Pacifiers OK For Breastfeeding Infants
May 1, 2012

Pacifiers OK For Breastfeeding Infants

Connie K. Ho for

When Beyoncé first had her baby, the media went wild over her decision to breastfeed in public. Following that breastfeeding incident, breastfeeding is again in the news; however, it´s in relation to a new medical study rather than a celebrity happening. An experiment by physicians at Oregon Health and Science University (OHSU) challenges the perspective that pacifiers interfere with breastfeeding.

The study, presented Monday, April 30 at the annual meeting of the Pediatric Academic Societies in Boston, found that limiting pacifier use increased an infant´s consumption of formula during hospitalization.

“We were really surprised and disappointed because we had hoped that limiting pacifiers would improve breast-feeding rates,” commented Dr. Carrie Phillipi, an associate professor of pediatrics at OHSU and co-author of the study, in an interview with Time magazine.

Breastfeeding was originally promoted because it was thought to help infants have fewer illnesses; reduce risk of asthma, certain cancers, and obesity; as well as help mothers lose post-pregnancy weight. The American Academy of Pediatrics (AAP) recommended that mothers solely breastfeed children six months after birth. The World Health Organization (WHO) and the United Nations Children´s Fund (UNICEF) also promoted breastfeeding with the Ten Steps to Successful Breastfeeding. Medical centers that followed the 10 steps were qualified to be named as Baby-Friendly Hospitals by WHO.

"The primary reason for WHO's policy on pacifiers is the potential for interference with suckling and establishing lactation," noted Dr. Chessa Lutter, a senior advisor for the Pan American Health Organization/World Health Organization, in a Today Show segment. "There is some evidence to suggest that giving pacifiers or bottle nipples can interfere with suckling and getting a good latch on. It's very important that the baby be able to properly latch on, which evolves over baby´s first week of life. Establishing a good suck is extremely important for the mother as well, so her own nipple isn´t irritated or damaged."

In December 2010, OHSU, which had been working to be named a Baby-Friendly Hospital, created a new policy that stated that pacifiers were to only be given to newborns for special circumstances like for treatment following painful procedures. With this policy in place, Dr. Laura Kair and Dr. Carrie Phillipi implemented a project to see if eliminating pacifier distribution would increase exclusive breastfeeding. Findings between June 2010 and August 2011 actually showed that the rate of exclusive breastfeeding decreased and that the number of infants receiving formula increased.

"There is a great deal of energy nationally as well as internationally in support of increasing the number of Baby-Friendly Hospitals," remarked Kair, pediatric resident at OHSU Doernbecher Children's Hospital, in a prepared statement. "Taken together, the 10 steps improve exclusive breastfeeding rates in the hospital. However, the effect of pacifier use on initiation and duration of exclusive breastfeeding has not been well-established in the medical literature.”

The researchers believe that there should be discussion regarding the pacifiers, as the findings prove to be different from information that was previously publicized by organizations like the AAP and WHO.

"Our goal with publicizing this data is to stimulate conversation and scientific inquiry about whether there is sufficient evidence to support the universal recommendation of not offering pacifiers to breastfeeding infants in the first few days to weeks of life," Kair continued. "This subject poses an additional dilemma for parents and pediatric providers as pacifier use is associated with a decreased risk of sudden infant death syndrome (SIDS), and the AAP recommends using a pacifier for sleep after breastfeeding is established."