Klin Padiatr 2000; 212(5): 273-276
DOI: 10.1055/s-2000-9687
ORIGINALARBEIT

Georg Thieme Verlag Stuttgart ·New York

Pacifier use and sleep position in 2 to 4 month old infants

Säuglingssauger-Gebrauch und Schlafposition bei 2 - 4 Monate alten Säuglingen:I.  A.  Kelmanson
  • Department of Paediatrics No. 3, St. Petersburg State Paediatric Medical Academy
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Abstract:

Much interest has been raised in optimal infant care practices which can be preventive against sudden infant death syndrome (SIDS). In particular, avoiding prone sleep and the use of a pacifier were reported to be associated with a reduced risk for SIDS. It was suggested that potential beneficial effect resulted from the use of a pacifier might be ascribed at least in part to the prevention of an infant to be put prone to sleep and/or to turn down prone in sleep. To explore this hypothesis, the study aimed to analyse potential interaction between the habitual sleep position and the regular use of a pacifier in 2 - 4-month-old infants, age known for the peak incidence of SIDS. 192 randomly selected clinically healthy infants born in St. Petersburg in 1997 - 1998 entered the survey. The mothers were asked to complete the questionnaires addressing infant, maternal, and demographic major characteristics as well as sleep routine and other child care practices with particular emphasis on the use of a pacifier. Of 181 infants for whom the mothers were able to define typical position the baby was put to sleep and/or found, 174 (96.1 %) were usually put to sleep non-prone: 103 on the back, and 71 on the side. In 51 of 181 cases (28.2 %) the babies habitually changed their position in sleep. Of 174 babies usually put to sleep non-prone, 6 (3.5 %) usually turned to front. Putting baby to sleep on the side compared with on the back bore the risk to turn to front equal to 3.01 (95 % CI: 0.42 - 34.0). There was no difference in any infant, maternal, and demographic characteristic between the groups of the babies usually put to sleep prone and non-prone. Of 192 infants, 117 (60.9 %) were usually left to sleep with a pacifier, and there was no significant association between the use of a pacifier and optional prone or non-prone position the baby was usually put to sleep. Likewise, the use of a pacifier did not significantly influence infant's position when found.Conclusion: In clinically healthy 2-to-4-month-old babies, the use of a pacifier does not have major influence on the choice of sleep position and infant's propensity to spontaneously modify it during sleep.Abbreviations: CI=confidence interval, OR=odds ratio, SIDS=sudden infant death syndrome

Zum Fragenkomplex um die päventive Wirkung der Schlafposition für den plötzlichen Kindstod (SIDS) gehört auch der mögliche Einfluss von Säuglingssaugern auf die Schlafposition. Es wurde angenommen, dass die Benutzung von Saugern die Einnahme der Bauchlage zum Einschlafen oder während des Schlafes verhindern könne. Das Ziel der Studie war es deshalb, bei 2 - 4 Monate alten Säuglingen den möglichen Einfluss zwischen Saugerbenutzung und Schlafposition zu überprüfen. 192 klinisch gesunde Säuglinge, die zwischen 1997 und 1998 in St. Petersburg geboren worden waren, konnten in die randomisierte Studie aufgenommen werden. Die Mütter wurden standardisiert über Schlafverhalten, Pflegetechniken und den Gebrauch von Säuglingssaugern befragt. Von 181 verwertbaren Befragungen gaben 174 (96,1 %) der Mütter an, ihre Säuglinge nicht in Bauchlage, 103 in Rücken- und 71 in Seitenlage zum Schlaf zu positionieren. 28,2 % der beobachteten Säuglinge veränderten ihre Schlafposition während der Schlafphase. 6 (3,5 %) von 174 Säuglingen, die primär in Rückenlage verbracht worden waren, änderten ihre Position in die Bauchlage. Ähnlich hoch war der Prozentsatz für Säuglinge, die primär in Seitenlage verbracht worden waren. 117 (60,9 %) der Säuglinge benutzten zum Einschlafen einen Sauger, ohne dass ein Zusammenhang mit der Einschlafposition bestanden hätte. Ebenso bestand kein signifikanter Einfluss der Saugerbenutzung auf die Schlafwiederfindungssituation. Schlussfolgerungen: Bei gesunden 2 - 4 Monate alten Säuglingen hat die Benutzung eines Saugers sowohl keinen Einfluss auf die Schlafposition als auch auf die spontanen Veränderungen von Positionen während des Schlafes.

Literatur

  • 01 Arnestad  M, Andersen  M, Rognum  T O. Is the use of dummy or carry-cot of importance for sudden infant death?.  Eur J Pediatr. 1997;;  156 968-970
  • 02 Beal  S M. Sleeping position and SIDS: past, present, future.  In: Rognum TO (ed). Sudden Infant Death Syndrome. New Trends in the Nineties. Scandinavian University Press, Oslo; 1995;: 147-151
  • 03 Blackwell  C C, Weir  D M, Busuttil  A. Infectious agents and SIDS: Analysis of risk factors and preventive measures.  J SIDS Inf Mort. 1997;;  2 61-76
  • 04 Chiodini  B A, Thach  B. Impaired ventilation in infants sleeping facedown: Potential significance for sudden infant death syndrome.  J Pediatr. 1993;;  123 686-692
  • 05 Cozi  F, Albani  R, Cardi  E. A common pathophysiology for sudden cot death and sleep apnea (The vaccum-glossoptosis syndrome).  Med Hypoth. 1979;;  5 329-338
  • 06 Fleming  P J, Blair  P S, Bacon  C et al. Environment of infants during sleep and risk of the sudden infant death syndrome: results of 1993 - 5 case-control study for confidential inquiry into stillbirths and deaths in infancy.  Brit Med J. 1996;;  313 191-195
  • 07 Gastro-oesophageal reflux and apparent life-threatening events in infancy (Editorial) .Lancet II 1988;. 261-262
  • 08 Groswasser  J, Scaillet  S, Simon  T et al. How often are non prone infants found prone?.  Ann Esp Pediatr Suppl. 1997;;  92 27
  • 09 Hoffman  H J, Hillman  L S. Epidemiology of the sudden infant death syndrome: maternal, neonatal, and postneonatal risk factors.  Clin Perinatol. 1992;;  19 717-737
  • 10 Hunt  C E. Sudden infant death syndrome. In: Beckerman RC, Brouillette RT, Hunt CE (eds). Respiratory control disorders in infants and children. Williams & Wilkins, Baltimore; 1992;: 190-211
  • 11 Hunt  C E. Infant sleeping position and SIDS risk.  Pediatrics. 1994;;  94 105-107
  • 12 Irgens  L M, Markestad  T, Baste  V et al. Sleeping position and sudden infant death syndrome in Norway 1967 - 91.  Arch Dis Child. 1995;;  75 478-482
  • 13 Jonge de  G A, Burgmejer  R JF, Engelberts  A C et al. Sleeping position for infants and cot death in the Netherlands 1985 - 91.  Arch Dis Child. 1993;;  69 660-663
  • 14 Larsson  E F, Dahlin  K G. The prevalence and the etiology of the initial dummy and finger-sucking habit.  Am J Orthod. 1985;;  87 432-435
  • 15 Meny  R G, Rubin  J D. Infant sleep position and SIDS risk, 1995: A parent survey and analysis of SIDS deaths in Maryland.  J SIDS Inf Mortal. 1997;;  2 111-115
  • 16 Mitchell  E A, Aley  P, Eastwood  J. The national cot death prevention programme in New Zealand.  Austr J Publ Health. 1992;;  16 158-161
  • 17 Mitchell  E A, Taylor  B J, Ford  R PK et al. Dummies and the sudden infant death syndrome.  Arch Dis Child. 1993;;  68 501-504
  • 18 Nelson  E A, Taylor  B J, Weatherall  I L. Sleeping position and infant bedding may predispose to hyperthermia and the sudden infant death syndrome.  Lancet. 1989;;  1 199-201
  • 19 Positioning and sudden infant death syndrome (SIDS): update .American Academy of Pediatrics Task Force on Infant Positioning and SIDS. Pediatrics 1996; 98: 1216-1218
  • 20 Tonkin  S, Beach  D. The vulnerability of the infant upper airway.  In: Harper RM, Hoffman HJ (eds). Sudden Infant Death Syndrome: Risk Factors and Basic Mechanisms. PMA Publishing Corp., New York; 1988;: 417-422
  • 21 Tuffnell  C S, Petersen  S A, Wailoo  M P. Prone sleeping infants have a reduced ability to lose heat.  Early Hum Dev. 1995;;  43 109-116
  • 22 Weiss  P PW, Chem  C. To soothe or not to soothe, that is the question …. A paper presented to the 23. Jahrestagung der Deutsch-Österreichischen Gesellschaft für Neonatologie und Pädiatrische Intensivmedizin, Münster,; 17 October 1997:
  • 23 Wigfield  R, Fleming  P J. The prevalence of risk factors for SIDS: Impact of an intervention campaign.  In: Rognum TO (ed). Sudden Infant Death Syndrome. New Trends in the Nineties. Scandinavian University Press, Oslo; 1995;: 124-128
  • 24 Willinger  M, Hoffman  H J, Scheidt  P C et al. Infant sleep position and SIDS in the United States.  Am J Dis Child. 1993;;  147 460
  • 25 Winter  G B. Problems involved with the use of comforters.  Int Dent J. 1980;;  30 28-38
  • 26 Wooding  A R, Boyd  J, Geddis  D C. Sleep patterns of New Zealand infants during the first 12 months of life.  J Paediatr Child Health. 1990;;  26 85-88

I. A. Kelmanson

Department of Paediatrics No. 3 St. Petersburg State Paediatric Medical Academy

Litovskaya 2

St. Petersburg, 194 100

Russia

Phone: Tel./Fax (8 12) 5 35-28-50

Email: E-mail: ikel@atrium.cor.neva.ru

    >