Tuesday, September 7, 2010

Pacifiers for SIDS prevention?

Reducing the risk of sudden infant death syndrome (SIDS) is an outstanding example of how family physicians have partnered with professional and community organizations to successfully address an important public health problem. In 2005, AFP published an editorial that examined the progress of the then decade-long "Back to Sleep" campaign in reducing the annual U.S. incidence of SIDS from more than 5,000 to fewer than 2,500.

In recent years, however, SIDS prevention has been the subject of controversy. In 2005, the American Academy of Pediatrics released new guidelines that suggested offering infants a pacifier at nap times and bedtime, based on evidence from observational studies showing a protective effect of pacifier use against SIDS. However, many physicians expressed concern that this practice could discourage women from prolonged breastfeeding and have unintended health consequences for mothers and babies.

We revisit the controversy regarding pacifiers and SIDS prevention in the September 1st issue's Letters to the Editor, which features an exchange of views prompted by recent review articles on SIDS and risks and benefits of pacifiers. Given this information, do you think that pacifier use should be encouraged after breastfeeding is well established, as the AAP and AFP's authors recommend? Or do you feel that the evidence isn't strong enough to support this practice, and may in fact "give parents a false sense of security," as Dr. David and Katherine Abdun-Nur argue?

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