Pacifier use and sleep position in 2 to 4 month old infants

Much interest has been raised in optimal infant care practices which can be preventive against sudden infant death syndrome (SIDS). In particular, avoiding prone sleep and the use of a pacifier were reported to be associated with a reduced risk for SIDS. It was suggested that potential beneficial effect resulted from the use of a pacifier might be ascribed at least in part to the prevention of an infant to be put prone to sleep and/or to turn down prone in sleep. To explore this hypothesis, the study aimed to analyse potential interaction between the habitual sleep position and the regular use of a pacifier in 2-4-month-old infants, age known for the peak incidence of SIDS. 192 randomly selected clinically healthy infants born in St. Petersburg in 1997-1998 entered the survey. The mothers were asked to complete the questionnaires addressing infant, maternal, and demographic major characteristics as well as sleep routine and other child care practices with particular emphasis on the use of a pacifier. Of 181 infants for whom the mothers were able to define typical position the baby was put to sleep and/or found, 174 (96.1%) were usually put to sleep non-prone: 103 on the back, and 71 on the side. In 51 of 181 cases (28.2%) the babies habitually changed their position in sleep. Of 174 babies usually put to sleep non-prone, 6 (3.5%) usually turned to front. Putting baby to sleep on the side compared with on the back bore the risk to turn to front equal to 3.01 (95% CI: 0.42-34.0). There was no difference in any infant, maternal, and demographic characteristic between the groups of the babies usually put to sleep prone and non-prone. Of 192 infants, 117 (60.9%) were usually left to sleep with a pacifier, and there was no significant association between the use of a pacifier and optional prone or non-prone position the baby was usually put to sleep. Likewise, the use of a pacifier did not significantly influence infant's position when found.

In clinically healthy 2-to-4-month-old babies, the use of a pacifier does not have major influence on the choice of sleep position and infant's propensity to spontaneously modify it during sleep.