SIDS is the leading cause of death among infants between the ages of one month and one year, claiming between 2,300 and 2,500 lives every year in the United States.

Other Risk Factors

For the latest study, investigators analyzed 185 cases of babies who died from SIDS in 10 Northern California counties and Los Angeles County from 1997 to 2000. They compared the SIDS infants to 312 normal infants of a similar age and from similar socio-economic and ethnic backgrounds.

"Pacifier use has been linked to lower rates of SIDS for some time, but this is the first study to examine this relationship comprehensively and in the context of its interaction with other risk factors for SIDS," says lead researcher De-Kun Li, MD, PhD, of Kaiser Permanente's Division of Research in Oakland.

The protective effect of the pacifier seemed evident even for those infants who were in an adverse sleep environment, such as sleeping face down or on the side, sleeping with a mother who smoked, or sleeping on soft bedding, the researchers found.

Another Strategy

Pacifiers may help protect an infant because the bulky handle stops the baby from accidentally suffocating in heavy blankets or soft bedding, says Li. Also, the pacifier handle may alter an infant's sleep environment by changing the configuration of the airway passage surrounding the nose and mouth, he notes.

In the early 1990s, a broad campaign urging parents to put their babies to sleep on their backs helped reduce the number of SIDS deaths by more than 50 percent.

"We believe that pacifier use may be another strategy for further reducing the risk of SIDS," says Diana B. Petitti, MD, MPH, the lead researcher for Kaiser Permanente's Southern California study site, the Department of Research and Evaluation in Pasadena.