Is the use of dummy or carry-cot of importance for sudden infant death?

Abstract

The study was undertaken to test the significance of dummy use and carry-cots for counts of sudden infant death (SID). Based on the impression that very few SID victims have a dummy (comforter, pacifier) in their mouth at the time of death, and that a high proportion of SID babies were found dead in a carry-cot (portable crib, pram), a case-control study was performed. Questionnaires were sent to 167 parents of SID victims and to 352 parents of live-infants matched for sex and time of birth. Questionnaires were returned by 121 parents of SID victims (73%) and 307 parents of controls (87%). Only 4 SID victims (3%) were found dead with a dummy in their mouth. A quarter of the controls always used a dummy, 24% during night-time and 23% during daytime between 0 and 2 months of age, whereas this was only true for 10% in the SID group, the odds ratios being 0.27 for night-time and 0.36 for daytime. This trend was also seen until 1 year of life. Of the SID victims, 48% were found dead in a carry-cot, 79% during the cold time of the year and two thirds outdoors. Most deaths occurred during the afternoon (12 pm–5 pm). In both SID and control groups daytime use of carry-cots was equally frequent. Approximately 40% in both groups slept in such a cot between 5–7 days a week during the daytime.

Conclusion The use of dummy could be a favourable factor in the prevention of SID. Because of the frequent use of carry-cots during the daytime both in the SID group and the control group, the high percentage of SID in such cots does not seem to be of significance. However the high frequency of deaths in outdoor placed carry-cots during the cold period of the year may give clues to understanding the death mechanism in SID.