Effect of pacifier use on oral breathing in healthy newborn infants

Francesco Cozzi, Francesco Morini, Claudio Tozzi, Enea Bonci, Denis A. Cozzi

Research output: Contribution to journalArticle

Abstract

We tested the hypothesis that the use of a pacifier may affect the ability of some term infants to maintain effective oral breathing during prolonged nasal occlusion. Three nasal occlusion tests without a pacifier and 3 with a pacifier were alternately carried out in 20 healthy term infants (age 2-5 days). Once the infant commenced oral breathing, nasal occlusion was continued for up to 90 sec (prolonged nasal occlusion), provided the infant did not start crying and that arterial oxygen saturation (SaO2) did not drop to ≤ 80%. The response to nasal occlusion was considered maladaptive if oral breathing was accomplished with signs of upper airway obstruction. After nasal occlusion, the infants succeeded in starting oral breathing in all instances after a delay which was strongly correlated to the drop in SaO2 (P <0.001). Once the infants commenced oral breathing, 17/20 infants presented a maladaptive response to 62% of all tests without pacifier, whereas 10/20 infants presented a maladaptive response to 30% of all tests with a pacifier in place (P <0.001). Following prolonged nasal occlusion, 18 of 19 infants presented a maladaptive response to 84% of all tests without pacifier, whereas 12 of 19 infants presented a maladaptive response to 41% of all tests with a pacifier in place (P <0.001). Thus, after prolonged nasal occlusion with or without pacifier, the drop in mean SaO2 from baseline values changed in accordance with an appropriate and maladaptive response (-4 ±1 vs. -7 ± 1; P <0.001). We conclude that normal term infants often present with a maladaptive response to prolonged nasal occlusion. The use of a pacifier enhances the infant's ability to maintain a more adequate oral air flow.

Original languageEnglish
Pages (from-to)368-373
Number of pages6
JournalPediatric Pulmonology
Volume33
Issue number5
DOIs
Publication statusPublished - 2002

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Keywords

  • Dummy
  • Hypoxemia
  • Mouth breathing
  • Nasal occlusion
  • Obligatory nasal breathing
  • Pacifier
  • SIDS
  • Sleep apnea
  • Upper airway obstruction
  • Upper airway resistance

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

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