By Kelly Bonyata, BS, IBCLC
- When can I begin using a pacifier?
- What should I consider before using a pacifier?
- When to avoid the pacifier
- Can pacifiers help prevent SIDS?
- In conclusion...
- Links.......
| When can I begin using a pacifier? |
It is recommended that pacifiers and other types of artificial nipples be avoided for at least the first 3-4 weeks. I'd personally suggest that most breastfed babies - if they get a pacifier at all - would be better off without a pacifier until mom's milk supply is well established (6-8 weeks, usually) and the 6 week growth spurt is over. That way you've established a good milk supply and don't lose any much-needed breast stimulation to a pacifier.
| What should I consider before using a pacifier? |
After the early weeks, pacifier use is less likely to cause problems as long as you are aware of the following:
- Never substitute a pacifier for a feeding at the breast or try to hold the baby off longer between feedings with one. (See Should baby be on a schedule?)
- There are studies that indicate that babies who take a pacifier tend to wean earlier than those who do not. This is most likely because as a baby gets older - once he's established on solid food - it is often his desire to suck that ensures he continues to seek out the breast often. Babies who use pacifiers are getting that need to suck met with something other than the breast, and therefore may decide to give up breastfeeding sooner than if they did not take a pacifier.
- Some babies who take pacifiers are more prone to oral yeast (thrush) which can be transferred to mom's nipples.
- A number of studies have shown a link between pacifier use and an increased incidence of ear infections.
- Pacifiers can result in choking or strangulation if the pacifier breaks or if it is tied around the neck (which it never should be). Follow all safety guidelines and keep an eye out for the many pacifier safety recalls. Also, keep in mind that latex allergy is becoming an increasing problem - consider using a silicone pacifier rather than latex.
- Prolonged pacifier use can result in teeth misalignment, and can also occasionally lead to shaping of the soft palate or speech problems.
- Giving baby a pacifier will increase mom's chances of ovulating and getting pregnant. Exclusive breastfeeding, depending upon your breastfeeding frequency and other factors, is a method of birth control that can be more than 98% effective during the first 6 months and 94% effective during the second six months. Ensuring that all of baby's sucking needs are met at the breast increases the effectiveness of this method of contraception.
| When to avoid the pacifier |
If you observe any of the following problems, it would be a good idea to discontinue pacifier use, at least until the problem is resolved:
- Pacifier use reduces your baby's frequency or duration of feeds (newborns should be nursing at least 8 to 12 times a day).
- Baby is having difficulties nursing well (this may be due to nipple confusion).
- Baby is having problems with weight gain (in which case baby needs to nurse as often as possible).
- Mom is having problems with sore nipples (baby may be causing this due to nipple confusion)
- Mom is having milk supply problems (in which case she needs to put baby to breast, not pacifier, at every opportunity in order to increase milk supply).
- Mom and/or baby have thrush, particularly if it's hard to get rid of or repeated.
- Baby is having repeated ear infections (an increased incidence of ear infections has been linked to pacifier use).
| Can pacifiers help prevent SIDS? |
Have you heard in the news that pacifier use might help to prevent SIDS? Here's what the American Academy of Pediatrics says about this in their March 2000 Policy Statement Changing Concepts of Sudden Infant Death Syndrome: Implications for Infant Sleeping Environment and Sleep Position:
Four recent studies have reported a substantially lower SIDS incidence among infants who used pacifiers than among infants who do not. Although this association has been strong and consistent, it does not prove that pacifier use prevents SIDS. Mechanisms by which pacifiers might protect against SIDS have been proposed, such as stinting of the upper airway, but data are lacking to demonstrate that any of them are relevant to SIDS. Conversely, other studies have demonstrated that pacifier use can be linked to a shortened duration of breastfeeding, increased susceptibility to otitis media, and increased dental malocclusion. The Task Force believes that additional outcome studies are required before a specific recommendation about pacifiers can be made.
| In conclusion... |
As long as you keep the above in mind and only use a pacifier sparingly, it is up to you whether and when you wish to comfort baby yourself or with a pacifier. However, keep in mind that there is no scientific evidence that suggests that babies have a need to suck independant of the need for food. When a baby is indicating a sucking need, it's generally best that baby be encouraged to nurse, especially if there is a weight gain concern. The breast was the first pacifier and in most cases remains the best.
