Intervention: Survey on Evidence statement Grade D: It is not possible pacifier use and knowledge of Findings: Analyzed data for 780 infants. Parents knew of advice against co-sleeping to draw a conclusion on the effectiveness of the SIDS prevention followed by in 469/780 (60%), smoking in 660/776 (85%), and prone sleeping in 613/780 intervention education intervention where (79%). Only 268/777 (35%) knew the recommendation to offer a pacifier at a research assistant discussed bedtime. At enrolment 449/780 (58%) did not use a pacifier. Of 210/338 infants Author’s conclusions: Parental knowledge of the SIDS prevention with aged less than 6 months followed up 41/112 (37%) non-users had started using a role of pacifiers in SIDS prevention was modest and caregivers by explaining the pacifier at bedtime (NNT 3). Over the same period, 37/98 (38%) users had much less than for other recommendations. contents of a printed one discontinued their pacifier. Otitis media did not differ between users and non-users Starting a pacifier prior to hospital discharge after page brochure at 12 months. birth was associated with greater use and lower discontinuation rates in the following year. Our Outcome: Pacifier use in broadly targeted ED-based educational intervention children aged under six was labour intensive but appeared successful in months increasing pacifier use. Pacifier use was not associated with increased otitis media. Study Population: Caregivers of 780 babies Comment: An uncontrolled before and after study under 12 months of age is not a robust design for testing an intervention. attending the emergency The study design means that a causal link between department in a county the intervention and the increase in pacifier use teaching hospital serving a cannot be established. Conducted in a single US mixed urban, suburban and state, predominantly single mother households may rural population in California, not generalise to UK/Wales setting. Impact of USA. interventions on SIDS rate not addressed. Because of the rarity of this intervention the number needed Date: Conducted between to treat (NNT) to prevent one case of SIDS would 26/11/2008 and 1/8/2011 be 8199
Intervention: Survey on pacifier use and knowledge of SIDS prevention followed by education intervention where a research assistant discussed SIDS prevention with caregivers by explaining the contents of a printed one page brochure Outcome: Pacifier use in children aged under six months Study Population: Caregivers of 780 babies under 12 months of age attending the emergency department in a county teaching hospital serving a mixed urban, suburban and rural population in California, USA. Date: Conducted between 26/11/2008 and 1/8/2011 Findings: 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 enrolment 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. Evidence statement Grade D: It is not possible to draw a conclusion on the effectiveness of the intervention Author’s conclusions: Parental knowledge of the role of pacifiers in SIDS prevention was modest and much less than for other recommendations. Starting a pacifier prior to hospital discharge after birth was associated with greater use and lower discontinuation rates in the following year. Our broadly targeted ED-based educational intervention was labour intensive but appeared successful in increasing pacifier use. Pacifier use was not associated with increased otitis media. Comment: An uncontrolled before and after study is not a robust design for testing an intervention. The study design means that a causal link between the intervention and the increase in pacifier use cannot be established. Conducted in a single US state, predominantly single mother households may not generalise to UK/Wales setting. Impact of interventions on SIDS rate not addressed. Because of the rarity of this intervention the number needed to treat (NNT) to prevent one case of SIDS would be 8199
CDR%20Research%20Evidence%20Review%20SUID%20report%20FINAL%20091014.docx