Effect Of Pacifier Use Research Articles

Pacifiers: A review

Pacifiers play a crucial role in infant care and soothing behaviors, and their use has been a subject of extensive research. This literature review aims to synthesize the existing body of knowledge on pacifiers and their impact on various aspects of infant development and well-being. Through an analysis of relevant studies, the review examines the effects of pacifier use on breastfeeding practices, oral health, sleep patterns, and emotional regulation in infants. Additionally, the review explores the potential benefits and risks associated with pacifier usage, considering factors such as age, duration of use, and weaning strategies. By consolidating and evaluating the findings from diverse studies, this review provides a comprehensive understanding of the implications of pacifiers on infants, aiding caregivers, healthcare professionals, and parents in making informed decisions regarding their use.

Anne sütünü etkileyen faktörler ve emzik kullanımının emzirme üzerine etkileri

Purpose: In this study, we aimed to determine the sociodemographic factors breastfeeding, pacifier use, the problems that may experience in breastfeeding, show effect of pacifier use on breatsfeeding. 
 Material and Methods: A questionnaire was applied by 349 mothers with babies between 24-60 months. 
 Results: The breastfeeding rate was 97%. Increasing week of birth, male gender, being first and/or only child, increasing maternal age, fathers’s support for breastfeeding, long maternity leave, increase the duration of breastfeeding; low birth weight, breastfeeding of siblings less than 6 months, high education level of mothers, pregnancy maternal smoking, early initiation of formula, pacifier use adversely affected breastfeeding. The pacifier use was 41,8%, the duration was 18±10,22 months. Pacifier use decreased breastfeeding, it increased the risk of weaning before 6 months by 5,1 times. 
 Conclusion: To increase duration of breastfeeding, mothers should be supperted, early initiation of additional food, formula, pacifier’s negative effects use on breastfeeding should be explained.

Daily Use of Pacifier in the First Years of Life Is Associated with Lower IQ at Age Six

Background: Literature on pacifier use is controversial, but mostly suggests negative effects especially on breastfeeding, dental occlusion, and speech development. Little is known about its influence on intelligence. This study assessed the influence of pacifier use duration and intensity on intelligence quotient (IQ) scores in six-year old children from a birth cohort. Methods: Data from 3,532 children from the 2004 Pelotas (Brazil) Birth Cohort were analyzed. Children were recruited and assessed at birth and followed-up at three months and at one, two, four, and six years. IQ was estimated using the Wechsler Intelligence Scale for Children. Data on pacifier use duration/intensity were obtained via interviews with mothers at all follow-up visits before age six. Crude and adjusted effects of pacifier use were assessed through linear regression. Findings: IQ was negatively associated with all pacifier use indicators. Children who used a pacifier all day long at any assessment had an IQ 0·18 SD lower than those who never used it all day. This effect increased with the number of assessments where all-day-long pacifier use was reported. Children who reported all-day-long pacifier use in the four assessments had an IQ 0·34 SD lower than those who never used it all day. Interpretation: We found strong evidence that intense pacifier use up to four years of age is associated with lower IQ at six years. A dose-response effect was observed, with greater IQ reduction in children who used a pacifier for longer. The mechanisms underlying this association need to be clarified. Funding Statement: Universidade Federal de Pelotas, ABRASCO, Wellcome Trust (2009-2013), WHO, PRONEX, CNPq, the Brazilian Ministry of Health, and the Child Pastorate. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Written informed consent was obtained from all mothers or guardians before data collection. The research ethics committee of the Universidade Federal de Pelotas Medical School approved all follow-up waves of the 2004 Pelotas (Brazil) Birth Cohort.

Effects of Pacifier Use on Transition Time from Gavage to Breastfeeding in Preterm Infants: A Randomized Controlled Trial.

Nonnutritive sucking (NNS) has been identified as having many benefits for preterm infants. NNS may improve the efficacy of oral feeding, reduce the length of time spent in orogastric (OG) tube feeding, and shorten the length of hospital stays for preterm infants. This study aimed to assess the effect of pacifiers on preterm infants in the transition from gavage to oral feeding, their time to discharge, weight gain, and time for transition to full breastfeeding. A prospective, randomized controlled trial was conducted in our center. Ninety infants were randomized into two groups: a pacifier group (PG) (n = 45) and a control group (n = 45). Eligibility criteria included body weight less than or equal to 1,500 g, gestational age (GA) younger than 32 weeks, tolerating at least 100 kcals/kg/day by OG feeding, growth parameters appropriate for GA, and a stable clinical condition. Mean GAs were 29.2 ± 1.86 versus 28.4 ± 1.84 weeks (p = 0.46), and birth weights were 1,188.2 ± 272 versus 1,112.8 ± 267 g (p = 0.72) in the PG and CG groups, respectively. The time for transition to full oral feeding (38 ± 19.2 days), time to transition to full breastfeeding (38.1 ± 20 days), and time to discharge (48.4 ± 19.2 days) in the PG were significantly shorter compared with the control group (49.8 ± 23.6, 49.1 ± 22, 65.3 ± 30.6 days, respectively) (p < 0.05). For preterm infants with gastrointestinal motility disturbance, similar symptoms (regurgitation, vomiting, abdominal distension) (n = 6, 22%) in the PG were significantly lower than the control group (n = 21, 77.8%) (p < 0.05). In this study, we determined that the method of giving pacifiers to preterm infants during gavage feeding reduced the infants' transition period to oral feeding and the duration of hospital stay. In addition, the pacifiers could be used during gavage feeding and in the transition from gavage to oral/breastfeeding in preterm infants to encourage the development of sucking ability.

Infant sleep and the influence of a pacifier.

Divergent opinions are found in the literature regarding the use of a pacifier. During the longitudinal follow-up of children, health professionals must take a position on this issue and offer clear information regarding the pros and cons of pacifier use so that parents/caregivers can feel comfortable enough to make their own decision. Evaluate the beneficial effects of pacifier use on the sleep quality of infants. A cross-sectional study was conducted at public day care centres in the city of Recife, Brazil. Interviews were held with 157 mothers of infants aged five to 13 months. Data were collected on the mother's and child's profiles. Child's sleep quality was determined using the Brief Infant Sleep Questionnaire. The results demonstrated no statistically significant differences between the group that used a pacifier and the group that did not use a pacifier with regard to sleep variables of the child. When deciding whether or not to permit pacifier use, the infant's sleep quality should not be considered a critical factor.

Conhecimento das mães acerca do uso da chupeta, amamentação e desenvolvimento da criança

O uso de chupeta é actualmente considerado um problema de Saúde Pública ao se constituir um dos determinantes principais que conduzem as mães a interromper precocemente a amamentação e pelo impacto negativo no desenvolvimento infantil. Objetivos: Explorar o conhecimento das mães sobre o efeito do uso da chupeta no processo da amamentação e desenvolvimento da criança; Identificar os factores que levaram as mães que amamentam ou amamentaram na introdução da chupeta aos filhos; Caracterizar o peso relativo evocado pelas mães que levam ao uso da chupeta no processo de amamentação e no desenvolvimento da criança; Relacionar o conhecimento das mães que amamentam ou amamentaram e cujos filhos usaram ou não chupeta sobre a sua influência no processo de amamentação e desenvolvimento da criança. Participantes e Métodos: Estudo descritivo-correlacional, segundo a metodologia quantitativa, junto de mães de crianças que amamentaram ou que ainda se encontravam a amamentar, cujos filhos frequentavam creches públicas ou privadas, situadas em meio urbano ou rural do distrito de Coimbra, através da aplicação de um Questionário, entre Abril e Junho/2016. Tratou-se os dados por computador e utilizou-se a estatística descritiva no tratamento da informação. Resultados: Grande percentagem de mães referiu que os filhos usaram chupeta, com início no primeiro dia de vida, por opção própria ou aconselhamento de um profissional de saúde. Percentagem elevada tomou a decisão da sua introdução por opção própria, para acalmar o filho. Houve grande dispersão de respostas relativamente à idade adequada para a retirar. Pequena percentagem revelou conhecimento sobre o impacto negativo no desmame precoce, processo de amamentação e desenvolvimento infantil.Conclusões: As mães não possuem uma globalidade de conhecimentos essenciais sobre a influência da chupeta no processo de amamentação e desenvolvimento infantil. É necessário apostar na formação dos profissionais de saúde para a transmissão de informações às mães.

Effects of pacifier use on transition to full breastfeeding and sucking skills in preterm infants: a randomised controlled trial.

To determine the effects of pacifier use on transition to full breastfeeding and sucking skills in preterm infants. Feeding problems in preterm infants cause delays in hospital discharge, extend mother-infant reunification and increase medical cost. Nutritive sucking skills of preterm infants may develop by improving non-nutritive sucking skills and increasing sucking experiences. A prospective, randomised controlled trial conducted in the Eastern Turkey. Seventy infants were randomised into two groups: a pacifier group (n=34) and a control group (n=36). Pacifier use was applied in the preterm infants in the pacifier group, up to switching to full breastfeeding. The infants in the control group did not use pacifiers. Data were collected by a researcher using the Preterm Infant Introductory Information Form, the Preterm Infant Monitoring Form and the LATCH Breastfeeding Assessment Tool. For the study, ethics committee approval, official permission and written informed consents of the families were obtained. The time to transition to full breastfeeding (123·06±66·56hours) and the time to discharge (434·50±133·29hours) in the pacifier group were significantly shorter compared to the control group (167·78±91·77 and 593·63±385·32hours, respectively) (p<0·05). The weight at transition to full breastfeeding (1944·12±275·67g) and the weight of discharge (1956·45± 268·04g) in the pacifier group were significantly lower compared to the control group (2155·58±345·57 and 2159·75±341·22g, respectively) (p<0·05). Sucking skills of the infants in the pacifier group at 48hours after transition to oral feeding and before the discharge was better than in the control group (p<0·05). Pacifier use improved the sucking skills and shortened the time to transition to full breastfeeding and to discharge in preterm infants receiving complementary feeding. Pacifier use may be recommended to accelerate transition to full breastfeeding and to improve the sucking skills in preterm infants who were fed by both oral route and complementary feeding in the neonatal intensive care units.

Pacifier use and interruption of exclusive breastfeeding: Systematic review and meta-analysis.

Identifying modifiable risk factor for exclusive breastfeeding (EBF) interruption is key for improving child health globally. There is no consensus about the effect of pacifier use on EBF interruption. Thus, the aim of this systematic review was to investigate the association between pacifier use and EBF interruption during the first six month. A search of CINAHL, Scopus, Web of Science, LILACS and Medline; from inception through 30 December 2014 without restriction of language yielded 1,866 publications (PROSPERO protocol CRD42014014527). Predetermined inclusion/exclusion criteria peer reviewed yielded 46 studies: two clinical trials, 20 longitudinal, and 24 cross-sectional studies. Meta-analysis was performed and meta-regression explored heterogeneity across studies. The pooled effect of the association between pacifier use and EBF interruption was 2.48 OR (95% CI=2.16-2.85). Heterogeneity was explained by the study design (40.2%), followed by differences in the measurement and categorization of pacifier use, the methodological quality of the studies and the socio-economic context. Two RCT's with very limited external validity found a null association, but 44 observational studies, including 20 prospective cohort studies, did find a consistent association between pacifier use and risk of EBF interruption (OR=2.28; 95% CI=1.78-2.93). Our findings support the current WHO recommendation on pacifier use as it focuses on the risk of poor breastfeeding outcomes as a result of pacifier use. Future studies that take into account the risks and benefits of pacifier use are needed to clarify this recommendation.

Pacifier Sucking Habit and its Relation to Oral Health of Children Aged 1-5 Years (comparative study)

Background: For many infants and children non-nutritive sucking habits are very common and one of those habits is pacifier suck- ing, however, if this habit persist beyond the age of 3 years it may cause esthetic, occlusal and psychological changes. This study was conducted to determine the effect of pacifier sucking habit on the oral health of children aged 1-5 years old in Baghdad city and to assess its role in the modification of the oral microflora. Materials and methods: The study was carried out among children aged 1-5 years old with no history of any systemic diseases nor taking any medical treatment for the past two weeks prior to the examination, 50 children with continuous pacifier sucking habit were chosen to be the study group, compared to 50 children without any sucking habit (control group) matching the study group in age and gender. Information sheet filled by the parents concerning general health and frequency of oral infections of their children was taken. Oral microorganisms samples were obtained from children and cultured aerobically using blood agar, MacConkey agar, chocolate agar and sabauraud, s dextrose agar. Results: Children with pacifier sucking habit showed higher frequency of having continuous oral infections (44%) whereas in non pacifier sucking group it was zero. Concerning the oral infections, a statistical difference was found by which the pacifier sucking children oral infections exceed significantly that of the non pacifier sucking children (P<0.01). Regarding the oral microorganisms, more types were found among pacifier sucking children. Candida, Sterp.pyogenes, strep.faecalis, E.coli, Acinetobacter and sterp. pneumonia were more common among pacifier sucking children. Conclusion: Pacifier use affect types and frequency of microorganisms found in the oral cavity which may affect the frequency of oral infections. Health programs should be constructed to improve parents’ knowledge concerning the effect of pacifier use in the oral health of their children and how to clean it if it used to reduce its contamination.

Barriers to Breast Feeding: A Review

Context: Exclusive breast feeding, (EBF) protects young infants from infectious illnesses; various factors, including pacifier use, may adversely affect the initiation and duration of breast feeding. Evidence Acquisition: Mesh terms relating to EBF were used to search articles published in PubMed between 2000 and 2014. In addition to studies done outside Iran, articles from Iran addressing the issue of pacifier use in infants that had not been published in the PubMed, but were collected from Iranian journals, were also included. Regarding pacifier use, search was limited to papers published during the last 5 years. Results: Rates of breastfeeding at 6 months were reported to vary from 3% to 95% and EBF from less than 1% to 33% in different parts of the world. A negative association between pacifier use and duration of breastfeeding was reported by 10 authors, with a meta-analysis from Turkey reporting a Risk Ratio of 1.952, 95% CI: 1.662 - 2.293. Some researchers, although observed an association between pacifier use and early cessation of EBF, but refuted a causal relationship. Conclusions: As available data on the effect of pacifier use is conflicting, and continuation of breast feeding till 6 months of age is crucial for optimal health outcomes in infants, it is prudent to avoid pacifier use totally or at least till breast feeding is established.

Pacifier use does not alter sleep and spontaneous arousal patterns in healthy term-born infants.

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. 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. 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. 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.

Pacifiers Disrupt Adults’ Responses to Infants’ Emotions

Research shows that pacifiers disrupt infants' mimicry of facial expressions. This experiment examines whether pacifiers interfere with caretakers' ability to mimic infants' emotions. Adults saw photographs of infants with or without a pacifier. When infants had pacifiers, perceivers showed reduced EMG activity to infants' smiles. Smiles of infants using a pacifier were also rated as less happy than smiles depicted without a pacifier. The same pattern was observed for expressions of distress: adults rated infants presented with pacifiers as less sad than infants without pacifiers. We discuss deleterious effects of pacifier use for the perceiver's resonance with a child's emotions.

Pacifier Use, Breastfeeding and Sudden Infant Death Syndrome

Objective: To review the effect of pacifier use in healthy term infants on breastfeeding duration and the risk of Sudden Infant Death Syndrome (SIDS). Keywords: Breastfeeding, infant, pacifier, SIDS, sudden infant death syndrome, systematic literature review

Sudden Infant Death Syndrome: An Update

Sudden Infant Death Syndrome: An Update

Cochrane Review: Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding

AbstractBackgroundTo successfully initiate and maintain breastfeeding for a longer duration, the World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of artificial teats or pacifiers for breastfeeding infants. Offering the pacifier instead of the breast to calm the infant may lead to less frequent episodes of breastfeeding and as a consequence may reduce breast milk production and shorten duration of breastfeeding; however, this remains unclear.ObjectivesTo assess the effect of pacifier use versus no pacifier use in healthy full‐term newborns whose mothers have initiated breastfeeding and intend to exclusively breastfeed, on the duration of breastfeeding, other breastfeeding outcomes and infant health.Search methodsWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2010).Selection criteriaRandomised and quasi‐randomised controlled trials comparing pacifier use versus no pacifier use in healthy full‐term newborns who have initiated breastfeeding regardless of whether they were born at home or in the hospital.Data collection and analysisTwo authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction.Main resultsWe found three trials (involving 1915 babies) for inclusion in the review but have included only two trials (involving 1302 healthy full‐term breastfeeding infants) in the analysis. Meta‐analysis of the two combined studies showed that pacifier use in healthy breastfeeding infants had no significant effect on the proportion of infants exclusively breastfed at three months (risk ratio (RR) 1.00; 95% confidence interval (CI) 0.95 to 1.06), and at four months of age (RR 0.99; 95% CI 0.92 to 1.06) and also had no effect on the proportion of infants partially breastfed at three months (RR 1.00; 95% CI 0.97 to 1.02), and at 4 months of age (RR 1.01; 95% CI 0.98 to 1.03).Authors' conclusionsPacifier use in healthy term breastfeeding infants, started from birth or after lactation is established, did not significantly affect the prevalence or duration of exclusive and partial breastfeeding up to four months of age. However, evidence to assess the short‐term breastfeeding difficulties faced by mothers and long‐term effect of pacifiers on infants' health is lacking.Plain Language SummaryEffect of pacifier use on duration of breastfeeding in full‐term infantsBreast milk is superior to other baby foods in providing balanced nutrition and protection against allergy and infection to newborns. Breastfeeding is recommended by the World Health Organization, exclusively in the first six months and then as a dietary supplement. Breastmilk production and supply are maintained by frequent suckling of the breast and nipple stimulation. A pacifier is a non‐nutritive sucking device used to calm an infant that has become a cultural norm in many parts of the world. However there is a widespread belief that pacifiers may interfere with breast milk production and lead to discontinuation of breastfeeding.Our review concluded that for mothers who are motivated to breastfeed their infants, pacifier use before or after breastfeeding was established did not significantly affect the prevalence or duration of exclusive and partial breastfeeding up to four months of age. The review provided moderate evidence from three randomised controlled trials (involving 1915 babies) comparing pacifier use and no pacifier use by healthy, full‐term breastfeeding infants; two of the trials (1302 babies) were included in the analysis. However, there is a widespread belief that pacifiers may interfere with breast milk production and lead to discontinuation of breastfeeding.

Pacifier Use Compared With No Pacifier Use in Breastfeeding Term Infants for Increasing Duration of Breastfeeding

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Exclusive Breastfeeding in Southern Brazil: Prevalence and Associated Factors

Worldwide strategies have been conducted in order to guarantee longer periods of exclusive breastfeeding for most children, especially those from developing countries. The evaluation of infant feeding practices and the identification of weaning risk factors are essential for public health policy planning. This cross-sectional study was carried out in Joinville, the biggest city of Santa Catarina State in the southern Brazilian region. The caregivers of children under 1 year of age were systematically selected for interview in previously drawn immunization units during the 2005 National Vaccination Campaign. A structured questionnaire was applied for collection of infant, maternal, and healthcare variables. A 24-hour food recall survey was included in order to evaluate infant feeding practices. Descriptive statistic analysis on breastfeeding prevalence and Poisson regression analysis of risk factors for discontinuing exclusive breastfeeding for infants up to 6 months of age were performed. Caregivers of 1,470 infants were interviewed. The feeding inquiry showed an overall rate of breastfeeding of 72.5% and a frequency of exclusive breastfeeding of 43.7% and 53.9% among infants younger than 6 and 4 months of age, respectively. The findings associated with the interruption of exclusive breastfeeding for infants up to 6 months were: higher infant age (P < 0.001), pacifier use (P < 0.001), and lower maternal educational level (P = 0.013). In developing countries, specific strategies must be created for the delivery of information about breastfeeding and the effect of pacifier use, especially for less educated women.

Analgesic Effects of Breast-feeding or Pacifier Use With Maternal Holding in Term Infants

First, to compare analgesic effects of breast-feeding versus pacifier use in newborn infants undergoing blood collection via heel sticks. Second, to compare analgesic effects of pacifier use with maternal holding versus nonmaternal holding. A prospective, randomized, controlled trial. Normal newborn nursery at academic teaching hospital. Full-term breast-feeding infants scheduled for routine newborn screening blood test via heel stick (n = 96). Interventions.-Infants randomized to 3 groups for analgesia: 1) breast-feeding, 2) pacifier use while held by mothers, 3) pacifier use while held by research assistants (nonmothers). Primary outcome was crying (percent of infants who cried during the procedure and mean percent of procedure time that infants cried). Secondary outcomes were physiologic measures. Fewer breast-feeding infants cried than infants using a pacifier while held by nonmothers both during the procedure (69% vs 100%, P < .01) and after the procedure (28% vs 60%, P = .03). Those infants crying during the procedure cried for less time if held by their mothers either breast-feeding (33%, P < .01) or using a pacifier (45%, P = .03) than those using a pacifier while being held by nonmothers (66%). Breast-feeding is more analgesic than pacifier use with nonmaternal holding. Maternal holding with either breast-feeding or pacifier use is more analgesic than nonmaternal holding with pacifier use, suggesting that maternal holding itself has an analgesic effect. Breast-feeding and maternal holding should be considered as pain-control measures for the neonate during heel-stick procedures.

Does the use of pacifiers shorten breastfeeding duration in infants?

Breastfeeding has a number of benefits for both mother and baby, which appear to increase with longer duration of breastfeeding. The use of pacifiers has been negatively associated with shortened breastfeeding duration. The aim of this review was to determine whether the use of pacifiers actually shortens breastfeeding duration in infants. The Cochrane library, Medline, CINAHL and Embase databases were searched for systematic reviews, randomized controlled trials and cohort studies examining the effect of pacifier use on breastfeeding duration. After applying appropriate inclusion criteria only two cohort studies were identified. In one the overall breastfeeding duration was longer in non pacifier-using infants compared to those given pacifiers (10 months vs. 7.5 months). The mean breastfeeding duration in children who were given pacifiers before 6 weeks of age was 168.5 days compared to 196.0 days for children who had a pacifier introduced later or never. However, there is no evidence to suggest any effect from occasional pacifier use, and it remains unclear whether pacifiers are an independent causal factor for reducing breastfeeding duration in infants.

Effect of pacifier use on oral breathing in healthy newborn infants.

We tested the hypothesis that the use of a pacifier may affect the ability of some term infants to maintain effective oral breathing during prolonged nasal occlusion. Three nasal occlusion tests without a pacifier and 3 with a pacifier were alternately carried out in 20 healthy term infants (age 2-5 days). Once the infant commenced oral breathing, nasal occlusion was continued for up to 90 sec (prolonged nasal occlusion), provided the infant did not start crying and that arterial oxygen saturation (SaO(2)) did not drop to < or = 80%. The response to nasal occlusion was considered maladaptive if oral breathing was accomplished with signs of upper airway obstruction. After nasal occlusion, the infants succeeded in starting oral breathing in all instances after a delay which was strongly correlated to the drop in SaO(2) (P < 0.001). Once the infants commenced oral breathing, 17/20 infants presented a maladaptive response to 62% of all tests without pacifier, whereas 10/20 infants presented a maladaptive response to 30% of all tests with a pacifier in place (P < 0.001). Following prolonged nasal occlusion, 18 of 19 infants presented a maladaptive response to 84% of all tests without pacifier, whereas 12 of 19 infants presented a maladaptive response to 41% of all tests with a pacifier in place (P < 0.001). Thus, after prolonged nasal occlusion with or without pacifier, the drop in mean SaO(2) from baseline values changed in accordance with an appropriate and maladaptive response (-4 +/- 1 vs. -7 +/- 1; P < 0.001). We conclude that normal term infants often present with a maladaptive response to prolonged nasal occlusion. The use of a pacifier enhances the infant's ability to maintain a more adequate oral air flow.