Pacifier Users Research Articles

The who, when, and why of pacifier use.

Social and familial consequences of pacifier use remain poorly understood. The present study attempts to shed more light on the characteristics of parents using pacifiers with their infants and to explore how pacifier use affects perceptions of infant emotionality, maternal stress, and parental efficacy. The study sample consisted of 428 mothers (range: 17-49 years) of infants (0-36 months) who completed a comprehensive questionnaire assessing infant and parent characteristics as well as parenting practices and pacifier use. We compared attitudes toward pacifiers, parenting stress, children's levels of reactivity and self-regulation, and maternal efficacy among Pacifier Users, Never-Users, and families that Tried-Pacifiers. The reported results reveal benefits of pacifier use for the family relationships, namely reduced parenting stress (p = 0.018), better parent-child dynamics (p < 0.001), and more positive perceptions of child's affectivity (p = 0.006), which are all important aspects of infant development. Our findings highlight developmental benefits of pacifier use, a practice that is known to have both positive and negative long-term consequences for healthy child development. It is, therefore, important for health professionals to have discussions about the pros and cons of pacifier use with parents. The study provides novel insights into how and why mothers use pacifiers and into the psychological consequences of this practice. We found pacifier use is associated with less maternal stress, better mother-child dynamics, and more positive perceptions of child's affectivity. Our findings document developmental benefits of pacifier use adding a new perspective to the debate on pacifiers. Doctors, health visitors, pediatric nurses, and midwives may consider this evidence when advising parents on pacifier use.

Sağlam Çocuk Polikliniğinde ve Yenidoğan Yoğun Bakım Ünitesinde Farmakolojik Olmayan Ağrı Giderme Yöntemlerinden Emzik Verme ve Anne Kucağının Yenidoğan Ağrısı Üzerine Etkisinin İncelenmesi

Introduction: The most important purpose in neonatal pain management is to minimize the pain felt by newborns and to help the newborn cope with pain. This study planned to examine the effects of two non-pharmacological methods, using pacifiers or maternal holding, on neonates’ pain admitted to the outpatient clinic (OC) and hospitalized in the Neonatal Intensive Care Unit (NICU). Material and Methods: Ninety newborns (30 used pacifiers, 30 maternal holding,30 control) who applied to the OC and 60 newborns (30 used pacifiers, 30 control) admitted to the NICU were prospectively included in this study. The Neonatal Infant Pain Scale (NIPS) was used to evaluate behavioral responses to pain perception. Physiological parameters of newborns and their durations of crying were also evaluated. Results: When the NIPS scores were analyzed in OC group during and after the procedure, the lowest score was found in the group using pacifiers (p&amp;lt;0.001). As for the NICU patients, both during and after the procedure, NIPS scores were found to be significantly lower in the pacifier users (p&amp;lt;0.001). It was observed that giving pacifiers and mathernal holding had positive effects on physiological parameters and duration of crying in OC patients (p&amp;lt;0.05). No significant difference in the NIPS score was found between OC and NICU group. Conclusion: This study showed that giving pacifiers and maternal holding during the procedure of blood sampling decreased the NIPS score, restored the changes in physiological parameters and decreased the duration of crying.

Prevalence of Malocclusion and Associated Variables in Preschool Children of Tbilisi, Georgia

Background:Primary dentition is a determinant for future permanent occlusion.Objective:This aimed to evaluate the prevalence of malocclusion and associated variables in the primary dentition among preschoolers in the city of Tbilisi, Georgia.Methods:A cross-sectional survey was conducted among kindergarten children aged 3–5 years. Orthodontic characteristics were assessed by one calibrated clinician (E.G). Questionnaires were given to parents to record associated variables like general health problems, functional changes, and the presence of non-nutritive sucking habits.Results:A total of 396 participants aged 3-5 were included in the study. The prevalence of malocclusion was 49.8%, without significant differences among genders. The prevalence of Class II malocclusion was 21.2%(±4.091), followed by a deep overbite,i.e, 10.7% (±3.14), crossbite,i.e, 7% (±2.561), anterior open bite,i.e, 6.9%, and Class III malocclusion,i.e, 1.6% (±1.513). A total of 41.5% of children with breathing problems had Class II and 13% had crossbite. Speech disorder in 46.8% of cases was associated with anterior open bite. Pacifier users had Class II in 22.5%, deep overbite in 12.2%, and open bite in 9.2% of cases. There was a high prevalence of anterior open bite (25.2%) in children with a thumb-sucking habit (RR=4.90). These data sets are statistically reliable (p &lt; 0.05).Conclusion:Almost half of the evaluated preschoolers had malocclusion. The most frequent disorder was Class II. Malocclusion is associated with non-nutritive sucking habits and mouth breathing.

357Infant pacifier sanitization and risk of food allergy: the Barwon Infant Study

Abstract Background Environmental microbial exposure and human gut microbiota play a role in development of the immune system and susceptibility to food allergy. Pacifier use has been inconsistently associated with allergy, but the association between sanitization and food allergy is unknown. We investigated the association between infant pacifier use, with a consideration of sanitization, and food allergy at age 1 in the Barwon Infant Study (BIS). Methods Questionnaire data were collected prospectively from pregnant mothers from the Barwon region of south-east Australia at baseline and at infant ages 1, 6, and 12 months. Pacifier sanitization was defined as the joint exposure of a pacifier and cleaning methods (antiseptic, mouth, tap water, boiling). Challenge-proven food allergy was determined at age 1. Results Any pacifier use at 6 months was associated with food allergy (aOR, 1.94; 95% CI, 1.04-3.61), but not at other ages. This overall association was driven by the joint exposure pacifier-antiseptic use (aOR, 5.90; 95% CI, 2.18-15.97) compared to no pacifier use. Among pacifier users, pacifier-antiseptic was still associated with food allergy (aOR, 3.88; 95% CI, 1.55-9.72) when compared to pacifier-no antiseptic use. Further, increased use of pacifier-antiseptic at 0, 1 or 2 interviews over the first 6 months was associated with higher food allergy risk (ptrend=0.005). Conclusions Joint exposure to antiseptics and pacifiers at 6 months increased the odds of food allergy, showing a trend with increased use over time. Key messages This is the first report of pacifiers used with antiseptic being positively associated with challenge-proven food allergy.

Infant pacifier sanitization and risk of challenge-proven food allergy: A cohort study

Environmental microbial exposure plays a role in immune system development and susceptibility to food allergy. We sought to investigate whether infant pacifier use during the first postnatal year, with further consideration of sanitization, alters the risk of food allergy by age 1 year. The birth cohort recruited pregnant mothers at under 28 weeks' gestation in southeast Australia, with 894 families followed up when infants turned 1 year. Infants were excluded if born under 32 weeks, with a serious illness, major congenital malformation, or genetic disease. Questionnaire data, collected at recruitment and infant ages 1, 6, and 12 months, included pacifier use and pacifier sanitization (defined as the joint exposure of a pacifier and cleaning methods). Challenge-proven food allergy was assessed at 12 months. Any pacifier use at 6 months was associated with food allergy (adjusted odds ratio, 1.94; 95% CI, 1.04-3.61), but not pacifier use at other ages. This overall association was driven by the joint exposure of pacifier-antiseptic use (adjusted odds ratio, 4.83; 95% CI, 1.10-21.18) compared with no pacifier use. Using pacifiers without antiseptic at 6 months was not associated with food allergy. Among pacifier users, antiseptic cleaning was still associated with food allergy (adjusted odds ratio, 3.56; 95% CI, 1.18-10.77) compared with no antiseptic use. Furthermore, persistent and repeated antiseptic use over the first 6 months was associated with higher food allergy risk (P= .029). This is the first report of a pacifier-antiseptic combination being associated with a higher risk of subsequent food allergy. Future work should investigate underlying biological pathways.

Malocclusion prevention through the usage of an orthodontic pacifier compared to a conventional pacifier: a systematic review.

This was to investigate the occurrence of malocclusion traits among children who were users of orthodontic or conventional pacifier by means of a systematic review. Search for articles involved five electronic databases: Latin American and Caribbean Health Sciences (LILACS), PsycINFO, PubMed (including MedLine), Scopus and Web of Science. Grey literature was partially assessed. Observational studies with children aged 6-60months who had used orthodontic or conventional pacifier were included. The risk of bias among included studies was assessed through the Joanna Briggs Institute Tool. From the 607 initially-identified papers only three were included after the selection process. All presented moderate risk of bias. Although an anterior open bite and accentuated overjet were identified among conventional users of pacifier in one study no differences were identified in the other two selected studies. Posterior crossbite frequency was not different in any of the included studies. There was also no difference regarding frequency and duration of use, except in the study that showed higher occurrence of open bite malocclusion in conventional pacifier users. The currently available evidence is insufficient to support the concept that the usage of orthodontic pacifiers is able to prevent malocclusion traits when compared to the usage of conventional pacifiers.

Factors associated with anterior open bite in children with developmental disabilities.

To investigate factors associated with anterior open bite in individuals aged from 2 to 33 years with developmental disabilities. This is a cross-sectional study. A total of 271 dental records were examined. The anterior open bite analyzed was determined based on clinic exam. These variables were also analyzed: gender, age, education level of mother, International Code of Diseases (ICD), mouth breathing, use of anticonvulsant drugs, hyperkinesis, pacifier use, thumb sucking, seizure, and involuntary movements. For the purposes of analysis, the individuals were categorized as being with and without anterior open bite. Variables with a p-value of < 0.25 in the bivariate analysis were incorporated into the logistic regression models. Mouth breathers had a 2.60-fold (95% CI: 1.35-5.01) greater chance of exhibiting anterior open bite than nasal breathers. Pacifier users are more likely to have an anterior open bite (3.32-fold, 95% CI: 1.62-6.77). Individuals with reported involuntary movements had a 2.66-fold (95% CI: 1.26-5.63) greater chance of exhibiting anterior open bite. Users of anticonvulsants drugs had a 3.05 (95% CI: 1.57-5.92) greater chance of showing anterior open bite. Involuntary movements, mouth breathing, using anticonvulsant drugs, and using pacifier are factors associated with anterior open bite in patients with developmental disabilities.

Children using Day Nurseries’ Facilities can be Associated with more Risk to Nonnutritive Sucking Habits

This study evaluated the expression of nonnutritive sucking habits and the presence of malocclusion in children using day nurseries' facilities. The 195 children (7-40 months) attending 18 public day nurseries were evaluated clinically in Ponta Grossa, Brazil. Statistical package software was used for descriptive, univariate, bivariate, and multiple logistic regressions of the data about the socioeconomic condition, educational family status, malocclusions, and prevalence of nonnutritive sucking habits among the children. The pacifier users had a statistically significant, explanatory association with open bite [odds ratio (OR) = 10.97; 95% confidence interval (CI): 4.95, 24.31; p < 0.0001]. The children older than 25 months had more open bite than younger children (OR = 6.07; 95% CI: 2.81, 13.11; p < 0.0001). Of the children examined, 35.4% had an anterior open bite, 0.51% had posterior cross-bite, and 1.03% showed finger-sucking habits. A high frequency of pacifier-sucking habits was found (52%), with a significant association between this habit and anterior open bite (p < 0.0001, OR = 7.49; 95% CI: 3.71, 15.15). The 126 children without open bite (36.5%) were pacifier users. There was suggestive, though nonsignificant, evidence of a difference in pacifier use by gender (males, 34%; females, 46%; p = 0.07). The 69 children with open bite (81.16%) were pacifier users and (18.84%) nonusers. The boys showed a slightly greater association with open bite (OR = 21.33; 95% CI: 6.12, 74.40; p < 0.0001) than girls (OR = 5.03; 95% CI: 1.26, 20.00; p = 0.02) in the age group of 25 to 40 months; however, it was not observed in younger children. Pacifier use is a predictor for open bite in children from the lower socioeconomic classes using day nurseries' facilities. The parents, guardians, and caregivers working in public day nurseries should be advised to monitor nonnutritive sucking habits in order to avoid or minimize the occurrence of malocclusion. It demonstrates that the permanence of the children in day nurseries may be linked with deleterious oral habits, and it discusses strategies to minimize the occurrence of alterations in the normal occlusion.

Pacifier Use, Finger Sucking, and Infant Sleep

Few studies to date have investigated the relationship between pacifier use or finger sucking and infant sleep. One hundred and four mothers of infants (ages 0–11 months) completed the Brief Infant Sleep Questionnaire (BISQ). Infants who engaged in finger sucking had fewer night wakings and longer stretches of nighttime sleep, although less daytime sleep. There were no significant differences in sleep patterns between pacifier users and infants who did not engage in nonnutritive sucking. Furthermore, no significant differences were found across groups for sleep ecology, including parental involvement at bedtime and following night wakings. Finally, infants were consistently able to retrieve their pacifiers independently by 7 months of age, although this did not appear to be associated with sleep outcomes. Results suggest that when parents are deciding whether to give their infant a pacifier, sleep may not be a critical factor. In contrast, parents of finger and thumb suckers should be reassured that this nonnutritive sucking is beneficial to sleep, at least in the first year of life.

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.

Sucking habits and anterior open bite among Venezuelan and Brazilian children

Culturally different population groups have distinct infant feeding practices, which presumably may be related to diverse occlusal features in the primary dentition. Aim: To investigate the associations between nutritive and non-nutritive sucking habits and the prevalence of anterior open bite, in children from Aragua-Venezuela and Sao Paulo-Brazil. Methods: Seven calibrated examiners (κ = 0.89-1.0) performed clinical assessments in Venezuelans (N = 809) and Brazilians (N = 1,377) aged 3-6 years. Sucking habits were investigated using questionnaires answered by the mothers. Data were analyzed using logistic regression models (α = 0.05). Results: Among 380 children with anterior open bite, 309 were Brazilians. Approximately 65% of Brazilians with pacifier-sucking habit lasting beyond 3 years of age had this malocclusion. Brazilians who prolonged pacifier and digit-sucking habits beyond 3 years of age have, respectively, 68.5 and 14.5 times more chances of presenting anterior open bite than children without sucking habits (p < 0.001). In Venezuelans with open bite, 37.7% had digit-sucking habits beyond 3 years of age, resulting in a high odds ratio (9.3; p < 0.001) when compared to children without this habit. No significant effect was found for bottle feeding. However, non-breastfed Venezuelan children or those breastfed for periods shorter than 6 months have a two-fold higher chance of presenting anterior open bite than children who were breastfed for longer periods, p = 0.008. Conclusions: Infant feeding had some effect on Venezuelan children, since insufficient breastfeeding was related to a higher prevalence of anterior open bite. Pacifier-sucking was more prevalent in Brazilians, corresponding to pronounced chances (8-68 times greater) of diagnosing anterior open bite in pacifier users compared to non-users. Among Venezuelans, on the other hand, digit-sucking effect surpassed that of pacifier use and was associated with far higher chances (6-9 times) for this malocclusion.

Using a pacifier to decrease sudden infant death syndrome: an emergency department educational intervention

Background. Pacifier use decreases the risk of sudden infant death syndrome (SIDS). An emergency department (ED) visit may provide an opportunistic ‘teachable moment’ for parents.Objectives. To test the hypotheses (1) that caregivers were less familiar with the role of pacifiers in sudden infant death (SIDS) prevention than other recommendations, and (2) that an ED educational intervention would increase pacifier use in infants younger than six months, and (3) that otitis media would not occur more frequently in pacifier users.Methods. We did an intervention-group-only longitudinal study in a county hospital ED. We measured pacifier use infants and baseline knowledge of SIDs prevention recommendations in caregivers. We followed up three months later to determine pacifier use, and 12 months later to determine episodes of otitis media.Results. We analyzed data for 780 infants. Parents knew of advice against co-sleeping in 469/780 (60%), smoking in 660/776 (85%), and prone sleeping in 613/780 (79%). Only 268/777 (35%) knew the recommendation to offer a pacifier at bedtime. At enrollment 449/780 (58%) did not use a pacifier. Of 210/338 infants aged less than 6 months followed up 41/112 (37%) non-users had started using a pacifier at bedtime (NNT 3). Over the same period, 37/98 (38%) users had discontinued their pacifier. Otitis media did not differ between users and non-users at 12 months.Conclusion. Caregiver knowledge of the role of pacifiers in SIDS prevention was less than for other recommendations. Our educational intervention appeared to increase pacifier use. Pacifier use was not associated with increased otitis media.

Feasibility of aerosol drug delivery to sleeping infants: a prospective observational study

ObjectivesDelivery of inhaled medications to infants is usually very demanding and is often associated with crying and mask rejection. It has been suggested that aerosol administration during sleep may be...

Honey Pacifier Use Among an Indigent Pediatric Population

Use of honey pacifiers by infants presenting to a pediatric clinic at a county hospital in Houston, Texas, was observed by several of our staff members. Although we could not find any published studies linking the use of honey pacifiers to infant botulism, we also could not find any studies assessing the prevalence of honey pacifier use in general. We conducted a cross-sectional, descriptive study using a novel survey that had 19 items. The survey was administered to the parents of children up to age 12 months presenting to a county hospital pediatric clinic for well-child care in Houston, Texas, from February 2010 to April 2011. There were 397 respondents. Approximately 11% of the respondents reported using honey pacifiers with their infant children. Reasons for use included tradition, infant preference, and perceived health benefits (eg, helps with constipation or colic). Approximately 20% of the honey pacifier users and 23% of the entire group reported knowledge of honey potentially causing an illness in children <12 months of age. Nearly 40% of all respondents also reported using herbal or folk remedies. Honey pacifier use was relatively common among this population, seen in ∼1 out of 10 respondents. A majority of the mothers surveyed (∼80%) were unaware of the potential dangers of giving honey to infants under age 12 months. Herbal medicine use was also common.

Do pacifiers increase the risk of nosocomial diarrhoea? A cohort study

DesignProspective cohort study.SettingTeaching paediatric hospital—Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Northeast Brazil.Participants378 of 536 infants admitted in paediatric wards from April to October 2009 were daily assessed...

Malocclusions and non-nutritive sucking habits: a preliminary study

Objective This study investigated the non-nutritive sucking habits in a sample of patients with malocclusions at the Unit of Pediatric Dentistry of the “Sapienza”, University of Rome. Materials and methods 81 children (average age 5.9 years) were examined from January to December 2008. All children showed typical malocclusions that could be associated with non-nutritive sucking habits (pacifier or finger). Increased overjet (OVJ), anterior openbite (OPB), and posterior crossbite (CRB) were recorded in this survey. A questionnaire was directed to parents. Results At the first examination 40.4% of pacifier users over 24 months were affected by an anterior OPB, 50% by a posterior CRB and 39.4% by an increased OVJ. Moreover, 40.4% of the children with finger or thumb sucking behavior were affected by an anterior OPB, 29.2% by a posterior CRB, and 42.4% by an increased OVJ. Conclusions No statistically significant associations could be detected between the non-nutritive sucking habits and the malocclusions. There was no difference in type of habit in children who presented an anterior OPB, while there was a higher prevalence rate of children with a posterior CRB who had sucked the pacifier and of children with increased OVJ who had sucked their finger.

Attitudes of Saudi mothers towards prolonged non-nutritive sucking habits in children.

The purpose of the present study was to evaluate Saudi mothers' attitude towards non-nutritive sucking habits by their children and report the methods they used to stop these habits. Across-sectional study involved 181 mothers of preschool children currently engaged in non-nutritive sucking habits (digit and pacifier) were studied. The information was obtained from a self-administered questionnaire completed by the mothers. The majority of mothers (69.1%) were from high socio-economic families, (77%) had university or higher education and more than half of them (58.6%) were employed. About 75% of the children were pacifier users, and 25% of them habitually sucked their digits. Nearly half of the mothers (43.5%) thought that the reason of acquiring the habit was because their children cried a lot at night. The majority of studied mothers (88.7%) considered sucking a harmful habit to their children' teeth, and 69.1% never accepted the sucking habit. High percentage (80.8%) of mothers tried to intervene with these habits and 61.0% of them tried their intervention when children were one year old or less. Most proposed reasons for mothers' intervention with sucking habits were their concerns that the habit might continue until the child become older (53.3%) followed by their concern that the habit might affect their children's permanent teeth (45.3%). The methods used by mothers were mostly non-invasive procedures which included restricting the use of pacifier to specific times in the day (63.0%), followed by reinforcement of positive behaviors and using rewards (26.0%). None of the mothers sought advice from pediatrician while only one mother (0.6%) consulted a dentist about sucking habits. This study shows that Saudi mothers are concerned about sucking habits and recognized the harmful effect on their children. These mothers, however, are in great need for education about ways of preventing the habits in the first place as well as professional advice and help in treatment cessation of already established habits.

Non-Nutritive Sucking Habits in Sleeping Infants

Background: Pacifier use has been postulated to decrease the risk of sudden infant death syndrome (SIDS). The responsible mechanisms are, however, unclear. Objectives: Since little is known about the non-nutritive sucking (NNS) habits of infants during sleep, we investigated NNS patterns and changes of physiological parameters during NNS in sleeping infants. Methods: Polygraphic recordings were performed in 12 infants with a median age of 55 days (range 7–82) who regularly used a pacifier during sleep. Episodes of active suckling (bursts) and quiescent periods were differentiated by video observations. We evaluated the time of suckling in relation to the total time of pacifier use, the median number of bursts per min, the median duration of single bursts and the median interval between 2 sequent bursts. In 48 randomly selected bursts, we additionally analyzed changes in heart rate, respiratory frequency and oxygen saturation compared to the 10-second period preceding the burst. Results: Median sleep time with a pacifier held in mouth was 31.3 min (13.0–117.6), of which 15.5% (6.4–36.7%) was spent with active suckling. The median number of bursts per min was 2.2 (1.2–4.5). The median duration of a burst was 3 s (1–22) and the median interval between 2 bursts was 10 s (1–1,434). Heart rate, respiratory frequency and oxygen saturation did not change significantly during suckling bursts. Conclusions: This pilot study presents important data for sucking habits in pacifier users which may provide a basis for further investigations concerning the efficacy of pacifiers in SIDS prophylaxis.

Use of a Fan During Sleep and the Risk of Sudden Infant Death Syndrome

To examine the relation between room ventilation during sleep and risk of sudden infant death syndrome (SIDS). Population-based case-control study. Eleven California counties. Mothers of 185 infants with a confirmed SIDS diagnosis and 312 randomly selected infants matched on county of residence, maternal race/ethnicity, and age. Intervention Fan use and open window during sleep. Main Outcome Measure Risk of SIDS. Fan use during sleep was associated with a 72% reduction in SIDS risk (adjusted odds ratio [AOR], 0.28; 95% confidence interval [CI], 0.10-0.77). The reduction in SIDS risk seemed more pronounced in adverse sleep environments. For example, fan use in warmer room temperatures was associated with a greater reduction in SIDS risk (AOR, 0.06; 95% CI, 0.01-0.52) compared with cooler room temperatures (0.77; 0.22-2.73). Similarly, the reduction associated with fan use was greater in infants placed in the prone or side sleep position (AOR, 0.14; 95% CI, 0.03-0.55) vs supine (0.84; 0.21-3.39). Fan use was associated with a greater reduction in SIDS risk in infants who shared a bed with an individual other than their parents (AOR, 0.15; 95% CI, 0.01-1.85) vs with a parent (0.40; 0.03-4.68). Finally, fan use was associated with reduced SIDS risk in infants not using pacifiers (AOR, 0.22; 95% CI, 0.07-0.69) but not in pacifier users (1.99; 0.16-24.4). Some differences in the effect of fan use on SIDS risk did not reach statistical significance. Fan use may be an effective intervention for further decreasing SIDS risk in infants in adverse sleep environments.

Pacifier use does not alter the frequency or duration of spontaneous arousals in sleeping infants

Objective It has been reported that pacifiers might reduce the risk of SIDS by favouring infants’ arousability from sleep. We evaluated the influence of a pacifier on the frequency and duration of spontaneous arousals in healthy infants. Methods Polygraphic recordings were performed in 14 infants with an age of 51.7 ± 19.9 days (means ± SD) who regularly used a pacifier during sleep. Cortical and subcortical arousals were scored according to the recommendations of the “International Paediatric Work Group on Arousals.” The number of arousals per 10-min-period and the duration of arousals were determined for periods of pacifier use as well as for periods after pacifier dislodgement and were compared with the data of 10 control infants (age 49.8 ± 16.5 days) who never used a pacifier. Results Altogether, 211 arousals in pacifier users and 225 arousals in non-users were scored. In pacifier users, 2.0 ± 1.6 arousals per 10-min-period with a duration of 12.2 ± 3.0 s occurred during pacifier use, and 1.7 ± 1.6 arousals per 10-min-period with a duration of 12.2 ± 3.1 s occurred during periods without pacifier. In pacifier non-users, 2.3 ± 1.2 arousals per 10-min-period (duration 13.9 ± 2.9 s) were scored. The results did not show a significant difference concerning frequency and duration of spontaneous arousals between pacifier users and non-users. Conclusions Our findings suggest that factors other than arousal mechanisms might be responsible for the efficacy of pacifiers in SIDS prophylaxis.