Lifewire: Pacifiers may keep SIDS at bay
Mar 23,2007 00:00 by Amy Winter

Pacifiers not only keep babies quiet or help them sleep, they might also save their lives.

According to an article in Nursing for Women's Health, a clinical practice journal, pacifiers could lower the risk of babies developing SIDS, or sudden infant death syndrome.

An American Academy of Pediatrics task force looking into the incident rate of SIDS agrees. It reinforces the idea that children younger than 1 year should use a pacifier to lower the risk of SIDS. "It's important to note that the AAP's pacifier recommendations are not unique," said author Dr. Elizabeth Damato. "A variety of studies have indicated that pacifier use lowers the risk of SIDS, and several other countries have made similar recommendations."

SIDS is the sudden and unknown death of a healthy infant younger than the age of 1, according to the KidsHealth Web site. The syndrome can strike with no warning. SIDS is determined as the cause of death once other probable death causes are ruled out.

The syndrome is the third leading cause of death for U.S. infants, killing more than 2,500 per year, according to KidsHealth. It occurs most often between the ages of 2 and 4 months and seems to strike boys more frequently than girls, with a ratio of 60 to 40 percent, according to An increased death rate is also noted during the colder months of fall and winter.

Here are some possible risk factors parents should avoid, according to KidsHealth:

- Don't smoke, drink or use illegal drugs when pregnant.

- Try to prevent a low birth weight.

- Prevent poor prenatal care.

- Avoid letting the baby sleep on their stomach.

- Don't let the baby overheat from its bedding or pajamas.

The most commonly reported risk factor for SIDS is stomach sleeping. Studies have found that infants who sleep on their stomachs die more often from SIDS than babies sleeping on their backs. Researchers believe that sleeping on the stomach places more pressure on the baby's jaw causing a narrowing of the airway, according to KidsHealth.

Another possible explanation is the risk of "rebreathing." If an infant is stomach sleeping on a soft mattress or with a pillow near its face, the soft area may form an enclosed space around the baby's mouth where exhaled air can become trapped. When the baby breathes the exhaled air, the carbon dioxide level increases while oxygen decreases.

Because there are no definite causes for SIDS, parents need to know how to prevent it, according to KidsHealth:

- Get regular prenatal care.

- Let your infant sleep on a firm mattress, not a soft surface like a pillow, waterbed or sheepskin.

- Place your baby on its back to sleep.

- Don't place your infant near stuffed toys, pillows or feathery blankets.

- Put the crib in your room.

- Give your baby a pacifier to sleep with during the first year.

Putting babies on their back in cribs, which was recommended by the American Academy of Pediatrics in 1992, has reduced the rate of SIDS by 40 percent, according to KidsHealth.

Although the numbers have decreased, SIDS still remains a common threat to infants. Therefore, pacifiers are recommended in an effort to eliminate more cases.

"Pacifiers should not be used before the age of 1 month in breastfed infants to avoid the disruption of regular eating habits," said Damato. "Also, infants should not be forced to take a pacifier and parents should not reinsert it once the infant falls asleep."

Avoid homemade pacifiers as well as those with strings or cords. And keep the pacifiers clean. They should be replaced regularly, according to Damato.

Although it looks as if pacifiers reduce the risk of SIDS, no one is sure why.

"Because SIDS happens so rarely, it is difficult to do large-scale controlled studies to determine why pacifiers might help," said Damato. "However, because the risk for serious side effects is greatly reduced if pacifiers are used properly, they are a safe and sensible option in the battle against SIDS."