Literature review for - Flourish Paediatrics

Studies used to make evidence statement for Use of Pacifiers and SIDS
Reference Moon 2007 Lancet Hauck 2005 Pediatrics Mitchell 2006 Pediatrics
Type of study Narrative review for pacifiers SLR SLR
Level of evidence III (aetiology) II (aetiology) II (aetiology)
Definition of
breastfeeding
N/A N/A N/A
Intervention Pacifier use
Pacifier use at last reference sleep
Pacifier use at last reference sleep
Comparator v’s none
N 4 studies 7 studies 8 studies
Population/study 6 case control studies
7 Case control studies 1966-2004
8 case control studies
information 2 Meta - analyses
(No RCT’s or prospective studies available)
Quality P P P
Results
Pacifiers reduced risk of SIDS
No RR given
Summary OR 0.39(0.31-0.50)
1 SIDS death could be prevented for every
2733 (95% CI: 2416–3334) infants who use
a pacifier when placed for sleep (number
needed to treat), based on the national SIDS
rate and the last-sleep multivariate SOR
resulting from this analysis.
Effect on risk Negative (reduces risk) Negative Negative
Clinical 1 1 1
importance
Clinical 1 1 1
relevance
Generalisability Y Y Y
Applicability Y Y Y
Note: there is overlap of studies between Moon, Mitchell and Hauck
There is a remarkably consistent
reduction of SIDS with pacifier use.
The mechanism by which pacifiers
might reduce the risk of SIDS is
unknown, Pooled OR for routine use of
pacifier 0.83 ( 0.75,0.93), Pooled OR
for pacifier use last sleep 0.48 (0.43,
0.54)
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