Pacifiers

The routine use of pacifiers is linked to early weaning.  The link is very clear.  But it isn’t known whether mothers who are having trouble are more likely to turn to pacifiers, or whether the pacifiers themselves are the problem. 

Pacifiers are linked to sucking problems, especially if they are used during the first few days.  Again, it isn’t clear whether they cause the problems, or whether mothers whose babies are already having trouble are more likely to use a pacifier.  But both these links do make it clear that if you feel breastfeeding isn’t going well, it makes more sense to look for skilled help than to start using a pacifier.

Pacifiers are linked to a lower milk intake at the time of greatest brain growth.  For the newborn who needs very frequent meals, and for the baby who isn’t growing well, this can be a serious problem.  The baby who needs to suck is usually looking for calories.  Giving a pacifier is like giving sugarless gum to someone who is trying to double his weight in a few months.  Spacing feedings is done for the mother’s convenience or to maintain her idea of “normal” feeding intervals, not for the baby’s well-being.

Pacifiers are linked to an increase in ear infections and thrush among babies in daycare.  Interestingly, the action of using a pacifier seems to be at least part of the problem, not just the cleanliness of the pacifier itself.

The American Academy of Pediatrics recommends that pacifiers, if used, be introduced only after breastfeeding is well-established.

UNICEF and the World Health Organization will not certify as Baby-Friendly any birth facility that routinely gives out pacifiers.  There are more than 20,000 certified Baby-Friendly facilities world-wide.  There are fewer than 75 in the United States and Canada.

“Letting a baby use you as a pacifier” is a normal nursing pattern.  Thereis no evidence to support limiting a baby’s time at the breast; there is considerable evidence that babies should not be limited.  However, if a baby seems to nurse all the time, with a frantic need to suck, a breastfeeding specialist should look at his breastfeeding effectiveness.  Babies who want to suck usually want food. 

Pacifiers were linked in one study to a lower IQ.  There is only one study that has made this connection, but the implication is that routinely “buying a baby off” with a pacifier, instead of meeting his need for stimulation and interaction, may slow down his mental development.

Latex pacifiers have been linked to latex allergies.  In a world in which latex allergies are increasing, it makes sense to look for a silicone (clear) pacifier if one is used, and to avoid putting other latex items in a baby’s mouth.                                                   

Pacifier use during tube-feedings is linked to improved weight gain in premies, although sucking on a softened breast is preferable.  Sucking during tube feeding releases digestive hormones, allowing a premature infant to absorb more from his food and gain weight more easily. 

Pacifier design does not appear to matter.  Although various companies market “orthodontic” or “exercise” pacifiers,there is no research to support one design over another for a baby with a  normal suck.  A clean finger is probably best, because it’s attached to a real person.  And a larger finger or adult thumb may make more sense, because babies are normally wide-mouthed at a breast.

Extended pacifier use is linked to problems in oral development.  Children's jaws don’t develop as broad an arch as they do with a normal year or more of no-gadget breastfeeding, resulting in an increased need for orthodontia and increased difficulty in nose breathing.

Nighttime sucking is good for babies.  Normally, of course, this means breastfeeding.  If your baby uses a pacifier instead during naps and night, you may increase his risk of SIDS by taking it away from him during his first year.

Babies with pacifiers don’t smile.  There’s no formal research, but you can check this one for yourself at any shopping mall.  Watch how babies with and without pacifiers relate to their surroundings.  Watch how adults relate to the babies.  Which babies smile?  When do adults smile at them and interact with them? 

What happens when the normal three-way interaction of sucking and calories and loving touch is disrupted with a pacifier?  We still know only some of the answers. 

Should they be as common as they are?

©2006 Diane Wiessinger, MS, IBCLC  www.normalfed.com