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MacMillan KK, Lewis AJ, Watson SJ, Power J, Galbally M. Maternal psychosocial predictors of pacifier use in a mother-infant interaction task: An observational study from the MPEWS pregnancy cohort. Infant Behav Dev 2020; 61:101505. [PMID: 33197785 DOI: 10.1016/j.infbeh.2020.101505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 10/19/2020] [Accepted: 11/01/2020] [Indexed: 10/23/2022]
Abstract
The prevalence of pacifier use is high but when it occurs outside of the recommended sleep context, it becomes more controversial. Using 211 mother-infant dyads recorded as part of the Mercy Pregnancy and Emotional Wellbeing Study, we examined the maternal psychosocial predictors of pacifier use within an interaction task (i.e., ten minutes face-to-face followed by 30-minutes unstructured play). Predictors included maternal emotional availability measured with the Emotional Availability Scales; depression measured by the Structured Clinical Interview for the DSM-IV-TR Clinician Version; and maternal history of childhood trauma measured by the Childhood Trauma Questionnaire. An unadjusted odds ratio demonstrated that women classified as non-emotionally available to their infants were three-and-a-half-times more likely to use a pacifier. Multivariate logistic regression including all maternal psychosocial predictors demonstrated that even when adjusting for cessation of breastfeeding, maternal emotional availability remained the only significant predictor of pacifier use. This is the first time that predictors of pacifier use have been examined with a sample of clinically depressed women, as well as women with childhood trauma history. The results provide preliminary evidence that women who are not emotionally available might be more likely to rely on a pacifier during mother-infant interaction.
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Affiliation(s)
| | | | - Stuart J Watson
- Psychology, Murdoch University, Perth, Australia; School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Josephine Power
- School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Megan Galbally
- Psychology, Murdoch University, Perth, Australia; School of Medicine, University of Notre Dame, Fremantle, Australia; Women's Health, Genetics and Mental Health Directorate, King Edward Memorial Hospital for Women, Subiaco, Australia; Faculty of Health and Medicine Sciences, University of Western Australia, Perth, Australia
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2
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Hermanson Å, Åstrand LL. The effects of early pacifier use on breastfeeding: A randomised controlled trial. Women Birth 2019; 33:e473-e482. [PMID: 31704126 DOI: 10.1016/j.wombi.2019.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND The majority of observational studies have found associations between pacifier use and shorter breastfeeding duration. Results from four randomised controlled trials did not reveal any difference in breastfeeding outcomes. The relationship between early pacifier use and breastfeeding outcomes remains unclear. AIM To investigate whether a recommendation of early pacifier use affects the proportion of breastfeeding at six months compared to a recommendation to avoid pacifier use during the first two weeks. METHODS An open, randomised controlled trial with parallel group design; 239 primiparous mothers and their term infants were randomly assigned to an intervention group or a control group. The primary outcome was the proportion of breastfeeding at six months. Secondary outcomes were the proportions of breastfeeding and breastfeeding problems at two and four months. To investigate factors which may influence breastfeeding, a multivariate logistic regressions analysis was performed. FINDINGS A total of 209 participants (87.5%) completed the study. There were no significant differences between the groups with respect to breastfeeding at six months. No negative association for breastfeeding between early versus late introduction of pacifier was found. Factors significantly associated with cessation of breastfeeding at six months were: use of nipple shield, intention to breastfeed, severe breastfeeding problems at two weeks, pacifier use at two months and lower educational level. CONCLUSION Early versus late recommendation of pacifier introduction did not affect the proportion of breastfeeding at six months. However, the compliance to the randomised group was insufficient. No negative association was found in the observational analysis.
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Affiliation(s)
- Åsa Hermanson
- Department of Obstetrics, and Gynaecology, University Hospital, Linköping, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
| | - Lotta Lindh Åstrand
- Department of Obstetrics, and Gynaecology, Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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3
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Cardiovascular autonomic dysfunction in sudden infant death syndrome. Clin Auton Res 2018; 28:535-543. [PMID: 29299712 DOI: 10.1007/s10286-017-0490-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 12/12/2017] [Indexed: 10/18/2022]
Abstract
A failure of cardiorespiratory control mechanisms, together with an impaired arousal response from sleep, are believed to play an important role in the final event of sudden infant death syndrome (SIDS). The 'triple risk model' describes SIDS as an event that results from the intersection of three overlapping factors: (1) a vulnerable infant, (2) a critical developmental period in homeostatic control and (3) an exogenous stressor. In an attempt to understand how the triple risk hypothesis is related to infant cardiorespiratory physiology, many researchers have examined how the known risk and protective factors for SIDS alter infant cardiovascular control during sleep. This review discusses the association between the three components of the triple risk hypothesis and major risk factors for SIDS, such as prone sleeping, maternal smoking, together with three "protective" factors, and cardiovascular control during sleep in infants, and discusses their potential involvement in SIDS.
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Abstract
Few studies to date have investigated the relationship between pacifier use or finger sucking and infant sleep. One hundred and four mothers of infants (ages 0-11 months) completed the Brief Infant Sleep Questionnaire (BISQ). Infants who engaged in finger sucking had fewer night wakings and longer stretches of nighttime sleep, although less daytime sleep. There were no significant differences in sleep patterns between pacifier users and infants who did not engage in nonnutritive sucking. Furthermore, no significant differences were found across groups for sleep ecology, including parental involvement at bedtime and following night wakings. Finally, infants were consistently able to retrieve their pacifiers independently by 7 months of age, although this did not appear to be associated with sleep outcomes. Results suggest that when parents are deciding whether to give their infant a pacifier, sleep may not be a critical factor. In contrast, parents of finger and thumb suckers should be reassured that this nonnutritive sucking is beneficial to sleep, at least in the first year of life.
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Affiliation(s)
- Rachel Butler
- a Saint Joseph's University , Philadelphia , Pennsylvania
| | - Melisa Moore
- b Children's Hospital of Philadelphia , Pennsylvania
| | - Jodi A Mindell
- a Saint Joseph's University , Philadelphia , Pennsylvania.,b Children's Hospital of Philadelphia , Pennsylvania
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5
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Horne RSC, Fyfe KL, Odoi A, Athukoralage A, Yiallourou SR, Wong FY. Dummy/pacifier use in preterm infants increases blood pressure and improves heart rate control. Pediatr Res 2016; 79:325-32. [PMID: 26488553 DOI: 10.1038/pr.2015.212] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 08/04/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Preterm infants are at increased risk of sudden infant death syndrome (SIDS). Use of a dummy/pacifier is thought to be protective against SIDS; accordingly, we assessed the effects of dummy/pacifier use on blood pressure, cerebral oxygenation, and heart rate control over the first 6 mo of life after term corrected age (CA) when SIDS risk is greatest. METHODS Thirty-five preterm infants were studied longitudinally at 2-4 wk, 2-3 mo, and 5-6 mo CA. Cardiac control was assessed from spectral indices of heart rate variability (HRV) in the low frequency (LF) and the high frequency (HF) range, and the ratio of HF/LF indicating sympathovagal balance was calculated. RESULTS Overall, at 2-3 mo, mean arterial pressure was significantly higher in the supine position in dummy/pacifier users in both quiet sleep (70 ± 2 vs. 60 ± 2 mm Hg; P < 0.05) and active sleep (74 ± 3 vs. 69 ± 2 mm Hg; P < 0.05). Dummy/pacifier users had higher LF HRV and LF/HF ratio and lower HF HRV. CONCLUSION Dummy/pacifier use increased blood pressure during sleep, at the age of greatest SIDS risk. Overall, LF HRV was elevated and HF HRV reduced in dummy/pacifier users, suggesting that dummy use alters cardiac control in preterm infants.
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Affiliation(s)
- Rosemary S C Horne
- The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia.,Department of Paediatrics, Monash University, Melbourne, Australia
| | - Karinna L Fyfe
- The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia.,Department of Paediatrics, Monash University, Melbourne, Australia
| | - Alexsandria Odoi
- The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia
| | - Anjalee Athukoralage
- The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia
| | - Stephanie R Yiallourou
- The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia.,Department of Paediatrics, Monash University, Melbourne, Australia
| | - Flora Y Wong
- The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia.,Department of Paediatrics, Monash University, Melbourne, Australia.,Monash Newborn, Monash Medical Centre, Melbourne, Australia
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Alm B, Wennergren G, Möllborg P, Lagercrantz H. Breastfeeding and dummy use have a protective effect on sudden infant death syndrome. Acta Paediatr 2016; 105:31-8. [PMID: 26175065 PMCID: PMC5049485 DOI: 10.1111/apa.13124] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 06/17/2015] [Accepted: 07/07/2015] [Indexed: 12/26/2022]
Abstract
We conducted a literature review on the effect of breastfeeding and dummy (pacifier) use on sudden infant death syndrome (SIDS). From 4343 abstracts, we identified 35 relevant studies on breastfeeding and SIDS, 27 on dummy use and SIDS and 59 on dummy use versus breastfeeding. Conclusion We found ample evidence that both breastfeeding and dummy use reduce the risk of SIDS. There has been a general reluctance to endorse dummy use in case it has a detrimental effect of breastfeeding. However, recent evidence suggests that dummy use might not be as harmful to breastfeeding as previously believed.
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Affiliation(s)
- Bernt Alm
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Göran Wennergren
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Per Möllborg
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Hugo Lagercrantz
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
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Wennergren G, Nordstrand K, Alm B, Möllborg P, Öhman A, Berlin A, Katz‐Salamon M, Lagercrantz H. Updated Swedish advice on reducing the risk of sudden infant death syndrome. Acta Paediatr 2015; 104:444-8. [PMID: 25656219 PMCID: PMC6680202 DOI: 10.1111/apa.12966] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 01/25/2015] [Accepted: 02/02/2015] [Indexed: 12/27/2022]
Abstract
This article reviews updated advice and factual material from the Swedish National Board of Health and Welfare on reducing the risk of sudden infant death syndrome. Issues covered by the guidance for parents and healthcare professionals include sleeping positions, smoking, breastfeeding, bed sharing and using pacifiers. Conclusion The guidelines conclude that infants under three months of age are safest sleeping in their own cot and that a pacifier can be used when they are going to sleep.
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Affiliation(s)
- Göran Wennergren
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | | | - Bernt Alm
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Per Möllborg
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Anna Öhman
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Anita Berlin
- Centre for Family and Community Medicine Department of Neurobiology, Care Sciences and Society Karolinska Institute Stockholm Sweden
| | - Miriam Katz‐Salamon
- Department of Women's and Children's Health Karolinska Institute Stockholm Sweden
| | - Hugo Lagercrantz
- Department of Women's and Children's Health Karolinska Institute Stockholm Sweden
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Odoi A, Andrew S, Wong FY, Yiallourou SR, Horne RSC. Pacifier use does not alter sleep and spontaneous arousal patterns in healthy term-born infants. Acta Paediatr 2014; 103:1244-50. [PMID: 25169652 DOI: 10.1111/apa.12790] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 07/28/2014] [Accepted: 08/25/2014] [Indexed: 12/01/2022]
Abstract
AIM Impaired arousal from sleep has been implicated in sudden infant death syndrome (SIDS). Sleeping in the prone position is a major risk factor for SIDS. Epidemiological studies have shown that pacifier use decreases the risk of SIDS, even when infants sleep prone. We examined spontaneous arousability in infants slept prone and supine over the first 6 months of life and hypothesised that spontaneous arousals would be increased in pacifier users, particularly in the prone position. METHODS Healthy term infants (n = 30) were studied on three occasions over the first 6 months after birth. Spontaneous cortical arousals and subcortical activations were scored and converted into frequency per hour of sleep. RESULTS There was no effect of pacifier use on total time spent sleeping or awake or the number of spontaneous awakenings at any age. There was also no effect of pacifier use on the frequency or duration of the total number of spontaneous arousals or on cortical arousals and subcortical activations. CONCLUSION Pacifier use did not alter infant spontaneous arousability at any of the three ages studied, in either the prone or supine sleeping position. Any preventative effect of pacifiers for SIDS may be through physiological mechanisms other than increased arousability.
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Affiliation(s)
- Alexsandria Odoi
- The Ritchie Centre; Monash Institute of Medical Research and Prince Henry's Institute and Monash University; Melbourne Victoria Australia
| | - Shanelle Andrew
- The Ritchie Centre; Monash Institute of Medical Research and Prince Henry's Institute and Monash University; Melbourne Victoria Australia
| | - Flora Y Wong
- The Ritchie Centre; Monash Institute of Medical Research and Prince Henry's Institute and Monash University; Melbourne Victoria Australia
- Monash Newborn; Monash Health; Melbourne Victoria Australia
- Department of Paediatrics; Monash University; Melbourne Victoria Australia
| | - Stephanie R Yiallourou
- The Ritchie Centre; Monash Institute of Medical Research and Prince Henry's Institute and Monash University; Melbourne Victoria Australia
- Department of Paediatrics; Monash University; Melbourne Victoria Australia
| | - Rosemary S C Horne
- The Ritchie Centre; Monash Institute of Medical Research and Prince Henry's Institute and Monash University; Melbourne Victoria Australia
- Department of Paediatrics; Monash University; Melbourne Victoria Australia
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