Pacifiers Do Not Interfere with Established Breastfeeding

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Nursing mothers are often discouraged from offering their newborns a pacifier due to a concern that it will lead to early termination of breastfeeding. A number of organizations, including the World Health Organization and the Academy of Pediatrics, warn that offering a pacifier in the first month of life will interfere with the quantity of milk a mother makes in the long-term. An analysis of the latest research however finds that pacifier use, even when allowed at birth, did not interfere with successful breastfeeding in two studies that included over 1,000 new, highly-motivated nursing mothers.

Mothers Should Make Personal Decision on Pacifier Use, Says Physician

The review, which is published in The Cochrane Library, pooled information which included one large group of 1,021 mothers who were already breastfeeding at two weeks and a smaller group of 281 mothers recruited before they began breastfeeding. In both groups, the women were assigned to either a group that received counseling to offer pacifiers to comfort a crying infant or a group that avoided pacifier use.

The researchers found that pacifier use made no significant difference in the proportion of babies who were still exclusively or partially breastfeeding at three months and at four months. The results were the same whether pacifier use was allowed from birth or initiated after breastfeeding had been established.

Read: The Complete Book of Breastfeeding, an Update to the Classic Guide

“We recommend that until further information becomes available… mothers who are well motivated to breastfeed be enabled to make a decision on the use of a pacifier based on personal preference,” the review authors concluded. Dr. Jacqueline Ho MD does, however, encourage new moms to find alternative methods to pacifiers first due to the absence of data on long-term health and development.

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Dr. Lori Feldman-Winter, a professor of Pediatrics at Cooper University Hospital, finds that the review lacks in data on short-term impact as well, such as whether pacifiers compromise the baby’s ability to suckle properly, which can lead to cracked nipples and mastitis for the mother.

Dr. Ho says that future research should be conducted to extend pacifier trials to six months, the recommended minimum duration of breastfeeding recommended by WHO. She also would like more research on mothers with lower motivation for breastfeeding and an assessment on the influence of pacifier use on health and development.

Read: Hospitals Encouraged to Promote Breastfeeding

The AAP recommends the use of a pacifier, after one month of age when breastfeeding is firmly established, due to evidence that suggests it may be protective against Sudden Infant Death Syndrome (SIDS). The group offers the following guidelines for parents:

• The pacifier should be used when putting the baby to sleep, but should not be reinserted once the baby falls asleep. If the baby refuses the pacifier, he or she should not be forced to take it.
• Pacifiers should not be coated in anything sweet.
• Pacifiers should be cleaned often and replaced regularly.

Journal Reference:
Jaafar SH, et al. Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database of Systematic Reviews 2011, Issue 3. Source: Health Behavior News Service

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