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a FSID Unit,
Department of Child Health, Developmental Physiology, Royal Hospital
for Children, St Michael's Hill, Bristol BS2 8BJ, UK, b Newcastle Neonatal Service,
Ward 35, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK, c Nuffield Institute for
Health, 71-75 Clarendon Road, Leeds LS2 9PL, UK
Correspondence to: Professor Fleming. email: peter.fleming{at}bris.ac.uk
Accepted 29 March 1999
OBJECTIVES
To
investigate the relation between pacifier use and sudden infant death
syndrome (SIDS).
DESIGNThree year
population based, case control study with parental interviews for each
death and four age matched controls.
SETTINGFive regions
in England (population > 17 million).
SUBJECTS325 infants
who had died from SIDS and 1300 control infants.
RESULTSSignificantly
fewer SIDS infants (40%) than controls (51%) used a pacifier for the
last/reference sleep (univariate odds ratio (OR), 0.62; 95% confidence
interval (CI), 0.46 to 0.83) and the difference increased when
controlled for other factors (multivariate OR, 0.41; 95% CI, 0.22 to
0.77). However, the proportion of infants who had ever used a pacifier
for day (66% SIDS v 66% controls) or night
sleeps (61% SIDS v 61% controls) was
identical. The association of a risk for SIDS infants who routinely
used a pacifier but did not do so for the last sleep became
non-significant when controlled for socioeconomic status (bivariate OR,
1.39 (0.93 to 2.07)).
CONCLUSIONSFurther
epidemiological evidence and physiological studies are needed before
pacifier use can be recommended as a measure to reduce the risk of SIDS.
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