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The Baby Friendly Hospital Initiative recommends that breastfeeding
newborns not be given pacifiers or dummies while in the hospital after
birth.
See
The ten steps to successful breastfeeding.
Newborns who need to suck should practice suckling at the breast and
the more frequent suckling at the breast will increase prolactin
production which will increase breast milk production.
Is the use of
pacifiers harmful to breastfeeding?
A number of studies of mothers and infants in various countries have
attempted to answer this question. Three studies observed mothers and
infants from birth and monitored pacifier use until 6 months, 1 year
or until breastfeeding ended. These studies were performed in Brazil,
New Zealand, and the United States respectively. The results of all
three studies were similar. Daily pacifier use starting before 4-6
weeks of age was associated in all three studies with a shortened
duration of full breastfeeding (breastfeeding with infrequent use of
water, small amounts of juice or tastes of food). Daily pacifier use
was also associated with decreased maternal confidence in
breastfeeding and concern about poor milk supply.
(
Howard, 2003
,
Victora, 1997
,
Vogel, 2001
).
Kramer and associates in Canada randomized a group of 281 women to
breastfeeding support (control group) or breastfeeding support and the
recommendation of avoidance of pacifier use and the use of alternative
means of comforting a crying or fussing infant (experimental group).
The mothers in the experimental group had decreased pacifier use 61%
versus 84% in the control group. Daily pacifier use was also
decreased in the experimental group 41% compared to 56% in the control
group. There was no difference between the two groups in exclusive
breastfeeding at 3 months (36% in the experimental group and 34% in
control group) or in discontinuation of breastfeeding at 3 months (19%
in the experimental group versus 18% in the control group). However,
when Kramer analyzed the data as an observational study, mothers who
used a pacifier daily had increased weaning at 3 months of age (25%
versus 13%) (
Kramer, 2001
).
The results of these 4 studies all show that early pacifier use is
associated with a shorter duration of breastfeeding. Whether early
pacifier use is a cause or is only a marker for mothers who are having
difficulty with breastfeeding, have decreased confidence in their
ability to breastfeed, or desire a short duration of breastfeeding is
unknown. Pacifier use beginning after 4 weeks of age does not seem to
be associated with a shorter duration of breastfeeding. Mothers who
want to breastfeed should avoid giving a pacifier to their baby until
breastfeeding is well established or until the baby is about 4 weeks
of age.
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