Reasons for Pacifier Use and Non-Use in African-Americans: Does Knowledge of Reduced SIDS Risk Change Parents' Minds?

J Immigr Minor Health. 2016 Apr;18(2):402-10. doi: 10.1007/s10903-015-0206-0.


To investigate African-American parental reasons for pacifier use or non-use, and whether knowledge of the association with decreased SIDS risk changes decisions about pacifier use. We conducted focus groups and individual interviews with mothers. Grounded theory methodology was used. 83 mothers participated; 72.3 % of infants used pacifiers. Reasons for pacifier use included comfort/soothing, safety/SIDS, and preference over digit-sucking. Reasons for pacifier non-use included infant refusal, fear of attachment, nipple confusion, and germs. Many parents were unaware that pacifier use reduces SIDS risk; however, most parents of non-users did not think that this knowledge would have changed their decision. Reasons included skepticism about the pacifier-SIDS link. Many reasons underlie African-American parental decisions about pacifier use. Providers should provide information about the benefits of pacifiers. Establishing for parents any plausible link between the protective mechanism of pacifiers and SIDS pathophysiology may be important in promoting pacifier use.

Keywords: Decision-making; Nipple confusion; Pacifier; Parental decision; Racial disparity; SIDS; Thumb sucking.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • African Americans / psychology
  • African Americans / statistics & numerical data*
  • Cross-Sectional Studies
  • Decision Making
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice / ethnology*
  • Humans
  • Infant
  • Infant Care / standards
  • Infant Care / trends
  • Infant, Newborn
  • Interviews as Topic
  • Male
  • Mother-Child Relations / ethnology
  • Mothers / psychology*
  • Pacifiers / statistics & numerical data*
  • Retrospective Studies
  • Risk Assessment
  • Risk Reduction Behavior
  • Socioeconomic Factors
  • Sudden Infant Death / prevention & control*
  • Young Adult