title: The effects of dummy/pacifier use on infant blood pressure and autonomic activity during sleep.
abstract: BACKGROUND
  Dummy/pacifier use is protective for sudden infant death syndrome (SIDS); however, the mechanism/s for this are unknown. As impaired cardiovascular control may be the underlying cause of SIDS, we assessed the effects of dummy/pacifier use on cardiovascular control during sleep within the first 6 months of life.
  
  
  METHODS
  Term infants, divided into dummy/pacifier users and non-dummy/pacifier users, were studied at 2-4 weeks (n = 27), 2-3 months (n = 35) and 5-6 months (n = 31) using daytime polysomnography. Heart rate, blood pressure (BP), heart rate variability (HRV), blood pressure variability (BPV), and baroreflex sensitivity (BRS) were measured in triplicate 1-2-min epochs during quiet and active sleep in the supine and prone positions.
  
  
  RESULTS
  Overall, during the non-sucking periods, in the prone position, the BP was higher (10-22 mmHg) in dummy/pacifier users compared to non-users at 2-4 weeks and 5-6 months (p < 0.05 for both). HRV and BRS were higher in dummy/pacifier users compared to non-users at 2-4 weeks (p < 0.05). Active sucking increased HRV and BPV, consistent with increased sympathetic activity in dummy/pacifier users.
  
  
  CONCLUSIONS
  Higher BP and HRV in dummy/pacifier users indicate increased sympathetic tone, which may serve as a protective mechanism against possible hypotension leading to SIDS; however, these effects were not apparent at 2-3 months, when the risk of SIDS is highest.
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Victoria, Australia.
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Yiallourou
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Victoria, Australia.
authors.forename: Hannah
authors.initials: H
authors.lastname: Poole
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Victoria, Australia.
authors.forename: Pallavi
authors.initials: P
authors.lastname: Prathivadi
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Victoria, Australia.
authors.forename: Alexsandria
authors.initials: A
authors.lastname: Odoi
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Victoria, Australia; Monash Newborn, Monash Medical Centre, Melbourne, Victoria, Australia; Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
authors.forename: Flora Y
authors.initials: FY
authors.lastname: Wong
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Victoria, Australia; Department of Paediatrics, Monash University, Melbourne, Victoria, Australia. Electronic address: rosemary.horne@monash.edu.
authors.forename: Rosemary S C
authors.initials: RS
authors.lastname: Horne
mesh_terms: D017704:Baroreflex / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D041361:Pacifiers / Q000009:adverse effects; D017286:Polysomnography; D016684:Prone Position / Q000502:physiology; D012890:Sleep / Q000502:physiology*; D013398:Sudden Infant Death / Q000209:etiology
keywords: Autonomic control; Blood pressure; Dummy/pacifier; Heart rate; Infant; Sudden infant death syndrome