Canadian Federation for the Study of Infant Deaths

For Immediate Release:
October 18, 2005

CFSID has considered very carefully the recent publication of Hauck et al., the statement of the Canadian Paediatric Society on pacifiers (2003) and the new recommendations of the American Academy of Pediatrics (also published in October 2005). A few studies have been published in the past 10 years identifying pacifier use as a protective factor against SIDS. In a recent publication in Pediatrics, Dr Fern Hauck has summarized these studies. Her goal was to quantify and evaluate the protective effect of pacifiers against SIDS. She concluded that "pacifiers should be offered to infants as a potential method to reduce the risk of SIDS."

It is important to highlight some particularities of the studies exploring the role of pacifier use. In these studies, scientists looked at the routine use of pacifiers and the use on the night before death. The evidence for prevention of SIDS with routine use of pacifier is not that strong and a very well done study (CESDI study from the UK) did not show routine pacifier use as a protective factor against SIDS.

As for pacifier use for the last sleep, there was indeed a protective effect against SIDS. The group not using a pacifier the last night was comprised of infants not routinely using one and of infants using a pacifier routinely but not having it the last night. And, three studies showed that not using a pacifier the night of the death, for infants used to have a pacifier, was a significant risk factor for SIDS. For these infants, therefore, it did seem that rather than conferring a protective effect, it is in fact the absence of pacifier that night which represented a risk.

This whole issue of pacifiers and SIDS was discussed at length in a meeting of medical experts from all over the world, which took place in July 2004 in Edmonton at the 8th SIDS International Conference. The consensus reached was that health professionals should not in general discourage pacifier use. But, if parents wanted to use a pacifier, they should do so all the time, for naps and at night, everyday, because of the increase risk of SIDS for infants not having a pacifier if they are used to having one. It was also felt that parents who did not want to use a pacifier should be free to do so.

CFSID agrees with the Canadian Paediatric Society and the consensus reached at the last SIDS International meeting concerning pacifier use.

CFSID's position on this issue is that more research is needed before a definitive statement can be made about using pacifiers with every infant to decrease the risk of SIDS.

a.. Health care professionals should not discourage routine use of pacifier for infants, and parents who want to offer a pacifier to their infant should feel free to do so.
b.. For breast fed infants, the use of pacifier should start after the first month of life (so as not to interfere with the initiation of breast feeding).
c.. Parents should not coat the pacifier in any sweet solution.
d.. Parents can take the pacifier away when the baby is about one year old.

Notes to Editors:

CFSID is Canada's only charity dedicated to solving the mystery of sudden infant deaths and the promotion of infant health. CFSID recently expanded its mandate to not only provide assistance to families that have experienced an infant's death due to Sudden Infant Death (SIDS) but to all families who experience an unexpected or unexplained death including perinatal deaths which include miscarriage and stillbirth.

To reduce the risk of SIDS parents should follow the following steps:

a.. Eliminate smoking in pregnancy. Do not let anyone smoke in the same room as your baby

b.. Always place your baby on the back to sleep even for naps

c.. Avoid overheating. Keep baby's head uncovered while sleeping

d.. The safest place for your baby to sleep is in a crib in the parent's room for at least the first six months

e.. Never sleep with a baby on a sofa, waterbed or armchair

f.. Inform and educate everyone helping to care for your baby about these steps

For more information please contact
Rick Kaufman
CFSID Executive Director
416-488-3260 - 1-800-363-7437

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