Using a pacifier may prevent SIDS

Doctors issue update on recommendations

There is a new and surprising tool for parents in the fight against sudden infant death syndrome (SIDS): a pacifier.

The American Academy of Pediatrics recently revised its recommendations for preventing SIDS to say that children should get a pacifier every time they go to bed—at night or at nap time—until the age of 1.

There are some caveats: Use the pacifier when putting an infant to bed, but do not reinsert it once the baby falls asleep. And if a baby is breastfed, wait four weeks before turning to a pacifier.

But the recommendation is controversial.

Dr. Ruth Lawrence, a pediatrics professor at the University of Rochester School of Medicine and vice chair of the United States Breastfeeding Committee, says she is concerned about giving an infant a pacifier at any time. "I would not force a breastfed baby to take a pacifier. They get plenty of sucking experience if they are allowed to breastfeed throughout the night," Lawrence says. "The important thing to remember is that breastfeeding in and of itself has some protective advantages against SIDS, and so it’s important to maintain breastfeeding."

According to Dr. Fern Hauck, an associate professor at the University of Virginia Health System and co-author of the pacifier study, researchers have found that some babies introduced to pacifiers too early were less likely to be long-term breastfeeders.

It’s not clear why pacifiers protect against SIDS, the sudden, unexplained death of a baby. And while the numbers have decreased dramatically in the past five years, nearly 2,300 babies died of SIDS in the United States in 2002.

Dr. Debra Weese-Mayer, a pediatrician in respiratory medicine at Rush University Medical Center, says the theory behind the pacifier use is comparable to falling asleep with a cough drop in your mouth. "If you’re drowsy and you’re doing something that requires a repetitive behavior, then you don’t really get into a deep sleep because you don’t want to choke on it," she says.

Hauck says researchers wanted to be cautious about potential downsides of pacifiers. "There is a slight increased risk of ear infections. But the risk is relatively low during the first year."

And although some parents worry that pacifiers could lead to misalignment of their children’s teeth, Paul Reggiardo, former president of the American Academy of Pediatric Dentistry, says there is no concern with children under 3.

Jennifer Hoeveler, an Evanston mother of two, including 10-week-old Macy, says even the unlikely side effects are worth the risk. "[SIDS] is a huge thing," she says. "Little things like bumps on the head or being addicted to a pacifier are not that big a deal; this is a life or death issue."

Pacifier use is one of just several ways to reduce the risk of SIDS, according to the American Academy of Pediatrics. Others include:

•  Babies should always be put to sleep on their backs—not on their sides, as previously suggested.

•  Do not put a baby to sleep in the parents’ bed. Rather, put him to sleep in a crib in the parents’ room, always on a firm mattress.

•  Avoid bumpers, stuffed animals or soft objects and loose blankets in the crib.

•  Do not rely on home monitors; there is no evidence they help prevent SIDS.

• Do not smoke during pregnancy.

Christina Wall, Medill News Service


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