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Infant pacifiers for reduction in risk of sudden infant death syndrome
Kim Psaila1, Jann P Foster2,3,4, Neil Pulbrook5
1School of Nursing and Midwifery, Western Sydney University, Penrith, DC, Australia.
Insights
No randomized controlled trials were found to confirm if pacifier use reduces the risk of sudden infant death syndrome (SIDS). More research is needed to support pacifier use for SIDS prevention.
Area of Science:
- Neonatal Health
- Pediatric Mortality Prevention
Background:
- Sudden infant death syndrome (SIDS) is the leading cause of infant mortality, defined as unexplained infant death during sleep.
- The 'triple risk model' suggests SIDS results from infant vulnerability, developmental stage, and external stressors.
- Epidemiological studies indicate pacifier use may reduce SIDS incidence, prompting investigation into its effectiveness.
Purpose of the Study:
- To determine if pacifier use during sleep reduces the risk of sudden infant death syndrome (SIDS).
Main Methods:
- A systematic search was conducted for randomized controlled trials (RCTs) and quasi-RCTs using major databases (CENTRAL, PubMed, Embase, CINAHL) up to March 2016.
- Eligibility criteria included trials with random or quasi-random allocation of infants up to one month postmenstrual age.
- Studies reported as abstracts, cluster, and cross-over RCTs were considered.
Main Results:
- No eligible randomized controlled trials were identified in the systematic search.
- There is a lack of high-quality evidence from RCTs specifically examining pacifier use for SIDS risk reduction.
Conclusions:
- Currently, there is no randomized controlled trial evidence to support or refute the use of pacifiers for the prevention of sudden infant death syndrome (SIDS).
- Further high-quality randomized controlled trials are necessary to establish the efficacy of pacifier use in SIDS prevention.
Background:
Sudden infant death syndrome (SIDS) has been most recently defined as the sudden unexpected death of an infant less than one year of age, with onset of the fatal episode apparently occurring during sleep, that remains unexplained after a thorough investigation, including the performance of a complete autopsy and a review of the circumstances of death and clinical history. Despite the success of several prevention campaigns, SIDS remains a leading cause of infant mortality. In 1994, a 'triple risk model' for SIDS was proposed that described SIDS as an event that results from the intersection of three factors: a vulnerable infant; a critical development period in homeostatic control (age related); and an exogenous stressor. The association between pacifier (dummy) use and reduced incidence of SIDS has been shown in epidemiological studies since the early 1990s. Pacifier use, given its low cost, might be a cost-effective intervention for SIDS prevention if it is confirmed effective in randomised controlled trials.
Objectives:
To determine whether the use of pacifiers during sleep versus no pacifier during sleep reduces the risk of SIDS.
Search Methods:
We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 2), MEDLINE via PubMed, Embase, and CINAHL to 16 March 2016. We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials.
Selection Criteria:
Published and unpublished controlled trials using random and quasi-random allocations of infants born at term and at preterm (less than 37 weeks' gestation) or with low birth weight (< 2500 g). Infants must have been randomised by one month' postmenstrual age. We planned to include studies reported only by abstracts, and cluster and cross-over randomised trials.
Data Collection And Analysis:
Two review authors independently reviewed studies from searches. We found no eligible studies.
Main Results:
We identified no randomised controlled trials examining infant pacifiers for reduction in risk of SIDS.
Authors' Conclusions:
We found no randomised control trial evidence on which to support or refute the use of pacifiers for the prevention of SIDS.