How does pacifier prevent sids

Campaigns to promote sleeping on the back have cut the incidence of SIDS significantly. But pacifier use showed benefits no matter the baby's age, how it slept and even if its mother smoked during or after pregnancy, according to the research, published online by the British Medical Journal.

The study adds to a growing body of evidence that pacifier use cuts SIDS risk, though the causes of the disorder and how pacifiers help protect against it remain poorly understood. Although some experts have suggested that the simple act of sucking on a pacifier may be helping to correct minor developmental deficiencies in the babies, Li believes it is much simpler. Myths persist that the use of pacifiers or thumb sucking will affect tooth development or the infant's ability to take to breast-feeding, but by simply waiting a few weeks to start using a pacifier and stopping when the baby becomes a toddler such impacts can be avoided, Li notes.

As a result, he and his colleagues unequivocally recommend pacifier use, particularly for babies whose habits or families put them at high risk. Follow David Biello on Twitter. Already a subscriber? Sign in. The association between pacifier use and reduced incidence of SIDS has been shown in multiple case-control studies. The mechanism by which pacifiers may provide protection is unclear, but does not appear related to changes in sleep architecture.

Whether or not to use pacifiers in breastfed infants has been a volatile subject for many years. A large RCT of pacifier use in breastfed infants showed that offering a pacifier at 15 days of age does not reduce the prevalence or duration of breastfeeding.

E-mail: stephen. Hauck FR, et al. Do pacifiers reduce the risk of sudden infant death syndrome? A meta-analysis. Vennemann MM, et al. Hanzer M, et al. Pacifier use does not alter the frequency or duration of spontaneous arousals in sleeping infants.

Sleep Med. Jenik AG, et al. Does the recommendation to use a pacifier influence the prevalence of breastfeeding? J Pediatr. The changing concept of sudden infant death syndrome: diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk.

The intent of our article on the risks and benefits of pacifiers was not to suggest that the pacifier is a better method of SIDS prevention. Rather, our intent was to report that a thorough literature review of the risks and benefits of the pacifier, which included the guidelines from the AAP and the Canadian Paediatric Society, revealed an association between pacifier use and SIDS reduction. On the contrary, the AAP guideline states that breastfeeding should be promoted for many reasons, yet there is insufficient evidence for recommending it as a SIDS reduction strategy.

In regard to concerns about the effect of pacifier use on breastfeeding, a recent systematic review 4 reported no adverse relationship based on the higher quality studies, confirming results of an earlier study suggesting the pacifier is more likely a marker for breastfeeding difficulties.

Guidelines recommend the pacifier as an option for SIDS prevention to be used with other proven methods, and recent studies show there is likely no direct negative effect of the pacifier on breastfeeding. Therefore, we should not discourage pacifier use, but instead discuss all of the benefits and risks with our patients. Me5 cells have gap junctions that form somato-somatic synapses among small groups of neurons [ 16 , 17 ].

Each neuron is almost entirely covered with processes that radiate from two or more astrocytes usually astrocytes cover more neurons [ 17 ]. The peripheral branches of mesencephalic trigeminal nucleus neurons mainly innervate mechanoreceptors in the periodontal ligament. These receptors are remarkably sensitive to movement of elevator muscles in the jaw; they are activated by a simple touch of the teeth, only a very small force is needed 1N and 4N in the anterior teeth and posterior teeth, respectively [ 18 - 20 ].

Moreover, Me5 periodontal mechanoreceptors of may "fire" in the absence of stimuli [ 21 ]. The central branches go to the motor trigeminal nucleus, reticular parvocellular area, and dorsolateral midbrain RF dorsal raphe nucleus [DRN] and lateral dorsal nucleus of the tegmentum [LDT] [ 22 ].

Passing through the large neurons of the nucleus Probst, located ventrally to the solitary tract, they reach the hypoglossal nucleus, trigeminal main sensory and caudate nucleus, solitary nucleus, and eventually the supra-trigeminal nucleus [ 24 - 26 ]. The nerve cells of the midbrain's RF, in particular those of the DRN and LDT, both directly and through the thalamus, send widespread aspecific projections to the entire cortex and form part of the ascending reticular activator system ARAS.

The Me5 provides glutamatergic signaling to Mo5 via its large pseudo-unipolar neurons and GABAergic signaling from its small Me5c neurons Figure 1 [ 27 , 28 ]. A newborn baby does not distinguish between day and night, and the hour neonate sleep rhythm [ 29 ] is independent of the environment and governed only by internal needs like hunger and thirst. Acetylcholine, dopamine, histamine, serotonin, and orexin production decrease, and there is inhibition of the parasympathetic nuclei and LC, which provides norepinephrine to sympathetic preganglionic spinal neurons.

When GABA reaches its target cells, they are inhibited because the membrane potential difference is highly negative following chloride entry. This inhibition prevents the release of neurotransmitters and the activity of critical proteins e.

Therefore, autopsy findings of infants with SIDS will likely exhibit deficient levels of these proteins. Their deficiency is likely an effect of SIDS rather than a cause. At a certain point during sleep, when the GABA level has increased and many cells are inhibited, an intrinsic mechanism of the brainstem is activated.

The Me5 is largely comprised of pseudo-unipolar cells, but its caudal termination Me5c consists of small multipolar cells that are typically GABAergic. Since they are located just across from the Mo5, they are normally inhibited under rest conditions. The masticatory muscles contract, and the teeth touch, which activates the Me5 and causes it to release glutamate onto ARAS nuclei, the PAG and parasympathetic nuclei.

The net result is attenuation of the inhibitory effects of GABA. Under these conditions, certain nerve cells die and activate glial cells that release IL1 beta and prostaglandins that increase substance P levels. These events are likely frequent but rarely end with a fatal outcome; however, they can affect infant development and possibly lead to extreme weakness of the "brainstem system," with many nuclei and cells that do not function properly.

In this scenario, a baby could have a high "sensitivity" to numerous factors that are normally non-lethal but could become so due to the weakness of the system at that time e.