Using a pacifier to decrease sudden infant death syndrome: an emergency department educational intervention

Abstract

Background. Pacifier use decreases the risk of sudden infant death syndrome (SIDS). An emergency department (ED) visit may provide an opportunistic ‘teachable moment’ for parents.Objectives. To test the hypotheses (1) that caregivers were less familiar with the role of pacifiers in sudden infant death (SIDS) prevention than other recommendations, and (2) that an ED educational intervention would increase pacifier use in infants younger than six months, and (3) that otitis media would not occur more frequently in pacifier users.Methods. We did an intervention-group-only longitudinal study in a county hospital ED. We measured pacifier use infants and baseline knowledge of SIDs prevention recommendations in caregivers. We followed up three months later to determine pacifier use, and 12 months later to determine episodes of otitis media.Results. We analyzed data for 780 infants. Parents knew of advice against co-sleeping in 469/780 (60%), smoking in 660/776 (85%), and prone sleeping in 613/780 (79%). Only 268/777 (35%) knew the recommendation to offer a pacifier at bedtime. At enrollment 449/780 (58%) did not use a pacifier. Of 210/338 infants aged less than 6 months followed up 41/112 (37%) non-users had started using a pacifier at bedtime (NNT 3). Over the same period, 37/98 (38%) users had discontinued their pacifier. Otitis media did not differ between users and non-users at 12 months.Conclusion. Caregiver knowledge of the role of pacifiers in SIDS prevention was less than for other recommendations. Our educational intervention appeared to increase pacifier use. Pacifier use was not associated with increased otitis media.

Protective benefit of predominant breastfeeding against otitis media may be limited to early childhood: results from a prospective birth cohort study

“…However, the skills, equipment and expertise for this are often not available when aiming to examine OM as part of a large‐scale, longitudinal, multidisciplinary population cohort, such as the present study. In such cases, parental‐report measures are often recommended and continue to be used to identify a broad presentation of OM that may include children with a wide range in severity of symptoms. The sensitivity of parental‐report OM has been estimated to be between 75 and 95%, with a specificity of 65–100%, with parents more likely to underestimate the number of episodes if the child had <6 episodes and overestimate episodes if the child had >6 episodes.…”

The Indoor Environment and Otitis Media among Australian Children: A National Cross-Sectional Study

“…We were not able to distinguish between acute OM, OM with effusion (OME) or recurrent AOM, and there are different spectra of risks for these conditions [29]. Despite this limitation, recent studies used parental reporting to measure the prevalence of OM [7,33]. The Raine study (Western Australian Pregnancy Cohort) [6] used parental reporting backed up by otoscopic examination by a specialist nurse.…”

Trends in the Incidence of Sudden Unexpected Infant Death in the Newborn: 1995-2014

“…7 A recent study found that pacifier use in the newborn nursery is a strong predictor of pacifier use later in infancy and that starting a pacifier before hospital discharge was associated with greater use and lower discontinuation in the following year. 29 In addition, a casecontrol study that explored the interaction of pacifier use and unsafe sleep conditions demonstrated a markedly attenuated SIDS risk in the presence of unsafe sleep conditions, including bed sharing, sleeping in the prone/side position, using pillows, and using soft bedding. 30 A recent British study also suggests that pacifier use is associated with a lower risk of SIDS in cosleepers.…”