Abstract
Pacifier use at sleep time decreases sudden infant death syndrome (SIDS) risk. It is yet unclear whether pacifier use can modify the impact of other sleep-related factors upon SIDS risk. The objective of this study was to examine the association between pacifier use during sleep and SIDS in relation to other risk factors and to determine if pacifier use modifies the impact of these risk factors. Data source was a population based case–control study of 260 SIDS deaths and 260 matched living controls. Pacifier use during last sleep decreased SIDS risk (aOR 0.30, 95% CI 0.17–0.52). Furthermore, pacifier use decreased SIDS risk more when mothers were ≥20 years of age, married, nonsmokers, had adequate prenatal care, and if the infant was ever breastfed. Pacifier use also decreased the risk of SIDS more when the infant was sleeping in the prone/side position, bedsharing, and when soft bedding was present. The association between adverse environmental factors and SIDS risk was modified favorably by pacifier use, but the interactions between pacifier use and these factors were not significant. Pacifier use may provide an additional strategy to reduce the risk of SIDS for infants at high risk or in adverse sleep environments.
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Willinger, M., et al. (1991). Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatric Pathology, 11, 677–684.
Hoyert, D. L., et al. (2001). Deaths: final data for 1999. National Vital Statistics Report, 49(8), 1–113.
Haglund, B. (1993). Cigarette smoking and sudden infant death syndrome: some salient points in the debate. Acta Paediatrica. Supplement, 82(Suppl 389), 37–39.
MacDorman, M. F., et al. (1997). Sudden infant death syndrome and smoking in the United States and Sweden. American Journal of Epidemiology, 146(3), 249–257.
Mitchell EA, Milerad J. Smoking and sudden infant death syndrome. WFO/TFI Reports 1999:http://tobacco.who.int/en/health/background-papers-ets.html.
Schoendorf, K. C., & Kiely, J. L. (1992). Relationship of sudden infant death syndrome to maternal smoking during and after pregnancy. Pediatrics, 90(6), 905–908.
Ponsonby, A.-L., et al. (1993). Factors potentiating the risk of sudden infant death syndrome associated with the prone position. New England Journal of Medicine, 329, 377–382.
Mitchell, E. A., et al. (1998). Sheepskin bedding and the sudden infant death syndrome. New Zealand Cot Death Study Group. Journal of Pediatrics, 133, 701–704.
Brooke, H., et al. (1997). Case-control study of sudden infant death syndrome in Scotland, 1992–5. BMJ, 314(7093), 1516–1520.
Kemp, J. S., et al. (1993). Unintentional suffocation by rebreathing: a death scene and physiologic investigation of a possible cause of sudden infant death. Journal of Pediatrics, 122, 874–880.
Scheers, N. J., et al. (1998). Sudden infant death with external airways covered: case-comparison study of 206 deaths in the United States. Archives of Pediatrics and Adolescent Medicine, 152, 540–547.
Mitchell, E. A., et al. (1996). Soft cot mattresses and the sudden infant death syndrome. New Zealand Medical Journal, 109(1023), 206–207.
Hauck, F. R., et al. (2003). Sleep environment and the risk of sudden infant death syndrome in an urban population: the Chicago Infant Mortality Study. Pediatrics, 111(5 Part 2), 1207–1214.
Fleming, P. J., et al. (1996). Environment of infants during sleep and risk of the sudden infant death syndrome: results of 1993–5 case-control study for confidential inquiry into stillbirths and deaths in infancy. Confidential Enquiry into Stillbirths and Deaths Regional Coordinators and Researchers. BMJ, 313(7051), 191–195.
L’Hoir, M. P., et al. (1998). Risk and preventive factors for cot death in The Netherlands, a low-incidence country. European Journal of Pediatrics, 157, 681–688.
Beal, S. M., & Byard, R. W. (1995). Accidental death or sudden infant death syndrome? Journal of Paediatrics and Child Health, 31(4), 269–271.
Baddock, S. A., et al. (2006). Differences in infant and parent behaviors during routine bed sharing compared with cot sleeping in the home setting. Pediatrics, 117(5), 1599–1607.
Kattwinkel, J., et al. (2000). Changing concepts of sudden infant death syndrome: implications for infant sleeping environment and sleep position. American Academy of Pediatrics. Task Force on Infant Sleep Position and Sudden Infant Death Syndrome. Pediatrics, 105(3 Pt 1), 650–656.
Blair, P. S., et al. (1999). Babies sleeping with parents: case-control study of factors influencing the risk of the sudden infant death syndrome. CESDI SUDI research group. BMJ, 319(7223), 1457–1462.
Carpenter, R. G., et al. (2004). Sudden unexplained infant death in 20 regions in Europe: case control study. Lancet, 363, 185–191.
McGarvey, C., et al. (2006). An 8 year study of risk factors for SIDS: Bed-sharing vs. non bed-sharing. Archives of Disease in Childhood, 91(4), 318–323.
McGarvey, C., et al. (2003). Factors relating to the infant’s last sleep environment in sudden infant death syndrome in the Republic of Ireland. Archives of Disease in Childhood, 88(12), 1058–1064.
Tappin, D., et al. (2005). Bedsharing and sudden infant death syndrome in Scotland: a case control study. Journal of Pediatrics, 147(9413), 32–37.
Ruys, J. H., et al. (2007). Bed-sharing in the first four months of life: a risk factor for sudden infant death. Acta Paediatrica, 96(10), 1399–1403.
Fleming, P. J., et al. (1999). Pacifier use and sudden infant death syndrome: results from the CESDI/SUDI case control study. CESDI SUDI Research Team. Archives of Disease in Childhood, 81, 112–116.
Hauck, F. R., et al. (2005). Do pacifiers reduce the risk of sudden infant death syndrome? A meta-analysis. Pediatrics, 116(5), e716–e723.
Li, D. K., et al. (2006). Use of a dummy (pacifier) during sleep and risk of sudden infant death syndrome (SIDS): population based case-control study. BMJ, 332(7532), 18–22.
Vennemann, M. M., et al. (2005). Modifiable risk factors for SIDS in Germany: results of GeSID. Acta Paediatrica, 94(6), 655–660.
Kattwinkel, J., et al. (2005). 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, 116(5), 1245–1255.
Hoffman, H. J., et al. (1988). Risk factors for SIDS. Results of the National Institute of Child Health and Human Development SIDS Cooperative Epidemiological Study. Annals of the New York Academy of Sciences, 533, 13–30.
Porter, K. S., & Thomas, S. D. (2002). Birth outcomes and infant mortality in Chicago, 1990–1999. Chicago, IL: Chicago Department of Public Health Epidemiology Program.
Centers for Disease Control and Prevention NCHS. Infant mortality rates, fetal mortality rates, and perinatal mortality rates, according to race: United States, selected years 1950–1999. (Accessed September 7, 2010, at www.cdc.gov/nchs/data/hus/tables/2001/01hus023.pdf).
Hauck, F. R., et al. (2002). The contribution of prone sleeping position to the racial disparity in sudden infant death syndrome: The Chicago Infant Mortality Study. Pediatrics, 110(4), 772–780.
Annie E. Casey Foundation. (2008). 2008 KIDS COUNT data book: State profiles of child well-being. Baltimore, MD: Annie E. Casey Foundation.
Mathews, T. J., & MacDorman, M. F. (2008). Infant mortality statistics from the 2005 period linked birth/infant death data set. National Vital Statistics Report, 57(2), 1–32.
National Infant Sleep Position survey database. (Accessed September 7, 2010, at http://dccwww.bumc.bu.edu/ChimeNisp/NISP_Data.asp).
Hauck, F. R., et al. (2008). Infant sleeping arrangements and practices during the first year of life. Pediatrics, 122(Suppl 2), S113–S120.
Willinger, M., et al. (2003). Trends in infant bed sharing in the United States, 1993–2000: The National Infant Sleep Position study. Archives of Pediatrics and Adolescent Medicine, 157(1), 43–49.
Ponsonby, A.-L., et al. (2002). Population trends in sudden infant death syndrome. Seminars in Perinatology, 26(4), 296–305.
Acknowledgments
We thank Kristen Wells, PhD for statistical assistance. This study was supported by HRSA grant 1R40MC08963-01 and by funding from First Candle.
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Moon, R.Y., Tanabe, K.O., Yang, D.C. et al. Pacifier Use and Sids: Evidence for a Consistently Reduced Risk. Matern Child Health J 16, 609–614 (2012). https://doi.org/10.1007/s10995-011-0793-x
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DOI: https://doi.org/10.1007/s10995-011-0793-x