Our key message with the use of dummy is if using one, do so consistently. If you choose to use a dummy then you should provide this for baby at every sleep time – for naps and at night.
Research shows that dummy use has a protective effect of the incidence of SUDI, especially when cases where a dummy was used for the last sleep are examined. Dummies appear to help keep the airway open although the actual mechanism for how they protect babies is not clear. One theory is that sucking a dummy helps regulate the autonomic control that regulates the cardiovascular system when a baby is sleeping. This appears to be the case even in babies who suck a dummy until asleep and then the dummy falls out. Although it is not clear why, it seems that the protective effect continues for these babies throughout their sleep time, even when the dummy is not in place.
One clear message from research shows that infants who died from SUDI often routinely used a dummy but did not for their last sleep. It suggests that is a baby uses a dummy they should be offered this for all sleeps.
If a baby is not being breastfed a dummy can be offered as son as parents wish to do so if this is their choice.
There is some controversy on dummy use and whether it has a detrimental effect on breastfeeding. Evidence suggests that introducing a dummy after 1 week has shown no detrimental effect on breastfeeding. In the UK the general advice is that if you are breastfeeding and wish to use a dummy, you should wait until breastfeeding is well established (some organisations take this to be at around 4 weeks.).
Some observational research studies have shown an association between dummy use and reduced breastfeeding duration, although a recent study, called a Cochrane review (a systematic review of the research conducted to date and deemed the highest standard in evidence-based studies) showed no effect on breastfeeding rates for fully or partially breastfed infants at 3 and 4 months of age using a dummy compared to non-dummy users).
The link between shortened duration of breastfeeding and dummy use is likely to be due to several factors rather than dummy use alone. Some women find breastfeeding difficult and decide to stop. Other women stop because they are weaning their baby.
If a baby is using a dummy there are some basic steps to ensure it is being used correctly and safely:
You should never force a baby to take a dummy, or put it back in if the baby spits it out.
The dummy should be offered for every period of sleep, including daytime naps.
If the dummy falls out while your baby is sleeping, do not wake the baby up to put it back in. However, if the baby wakes up, you should offer the dummy again.
If your baby was premature, a dummy may have been given before breast-feeding had started. You should continue to follow your doctors’ advice on this.
Don’t use a neck cord, and never coat a dummy in anything sweet.
It is recommended that dummies are stopped between 6 and 12 months.
The Evidence For Our Safe Sleep Message On Dummy Use
Multiple case control studies and 2 meta analyses have shown that dummy use has a protective effect.
The use of a dummy for all sleep times could reduce the risk of SUDI in a range from 50% – 90%.
Dummy’s protect babies in several ways – keeping their airways clear and helping maintain their cardiovascular regulatory system when sleeping.
Dummy use has not been shown to adversely affect breastfeeding rates.