pacifiers and preemies

[RN4BABES]

The odd time, we get parents who refuse to allow their prem to suck on a soother. Generally, the nurses in our unit feel that our babies are stressed enough in here and we believe the comfort they receive from sucking on a soother far outweighs any possible "outcomes" of possible "nipple confusion" down the road. How to deal with the parent? What policies/guidelines/tips, if any, does anyone have?

[ukstudent]

Why is nobody talking about the HUGE reduction in SIDs with the use of pacifiers. A whopping 90% reduction. Also nonnutritive sucking is required for optimal gut development.

[Gompers, BSN, RN]

I'm going to add that to, "IQ or eye sight".

Tell me about it! These new oxygen guidelines are making it almost impossible to keep a baby from desatting all the time. Trying to keep their sats around 85-90%, it doesn't take much before they are dipping into the 70's on a regular basis. What good is great eyesight when a baby develops PVL due to constant ischemia?

[justjenny]

Would anyone consider it unethical to give a paci to a baby whose parents had requested it not be used? It seems like such a small thing, but I do understand the concept of the slippery slope.

I truly believe that any parent requesting no pacifiers does not fully understand their use in an NICU environment. I can argue both ways....as a young mother I stressed about some of the same things our parents do (my baby was never in the NICU - but even parents with big, fat, healthy full term babies struggle with "nipple confusion" stories and books providing outdated information) I agree with other posters that education is truly what is needed in these situations. There are very few ways that we can comfort an infant during lab draws, etc. so I believe that it is NOT unethical because I am advocating for my patient. There is no slippery slope because we are using evidence based practice to provide developmentally appropriate care for these babies....what is unethical is telling the parents one thing (oooh, we won't use a pacifier if you don't want us to) and then doing another "behind their backs".

Jenny