Skip to main content

Advertisement

SpringerLink
Log in

Reasons for Pacifier Use and Non-Use in African-Americans: Does Knowledge of Reduced SIDS Risk Change Parents’ Minds?

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

To investigate African-American parental reasons for pacifier use or non-use, and whether knowledge of the association with decreased SIDS risk changes decisions about pacifier use. We conducted focus groups and individual interviews with mothers. Grounded theory methodology was used. 83 mothers participated; 72.3 % of infants used pacifiers. Reasons for pacifier use included comfort/soothing, safety/SIDS, and preference over digit-sucking. Reasons for pacifier non-use included infant refusal, fear of attachment, nipple confusion, and germs. Many parents were unaware that pacifier use reduces SIDS risk; however, most parents of non-users did not think that this knowledge would have changed their decision. Reasons included skepticism about the pacifier-SIDS link. Many reasons underlie African-American parental decisions about pacifier use. Providers should provide information about the benefits of pacifiers. Establishing for parents any plausible link between the protective mechanism of pacifiers and SIDS pathophysiology may be important in promoting pacifier use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Murphy SL, et al. Deaths: final data for 2010, in Natl Vital Stat Rep2013. Hyattsville: National Center for Health Statistics; 2010.

    Google Scholar 

  2. Mathews TJ, Macdorman MF. Infant mortality statistics from the 2010 period linked birth/infant death data set. Natl Vital Stat Rep. 2013;62(8):1–27.

    PubMed  Google Scholar 

  3. Perez-Stable EJ, et al. Nicotine metabolism and intake in black and white smokers. JAMA. 1998;280(2):152–6.

    Article  CAS  PubMed  Google Scholar 

  4. Ateah CA, Hamelin KJ. Maternal bedsharing practices, experiences, and awareness of risks. J Obstet Gynecol Neonatal Nurs. 2008;37(3):274–81.

    Article  PubMed  Google Scholar 

  5. Willinger M, et al. Trends in infant bed sharing in the United States, 1993–2000: the National Infant Sleep Position Study. Arch Pediatr Adolesc Med. 2003;157(1):43–9.

    Article  PubMed  Google Scholar 

  6. Colson ER, et al. Trends and factors associated with infant bed sharing, 1993–2010: the National Infant Sleep Position Study. JAMA Pediatr. 2013;167(11):1032–7.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Hauck FR, et al. Do pacifiers reduce the risk of sudden infant death syndrome? A meta-analysis. Pediatrics. 2005;116(5):e716–23.

    Article  PubMed  Google Scholar 

  8. Mitchell EA, et al. Should pacifiers be recommended to prevent SIDS? Pediatrics. 2006;117(5):1755–8.

    Article  CAS  PubMed  Google Scholar 

  9. Li DK, et al. Use of a dummy (pacifier) during sleep and risk of sudden infant death syndrome (SIDS): population based case-control study. BMJ. 2006;332(7532):18–22.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Vennemann MM, et al. Sleep environment risk factors for sudden infant death syndrome: the German Sudden Infant Death Syndrome Study. Pediatrics. 2009;123(4):1162–70.

    Article  PubMed  Google Scholar 

  11. Moon RY, et al. Pacifier use and SIDS: evidence for a consistently reduced risk. Matern Child Health J. 2012;16(3):609–14.

    Article  PubMed  Google Scholar 

  12. Franco P, et al. The influence of a pacifier on infants’ arousals from sleep. J Pediatr. 2000;136(6):775–9.

    CAS  PubMed  Google Scholar 

  13. Kahn A, et al. Sudden infant deaths: from epidemiology to physiology. Forensic Sci Int. 2002;130(Suppl):S8–20.

    Article  PubMed  Google Scholar 

  14. Franco P, et al. Pacifier use modifies infant’s cardiac autonomic controls during sleep. Early Hum Dev. 2004;77(1–2):99–108.

    Article  PubMed  Google Scholar 

  15. Tonkin SL, et al. Effect of pacifier use on mandibular position in preterm infants. Acta Paediatr. 2007;96(10):1433–6.

    Article  PubMed  Google Scholar 

  16. Horne RS, et al. Sudden infant death syndrome: implications of altered physiological control during sleep. Curr Pediatr Rev. 2010;6(1):30–8.

    Article  Google Scholar 

  17. Moon RY. American Academy of Pediatrics, task force on sudden infant death syndrome. Policy statement-SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics. 2011;128(5):1030–9.

    Article  PubMed  Google Scholar 

  18. L’Hoir MP, et al. Dummy use, thumb sucking, mouth breathing and cot death. Eur J Pediatr. 1999;158:896–901.

    Article  PubMed  Google Scholar 

  19. Larsson E. The effect of dummy-sucking on the occlusion: a review. Eur J Orthod. 1986;8:127–30.

    Article  CAS  PubMed  Google Scholar 

  20. Daly KA, Giebink GS. Clinical epidemiology of otitis media. Pediatr Infect Dis J. 2000;19(5 Suppl):S31–6.

    Article  CAS  PubMed  Google Scholar 

  21. Darwazeh AM, Al-Bashir A. Oral candidal flora in healthy infants. J Oral Pathol Med. 1995;24(8):361–4.

    Article  CAS  PubMed  Google Scholar 

  22. North K, et al. Pacifier use and morbidity in the first six months of life. Pediatrics. 1999;103(3):E34.

    Article  CAS  PubMed  Google Scholar 

  23. Pansy J, et al. Pacifier use: What makes mothers change their mind? Acta Paediatr. 2008;97(7):968–71.

    Article  PubMed  Google Scholar 

  24. Giacomini MK, Cook DJ. Users’ guides to the medical literature: XXIII. Qualitative research in health care B. What are the results and how do they help me care for my patients? Evidence-based medicine working group. JAMA. 2000;284(4):478–82.

    Article  CAS  PubMed  Google Scholar 

  25. Giacomini MK, Cook DJ. Users’ guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid? Evidence-based medicine working group. JAMA. 2000;284(3):357–62.

    Article  CAS  PubMed  Google Scholar 

  26. Richards L, Morse JM. Readme first for a user’s guide to qualitative methods. 2nd ed. Thousand Oaks: Sage Publications Ltd; 2007.

    Google Scholar 

  27. Mays N, Pope C. Rigour and qualitative research. BMJ. 1995;311(6997):109–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Mays N, Pope C. Qualitative research in health care. Assessing quality in qualitative research. BMJ. 2000;320(7226):50–2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Madriz E. Focus groups in feminist research. In: Denzin NK, Lincoln YS, editors. Handbook of qualitative research. Thousand Oaks: Sage Publications Inc; 2000. p. 835–50.

    Google Scholar 

  30. Kaplowitz MD. Statistical analysis of sensitive topics in group and individual interviews. Qual Quant. 2000;34(4):419–31.

    Article  Google Scholar 

  31. Joyner BL, et al. Where should my baby sleep? A qualitative study of African-American infant sleep location decisions. J Natl Med Assoc. 2010;102(10):881–9.

    Article  PubMed  Google Scholar 

  32. Moon RY, et al. Qualitative analysis of beliefs and perceptions about sudden infant death syndrome (SIDS) among African-American mothers: implications for safe sleep recommendations. J Pediatr. 2010;157(1):92–7 e2.

    Article  PubMed  Google Scholar 

  33. Oden R, et al. Factors influencing African-American mothers’ decisions about sleep position: a qualitative study. J Natl Med Assoc. 2010;102(10):870–80.

    Article  PubMed  Google Scholar 

  34. Krueger RA, Casey MA. Focus groups: a practical guide for applied research. 3rd ed. Thousand Oaks: Sage Publications, Inc.; 2000.

    Google Scholar 

  35. NVivo 10. QSR International Pty Ltd. Melbourne, Australia; 2013.

  36. Denzin NK, Lincoln YS. Strategies of qualitative inquiry. Thousand Oaks: Sage Publications Ltd; 2003.

    Google Scholar 

  37. Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches. 2nd ed. Thousand Oaks, CA: Sage Publications, Inc.; 2003.

    Google Scholar 

  38. Hauck FR, et al. Sleep environment and the risk of sudden infant death syndrome in an urban population: the Chicago Infant Mortality Study. Pediatrics. 2003;111(5 Part 2):1207–14.

    PubMed  Google Scholar 

  39. McGarvey C, et al. Factors relating to the infant’s last sleep environment in sudden infant death syndrome in the Republic of Ireland. Arch Dis Child. 2003;88(12):1058–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Carpenter RG, et al. Sudden unexplained infant death in 20 regions in Europe: case control study. Lancet. 2004;363:185–91.

    Article  CAS  PubMed  Google Scholar 

  41. Tappin D, et al. Used infant mattresses and sudden infant death syndrome in Scotland: case-control study. BMJ. 2002;325:1007–12.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Arnestad M, et al. Is the use of dummy or carry-cot of importance for sudden infant death? Eur J Pediatr. 1997;156:968–70.

    Article  CAS  PubMed  Google Scholar 

  43. Mitchell EA, et al. Dummies and the sudden infant death syndrome. Arch Dis Child. 1993;68:501–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Fleming PJ, et al. Pacifier use and sudden infant death syndrome: results from the CESDI/SUDI case control study. CESDI SUDI research team. Arch Dis Child. 1999;81:112–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Centers for Disease Control and Prevention. Assessment of infant sleeping position—selected states, 1996. MMWR. 1998;47(41):873–7.

    Google Scholar 

  46. Centers for Disease Control and Prevention. Progress in reducing risky infant sleeping positions—13 states, 1996–1997. MMWR. 1999;48(39):878–82.

    Google Scholar 

  47. Chung EK, et al. Infant sleep position: associated maternal and infant factors. Ambul Pediatr. 2003;3(5):234–9.

    Article  PubMed  Google Scholar 

  48. Hauck FR, et al. The contribution of prone sleeping position to the racial disparity in sudden infant death syndrome: the Chicago Infant Mortality Study. Pediatrics. 2002;110(4):772–80.

    Article  PubMed  Google Scholar 

  49. Saraiya M, et al. Trends and predictors of infant sleep positions in Georgia, 1990 to 1995. Pediatrics. 1998;102(3):e33.

    Article  CAS  PubMed  Google Scholar 

  50. Taylor JA, Davis RL. Risk factors for the infant prone sleep position. Arch Pediatr Adolesc Med. 1996;150:834–7.

    Article  CAS  PubMed  Google Scholar 

  51. Willinger M, et al. Factors associated with the transition to nonprone sleep positions of infants in the United States: the National Infant Sleep Position Study. JAMA. 1998;280:329–35.

    Article  CAS  PubMed  Google Scholar 

  52. Corwin MJ, et al. Secular changes in sleep position during infancy: 1995–1998. Pediatrics. 2003;111(1):52–60.

    Article  PubMed  Google Scholar 

  53. Lahr MB, et al. Maternal–infant bedsharing: risk factors for bedsharing in a population-based survey of new mothers and implications for SIDS risk reduction. Matern Child Health J. 2007;11(3):277–86.

    Article  PubMed  Google Scholar 

  54. Fu LY, et al. Infant sleep location: associated maternal and infant characteristics with sudden infant death syndrome prevention recommendations. J Pediatr. 2008;153(4):503–8.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Schwartz RH, Guthrie KL. Infant pacifiers: an overview. Clin Pediatr (Phila). 2008;47(4):327–31.

    Article  Google Scholar 

  56. Thumb sucking and pacifier use. J Am Dent Assoc. 2007;138:1176.

    Article  Google Scholar 

  57. Degan VV, Puppin-Rontani RM. Prevalence of pacifier-sucking habits and successful methods to eliminate them—a preliminary study. J Dent Child (Chic). 2004;71(2):148–51.

    Google Scholar 

  58. Duncan K, et al. Sucking habits in childhood and the effects on the primary dentition: findings of the Avon Longitudinal Study of Pregnancy and Childhood. Int J Paediatr Dent. 2008;18(3):178–88.

    Article  PubMed  Google Scholar 

  59. Poyak J. Effects of pacifiers on early oral development. Int J Orthod Milwaukee. 2006;17(4):13.

    PubMed  Google Scholar 

  60. American Academy of Pediatric Dentistry, Council on Clinical Affairs, Policy Statement on Oral Habits. 2000. http://www.aapd.org/media/Policies_Guidelines/P_OralHabits.pdf. Cited 14 Nov 2014.

  61. Adair SM, et al. Evaluation of the effects of orthodontic pacifiers on the primary dentitions of 24- to 59-month-old children: preliminary study. Pediatr Dent. 1992;14(1):13–8.

    CAS  PubMed  Google Scholar 

  62. Jenik AG, et al. Does the recommendation to use a pacifier influence the prevalence of breastfeeding? J Pediatr. 2009;155(3):350–4 e1.

    Article  PubMed  Google Scholar 

  63. Jaafar, S.H., et al., Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev. 2011;3:CD007202.

  64. Kramer MS, et al. Pacifier use, early weaning, and cry/fuss behavior. JAMA. 2001;286(3):322–6.

    Article  CAS  PubMed  Google Scholar 

  65. Gartner LM, et al. Breastfeeding and the use of human milk. Pediatrics. 2005;115(2):496–506.

    Article  PubMed  Google Scholar 

  66. Kattwinkel J, et al. Task force on sudden infant death syndrome, American Academy of Pediatrics. The changing concept of sudden infant death syndrome: diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics. 2005;116(5):1245–55.

    Article  Google Scholar 

  67. Eidelman AI, Schanler RJ. AAP section on breastfeeding, policy statement: breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827–41.

    Article  Google Scholar 

  68. Weiss P, Kerbl R. The relatively short duration that a child retains a pacifier in the mouth during sleep: implications for sudden infant death syndrome. Eur J Pediatr. 2001;160:60–70.

    Article  CAS  PubMed  Google Scholar 

  69. Zempsky WT, Cravero JP. Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics. 2004;114(5):1348–56.

    Article  PubMed  Google Scholar 

  70. Curtis SJ, et al. A randomized controlled trial of sucrose and/or pacifier as analgesia for infants receiving venipuncture in a pediatric emergency department. BMC Pediatr. 2007;7:27.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Allen JA, et al. Progress in increasing breastfeeding and reducing racial/ethnic differences—United States, 2000–2008 births. MMWR Morb Mortal Wkly Rep. 2013;62:77–80.

    Google Scholar 

  72. U.S. Census Bureau, 2006–2010 American Community Survey. 2012. http://factfinder2.census.gov 23 March 2012.

  73. Bettegowda V, et al. Beliefs and practices regarding sudden infant death syndrome (SIDS) risk reduction among African American mothers, fathers, and caregivers in New York City: summary of SIDS focus groups, 2004, Bureau of Maternal, Infant and Reproductive Health, New York City Department of Health and Mental Hygiene: New York, NY.

  74. Colson ER, et al. Barriers to following the back-to-sleep recommendations: insights from focus groups with inner-city caregivers. Ambul Pediatr. 2005;5(6):349–54.

    Article  PubMed  Google Scholar 

  75. Chianese J, et al. Inner-city caregivers’ perspectives on bed sharing with their infants. Acad Pediatr. 2009;9(1):26–32.

    Article  PubMed  Google Scholar 

  76. Mosley JM, et al. Infant sleep position: discerning knowledge from practice. Am J Health Behav. 2007;31(6):573–82.

    Article  PubMed  Google Scholar 

  77. Ball HL. Reasons to bed-share: why parents sleep with their infants. J Reprod Infant Psychol. 2002;20(4):207–21.

    Article  Google Scholar 

  78. Hooker E, et al. Sleeping like a baby: attitudes and experiences of bedsharing in northeast England. Med Anthropol. 2001;19(3):203–22.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank the following people for their assistance in facilitating study participant recruitment: Zacharia Cherian MD, Sandra Cuzzi MD, Benjamin Gitterman MD, Myra Grissom MD, Angela Hubbard MD, Jayashri Janakiram RD and the staff at the WIC clinic at Children’s National Medical Center, Lisa Rainey MD, Danita Tucker-Powell MD, Gwendolyn Youngblood MD, and Ellie Hamburger MD and the staff at Children’s Physicians and Associates- K Street. We would also like to thank Sybille Swanson and Marlene Lee RN for their assistance with focus groups. None of the above stated persons received any compensation for their contributions. This study was supported by NIH grants P20MD000198 and K24RR23681-01A1, and AHRQ grant 1RO3HS016892-01A1. The funding was used for design and conduct of the study; collection, management, analysis, and interpretation of the data; and manuscript preparation.

Conflicts of interest

All of the authors declare no potential conflicts of interest. Dr. Moon had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Author information

Authors and Affiliations

  1. Goldberg Center for Community Pediatric Health, Children’s National Medical Center, Washington, DC, USA

    Brandi L. Joyner, Rosalind P. Oden & Rachel Y. Moon

  2. Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA

    Rachel Y. Moon

  3. Division of General Pediatrics and Community Health, Children’s National Medical Center, 111 Michigan Avenue, NW, Washington, DC, 20010, USA

    Rachel Y. Moon

Authors
  1. Brandi L. Joyner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rosalind P. Oden
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rachel Y. Moon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rachel Y. Moon.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Joyner, B.L., Oden, R.P. & Moon, R.Y. Reasons for Pacifier Use and Non-Use in African-Americans: Does Knowledge of Reduced SIDS Risk Change Parents’ Minds?. J Immigrant Minority Health 18, 402–410 (2016). https://doi.org/10.1007/s10903-015-0206-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-015-0206-0

Keywords

Search

Navigation