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Dummies

Dummies (also known as pacifiers) have long been used by parents who feel they help soothe or settle their baby. Recently some studies have suggested they may reduce the risk of Sudden Infant Death Syndrome (SIDS).

Research has shown that sucking (e.g. breastfeeding, finger-sucking or dummy use) has a calming and soothing effect on babies, including a reduced response to pain. In addition, since the early 1990s studies have shown that dummy use is associated with a reduced risk of Sudden Infant Death Syndrome (SIDS), compared with babies who did not use a dummy.

  • Recent American SIDS risk studies have found that dummy use is associated with a lower risk of SIDS.Use of a dummy (pacifier) during sleep and risk of sudden infant death syndrome (SIDS): population based case-control study. Li et al., 2006; Pacifier Use and Sids: Evidence for a Consistently Reduced Risk. Moon et al., 2012
  • One of the largest UK SIDS risk studiesPacifier use and sudden infant death syndrome: results from the CESDI/SUDI case control study. Fleming et al., 1999 along with many studies elsewhere in Europe, Australasia and the Americas, have found the same association.
  • However the most recent UK SIDS risk studyHazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. Blair et al., 2009 found that the importance of dummy-use in explaining SIDS risk had decreased, since the earlier large study.

Because of the strong protective effect found in some studies, some authorities now suggest that parents think about using a dummy when settling their baby to sleep. However, it is not known how dummies reduce SIDS risk. Some theoriesUse of a dummy (pacifier) during sleep and risk of sudden infant death syndrome (SIDS): population based case-control study. Li et al., 2006; Sudden Infant Death Syndrome: implications of altered physiological control during sleep. Horne et al., 2010 include that they may prevent babies from turning their face into bedding, alter the way babies’ hearts work, or stop them from sleeping too deeply. These theories are also among those used to explain why breastfeeding reduces SIDS risk. It might also be that there is something else - that we don’t know yet - about people who are more likely to use dummies which puts their babies at lower risk. They may, for example, be more likely to check regularly on their babies while they sleep, or to keep their babies in the same room.Dummy (pacifier) use reduces the risk of SIDS - But how? Mee et al., 2007

In some of the SIDS studies it was only babies who didn’t have a dummy – but normally used one – that were more vulnerable.e.g. Factors relating to the infant’s last sleep environment in sudden infant death syndrome in the Republic of Ireland. McGarvey et al., 2003 Those babies who never had a dummy were not at higher risk, which suggests that if you start giving your baby a dummy for sleep then you must always give it.

Studies have shown that dummy use can have unwanted effects. Somee.g. Pacifier use and sudden infant death syndrome: results from the CESDI/SUDI case control study. Fleming et al., 1999 have found that dummy use can lead to less breastfeeding and earlier weaning from the breast. An up-to-date review of researchPacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding (Review). Jaafar et al., 2012 found dummies did not cause mothers to stop breastfeeding earlier (up to when their babies were 4 months old) when they were very motivated to breastfeed. However they were not able to say whether or not less motivated mothers might be disadvantaged by dummy use. Breastfeeding in itself reduces the risk of SIDS, along with other diseases, and helps with mother-baby bonding.

Some research has found links between dummy use and tummy and chest infections, and recurrent infections of the middle ear, but the exact relationship betwee dummy use and infections is not yet clear. Pacifier use and morbidity in the first six months of life. North et al., 1999 and recurrent infections of the middle-ear.Is pacifier use a risk factor for acute otitis media? A dynamic cohort study. Rovers et al., 2008

For these reasons, along with the lack of information we have about how dummies work to reduce SIDS, and in which groups of babies they might have most effect, the UK Department of Health does not currently recommend dummy use as a way of reducing the risk of SIDS, however some SIDS prevention organisations do.

For more detailed information about dummies, see our Health Professional pages, or this Factsheet from the Lullaby Trust.

Last modified: 3rd December 2017