Modified Pacifier Brings Great Comfort to Tiny Patients

When Dr. Harriet Miller began working as a nurse in the neonatal intensive care unit (NICU) at the Winnie Palmer Hospital for Women and Babies in Orlando, Florida, she saw babies who were scared, stressed, and desperately in need of comfort.

When babies cry, parents often reach for a pacifier. But Miller found that her patients couldn’t use one.

Premature babies have difficulty breathing, so tubes are placed in their throats connecting them to a mechanical respirator. These tubes leave little room in tiny mouths for anything else. Put a pacifier in and it just falls out, making stressed babies even more frustrated.

“They were upset, they were crying but you couldn’t hear them cry because they were intubated,” Miller said. “It was just heartbreaking for me to see them. “

So Miller took out her bandage scissors and modified the pacifier, cutting a notch on the side so the tube fit alongside it. Her simple design not only made babies calmer, it significantly helped their recovery because they could channel their delicate resources from crying into healing.

“These babies don’t have a lot of excess energy that they can waste,” Miller said. “They’re trying to fight infections. They’re struggling to breathe. They don’t have a lot of tolerance for pain. They don’t have great reserves.”

In a study conducted at Orlando Health’s Center for Nursing Research, Miller saw heart rates drop, pain index decrease, and oxygen saturation rise in babies using the modified pacifier.

Today, several companies manufacture Miller’s pacifier design, and the invention has become the standard of care in NICUs across the country.

But Miller says the modified pacifier could be helping more infants. She is asking the Academy of Neonatal Nursing to make the pacifiers available anywhere they’re needed.

“I’ve been meeting with all these different groups to facilitate the use of these pacifiers,” she said. “It’s easy. It doesn’t require any kind of medication; it doesn’t require a doctor’s order or anything like that. It’s just a comfort measure for the baby.”

Other uses for the modified pacifier include use when transporting intubated babies by ambulance or helicopter or when soothing them during painful procedures.

“They don’t have to be premature babies that can use these pacifiers,” Miller said. “They just have to be intubated. Cardiac ICUs also have babies. They are not premature but they have heart conditions and they’re on mechanical ventilators. They weren’t using these pacifiers because they didn’t even know about them.”