Pacifier use and sudden infant death syndrome: Results from the CESDI/SUDI case control study

Abstract

Objectives - To investigate the relation between pacifier use and sudden infant death syndrome (SIDS). Design - Three year population based, case control study with parental interviews for each death and four age matched controls. Setting - Five regions in England (population > 17 million). Subjects - 325 infants who had died from SIDS and 1300 control infants. Results - Significantly 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)). Conclusions - Further epidemiological evidence and physiological studies are needed before pacifier use can be recommended as a measure to reduce the risk of SIDS.