"A baby who sleeps on his stomach without a pacifier has a 2.5 times greater risk of SIDS," explains De-Kun Li, a reproductive epidemiologist with Kaiser Permanente in Oakland, Calif., who led the research. "If you use a pacifier, that baby's risk disappears." The work draws on interviews with 185 mothers of SIDS babies and 312 mothers of control infants collected between 1997 and 2000.
Of course, this doesn't mean that babies should be allowed to sleep on their stomachs, he cautions. Campaigns to promote sleeping on the back have cut the incidence of SIDS significantly. But pacifier use showed benefits no matter the baby's age, how it slept and even if its mother smoked during or after pregnancy, according to the research, published online by the British Medical Journal.
The study adds to a growing body of evidence that pacifier use cuts SIDS risk, though the causes of the disorder and how pacifiers help protect against it remain poorly understood. Although some experts have suggested that the simple act of sucking on a pacifier may be helping to correct minor developmental deficiencies in the babies, Li believes it is much simpler. "The bulky handle sticks out," he notes. "If you have the bulky handle, even if the baby wants to bury [its] face in soft bedding, [it] can't." Plus, babies who sucked their thumb still benefited from pacifier use whereas, if sucking alone was responsible for the preventive mechanism, the thumb should have been enough.
Myths persist that the use of pacifiers (or thumb sucking) will affect tooth development or the infant's ability to take to breast-feeding, but by simply waiting a few weeks to start using a pacifier and stopping when the baby becomes a toddler such impacts can be avoided, Li notes. As a result, he and his colleagues unequivocally recommend pacifier use, particularly for babies whose habits or families put them at high risk. "A pacifier is a simple, easy to use and already widely used tool that can reduce SIDS," he concludes.