Why do pacifiers/dummies have a protective effect in sudden infant death Syndrome? A new hypothesis

IF 2.1 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Medical hypotheses Pub Date : 2024-11-01 DOI:10.1016/j.mehy.2024.111517
Paul N. Goldwater
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Abstract

The American Academy of Pediatrics recommends pacifier/dummy use to help prevent sudden infant death syndrome (SIDS). This recommendation is based on studies that have shown pacifier use reduces the risk of SIDS even under conditions regarded as increasing the risk of SIDS. Several unrelated mechanistic explanations have been used to explain this. These prior suggested mechanisms purported to underly the observed protective effect of pacifiers have not proven satisfactory and highlight the need for a more plausible explanation. Pacifier use is associated with increased salivary production. Saliva contains numerous antibacterial compounds that could provide a protective effect against bacterial colonisation. Infection is considered a key player in SIDS pathogenesis given that most SIDS risk factors relate to or align with infection, whereas mainstream research focusses on central homeostatic control of breathing, arousal and heart function. These, however, lack association with risk factors. Given infection is significant in the SIDS story, the increased production and antibacterial effect of saliva could provide an alternative mechanism worthy of consideration in the context of known preventable risk factors in the drive to reach a better understanding of SIDS pathogenesis and further decrease the incidence of SIDS.
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为什么奶嘴/奶嘴对婴儿猝死综合症有保护作用?一个新的假设
美国儿科学会建议使用安抚奶嘴/奶嘴来帮助预防婴儿猝死综合症(SIDS)。这项建议的依据是,有研究表明,即使在被认为会增加婴儿猝死综合症风险的条件下,使用安抚奶嘴也能降低婴儿猝死综合症的风险。有几种不相关的机制被用来解释这种情况。这些先前提出的机制被认为是所观察到的安抚奶嘴保护作用的基础,但事实证明这些机制并不令人满意,因此需要更合理的解释。使用安抚奶嘴与唾液分泌增加有关。唾液中含有多种抗菌化合物,可对细菌定植起到保护作用。感染被认为是婴儿猝死综合症发病机制中的关键因素,因为婴儿猝死综合症的大多数风险因素都与感染有关或相一致,而主流研究则侧重于呼吸、唤醒和心脏功能的中枢稳态控制。然而,这些因素与风险因素缺乏关联。鉴于感染在婴儿猝死综合症中的重要性,唾液分泌的增加和抗菌作用可能提供了另一种值得考虑的机制,结合已知的可预防风险因素,从而更好地了解婴儿猝死综合症的发病机理,进一步降低婴儿猝死综合症的发病率。
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来源期刊
Medical hypotheses
Medical hypotheses 医学-医学:研究与实验
CiteScore
10.60
自引率
2.10%
发文量
167
审稿时长
60 days
期刊介绍: Medical Hypotheses is a forum for ideas in medicine and related biomedical sciences. It will publish interesting and important theoretical papers that foster the diversity and debate upon which the scientific process thrives. The Aims and Scope of Medical Hypotheses are no different now from what was proposed by the founder of the journal, the late Dr David Horrobin. In his introduction to the first issue of the Journal, he asks ''what sorts of papers will be published in Medical Hypotheses? and goes on to answer ''Medical Hypotheses will publish papers which describe theories, ideas which have a great deal of observational support and some hypotheses where experimental support is yet fragmentary''. (Horrobin DF, 1975 Ideas in Biomedical Science: Reasons for the foundation of Medical Hypotheses. Medical Hypotheses Volume 1, Issue 1, January-February 1975, Pages 1-2.). Medical Hypotheses was therefore launched, and still exists today, to give novel, radical new ideas and speculations in medicine open-minded consideration, opening the field to radical hypotheses which would be rejected by most conventional journals. Papers in Medical Hypotheses take a standard scientific form in terms of style, structure and referencing. The journal therefore constitutes a bridge between cutting-edge theory and the mainstream of medical and scientific communication, which ideas must eventually enter if they are to be critiqued and tested against observations.
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