Sudden Infant Death Clinical Trial
Official title:
Influence of Pacifiers on Breastfeeding Duration: a Multicentre, Randomised Controlled Trial
The purpose of this study is to determine if the introduction of pacifier use to infants at 2 weeks of age, once breast feedings are well established, will affect the incidence and duration of successful breastfeedings.
The incidence of Sudden infant death syndrome in developing countries is comparable with
that of developed countries. Two important risk factors with implications for prevention are
prone sleeping position and the association with smoke. Also, breastfeeding has been
reported to be protective against SIDS.
In accordance with WHO/UNICEF recommendations, lactation consultants and other health
professionals within "Baby-Friendly" institutions typically discourage the use of pacifiers
in breastfed infants. The recent American Academy of Pediatrics policy statement, however,
recommends pacifier use, during periods of sleep as a potential method to reduce the risk of
SIDS. Previous observational studies had been unanimous in reporting an approximate doubling
of the risk of early weaning with daily pacifier use. However, randomized controlled trials
in developed countries, have not shown that giving pacifiers results in shorter
breastfeeding duration, except when pacifiers are given in the first 5 days. It has
therefore been seen that practically every author of a major study on the association
between breastfeeding and pacifier use has proposed that the question can only be fully and
completely answered by randomized studies. To date there are no large randomized studies
evaluating the influence of pacifier use on breastfeeding duration.
Our Primary outcome is to compare the prevalence of exclusive breastfeeding at three months
in infants between groups randomised to pacifier and no pacifier exposure once
breastfeedings have been fully established.
Second outcome: to evaluate the effects of the pacifier's introduction when breastfeeding is
firmly established at 15 days on the duration of breastfeeding.
Recruitment to the trial will take place in several public and private hospitals.
Those mothers who do not show a strong preference in regards to the introduction of the
pacifier, will be randomised during the postpartum visit at 2 weeks (if well established
breastfeeding is present) on two arms:
1. No pacifier,
2. Pacifier introduced at 15 days.
Structured telephone interviews will be conducted at 1, 2, 3, 4, 5, and 6 months and every
60 days thereafter until the breastfeeding has ended to record breastfeeding duration and
type (exclusive or not) and pacifier use.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor)
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