Docs Debate Pacifier Use

New research indicates that one SIDS death could be prevented for every 2,733 babies who use pacifiers.

While pacifiers can soothe fussy babies, the plastic gadgets also have been linked with lower rates of breastfeeding and higher risk for ear infection. But now the American Academy of Pediatrics (AAP) has weighed in, recommending pacifiers to help reduce the risk of sudden infant death syndrome (SIDS) in the first year of life.

New research indicates that one SIDS death could be prevented for every 2,733 babies who use pacifiers. Experts aren't sure why, but the lessened risk may be linked with changes in tongue positions or breathing patterns or with how easily pacifier-using infants awaken. Another study found that when infants already have risk factors, such as being put to sleep tummy-down or sleeping with a mother who smokes, pacifier use lowers SIDS rates dramatically.

The pediatricians' group recommends offering pacifiers at naps and nighttime from the age of 1 month to 1 year. Other experts worry that the recommendation will interfere with breastfeeding, even if pacifiers are withheld until after infants learn to latch onto the breast. Every major group in the United States that promotes breastfeeding, including some AAP breastfeeding experts, has rejected the recommendation on pacifiers, says James J. McKenna, Ph.D., director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame in Indiana. "It definitely has not been shown that pacifier use makes any difference in the survival of babies who are breastfed exclusively, or that the potential negative effect of pacifiers on these babies makes pacifier use worth it."