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The effects of dummy/pacifier use on infant blood pressure and autonomic activity during sleep
Stephanie R Yiallourou1, Hannah Poole1, Pallavi Prathivadi1
1The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Victoria, Australia.
Insights
Dummy/pacifier use in infants may protect against sudden infant death syndrome (SIDS) by increasing blood pressure and heart rate variability, indicating enhanced sympathetic tone. However, this effect was not observed during the peak SIDS risk period at 2-3 months.
Area of Science:
- Neonatal physiology
- Cardiovascular regulation
- Sudden Infant Death Syndrome (SIDS) research
Background:
- Dummy/pacifier use is linked to reduced SIDS risk, but underlying mechanisms remain unclear.
- Impaired cardiovascular control is a potential factor in SIDS.
- This study investigates the impact of dummy/pacifier use on infant cardiovascular control during sleep.
Purpose of the Study:
- To assess the effects of dummy/pacifier use on cardiovascular control in infants.
- To explore potential protective mechanisms against SIDS related to cardiovascular function.
Main Methods:
- Polysomnography was used to study term infants (users vs. non-users) at 2-4 weeks, 2-3 months, and 5-6 months.
- Measurements included heart rate, blood pressure, heart rate variability, blood pressure variability, and baroreflex sensitivity during sleep.
- Data were collected in supine and prone positions during quiet and active sleep.
Main Results:
- Dummy/pacifier users exhibited higher blood pressure in the prone position at 2-4 weeks and 5-6 months compared to non-users.
- Heart rate variability and baroreflex sensitivity were elevated in dummy/pacifier users at 2-4 weeks.
- Active sucking was associated with increased heart rate variability and blood pressure variability, suggesting heightened sympathetic activity.
Conclusions:
- Elevated blood pressure and heart rate variability in dummy/pacifier users suggest increased sympathetic tone, potentially a protective mechanism against SIDS-related hypotension.
- These observed cardiovascular effects were not evident at 2-3 months, a period of highest SIDS risk.
Background:
Dummy/pacifier use is protective for sudden infant death syndrome (SIDS); however, the mechanism/s for this are unknown. As impaired cardiovascular control may be the underlying cause of SIDS, we assessed the effects of dummy/pacifier use on cardiovascular control during sleep within the first 6 months of life.
Methods:
Term infants, divided into dummy/pacifier users and non-dummy/pacifier users, were studied at 2-4 weeks (n = 27), 2-3 months (n = 35) and 5-6 months (n = 31) using daytime polysomnography. Heart rate, blood pressure (BP), heart rate variability (HRV), blood pressure variability (BPV), and baroreflex sensitivity (BRS) were measured in triplicate 1-2-min epochs during quiet and active sleep in the supine and prone positions.
Results:
Overall, during the non-sucking periods, in the prone position, the BP was higher (10-22 mmHg) in dummy/pacifier users compared to non-users at 2-4 weeks and 5-6 months (p < 0.05 for both). HRV and BRS were higher in dummy/pacifier users compared to non-users at 2-4 weeks (p < 0.05). Active sucking increased HRV and BPV, consistent with increased sympathetic activity in dummy/pacifier users.
Conclusions:
Higher BP and HRV in dummy/pacifier users indicate increased sympathetic tone, which may serve as a protective mechanism against possible hypotension leading to SIDS; however, these effects were not apparent at 2-3 months, when the risk of SIDS is highest.
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