meta-analysis of data from seven case-control studies that involved 1663 infants who had died from SIDS and 5373 control infants.

In multivariate analysis of data from four studies that controlled for various confounding factors, usual pacifier use was associated with significantly reduced risk for SIDS (summary odds ratio, 0.71). Also, in analysis of data from all seven studies, pacifier use during the last reference sleep was associated with significantly reduced risk for SIDS (OR, 0.39). The authors estimate that pacifier use could prevent 1 SIDS death for every 2733 infants who used pacifiers when placed down for sleep.

Comment ▸

The findings of these studies have led to the recent and controversial recommendations from the American Academy of Pediatrics that parents provide pacifiers when they put infants down to sleep. Although this study is based on an exhaustive search of the literature, and the authors attempted to control for various confounding factors, study quality was not assessed, and most studies were conducted during the earliest stages of the Back to Sleep campaign, when the SIDS rate was higher than it is today. These factors could have led the authors …

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