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Dummy/pacifier use in preterm infants increases blood pressure and improves heart rate control
Rosemary S C Horne1,2, Karinna L Fyfe1,2, Alexsandria Odoi1
1The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia.
Insights
Pacifier use in preterm infants may increase blood pressure and alter heart rate control during sleep. This study investigated the impact of pacifier use on physiological parameters in preterm infants during the highest risk period for SIDS.
Area of Science:
- Neonatal physiology
- Cardiovascular regulation
- Infant sleep studies
Background:
- Preterm infants face a higher risk of Sudden Infant Death Syndrome (SIDS).
- Pacifier use is hypothesized to offer protection against SIDS.
- The study examines the physiological effects of pacifier use in preterm infants.
Purpose of the Study:
- To assess the impact of pacifier use on blood pressure in preterm infants.
- To evaluate the effects of pacifier use on cerebral oxygenation.
- To determine the influence of pacifier use on heart rate control during the first six months of corrected age.
Main Methods:
- Longitudinal study of 35 preterm infants up to 6 months corrected age.
- Assessment of cardiac control using heart rate variability (HRV) spectral indices (LF and HF).
- Calculation of the sympathovagal balance ratio (HF/LF).
Main Results:
- Pacifier users exhibited significantly higher mean arterial pressure during quiet and active sleep at 2-3 months corrected age.
- Infants using pacifiers showed elevated low-frequency (LF) HRV and LF/HF ratio.
- Pacifier use was associated with reduced high-frequency (HF) HRV.
Conclusions:
- Pacifier use is linked to increased blood pressure during sleep in preterm infants at high SIDS risk.
- Pacifier use appears to alter cardiac control, indicated by elevated LF HRV and reduced HF HRV.
- Findings suggest a potential physiological impact of pacifier use on preterm infant cardiovascular regulation.
Background:
Preterm infants are at increased risk of sudden infant death syndrome (SIDS). Use of a dummy/pacifier is thought to be protective against SIDS; accordingly, we assessed the effects of dummy/pacifier use on blood pressure, cerebral oxygenation, and heart rate control over the first 6 mo of life after term corrected age (CA) when SIDS risk is greatest.
Methods:
Thirty-five preterm infants were studied longitudinally at 2-4 wk, 2-3 mo, and 5-6 mo CA. Cardiac control was assessed from spectral indices of heart rate variability (HRV) in the low frequency (LF) and the high frequency (HF) range, and the ratio of HF/LF indicating sympathovagal balance was calculated.
Results:
Overall, at 2-3 mo, mean arterial pressure was significantly higher in the supine position in dummy/pacifier users in both quiet sleep (70 ± 2 vs. 60 ± 2 mm Hg; P < 0.05) and active sleep (74 ± 3 vs. 69 ± 2 mm Hg; P < 0.05). Dummy/pacifier users had higher LF HRV and LF/HF ratio and lower HF HRV.
Conclusion:
Dummy/pacifier use increased blood pressure during sleep, at the age of greatest SIDS risk. Overall, LF HRV was elevated and HF HRV reduced in dummy/pacifier users, suggesting that dummy use alters cardiac control in preterm infants.
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Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.