Sudden Infant Death Syndrome (SIDS) and Pacifiers:

Aim: It has been hypothesized that the association of pacifier use with reduced risk of sudden infant death is mediated by forward movement of the mandible and tongue that helps open the upper airway. Our aim was to examine whether the mandible is moved forward when an infant is sucking on a pacifier, and if so, whether the mandible remains advanced after the pacifier is removed. Methods: In sixty clinically stable premature infants (corrected gestation age 36.5 +/0.3 weeks, mean +/SEM) the distance from each ear where the pinna met the cheek to the most prominent point of the chin was measured bilaterally, and the average was used as an index of mandibular position. Mandibular position was determined before and after allowing the infants to suck on a pacifier for 10-15 min, and after removing the pacifier. Results: There was a significant forward movement of the mandible when the infants were sucking on the pacifier (59.5 +/0.7 vs. 58.6 +/0.7 mm, p = 0.001), with no significant change after the pacifier was removed. Conclusions: Pacifier use in preterm infants was associated with a small significant forward displacement of the jaw. These data suggest that pacifier use may help protect the upper airway.