Giving a pacifier to an infant-particularly when placed for sleep-significantly reduces the risk of sudden infant death syndrome (SIDS), according to a recent report. Investigators performed a meta-analysis of seven published case-control studies that examined the risk of, and protective factors for, SIDS. After controlling for a large number of variables (including maternal and infant age, parity, birth weight, socioeconomic status, smoking, and sleep position), an inverse association remained between pacifier use and SIDS. Investigators calculated that, for every 2,733 infants who use a pacifier when placed for sleep, one SIDS death could be prevented.
The recommendation, therefore, is to offer a pacifier to an infant whenever he or she is placed for sleep-including during a daytime nap. Because a pacifier may have a detrimental effect on breastfeeding and may raise the risk of otitis media, other infections, and dental malocclusion, however, the authors recommend one up to 1 year of age only-a period that covers the peak age of incidence of SIDS and the early months when an infant's need for sucking is highest. A pacifier should be introduced only after breastfeeding has been well established, the authors advise (Hauck FR et al: Pediatrics 2005;116:e716).
Commentary These findings are reflected in the most recent policy statement from the American Academy of Pediatrics's Task Force on Sudden Infant Death Syndrome (Pediatrics 2005;116:1245). I'm reminded of when my children were infants: Every glove compartment, pocket, and diaper bag contained a "binkie"!