“The pacifier, a non-nutritive sucking device, which is given in an attempt to provide comfort and to stop crying. Its use has been documented since 1000 B.C. Infants have a biological need to suck, which includes non-nutritive sucking (NNS) on fingers, thumbs, and pacifiers. NNS is considered normal for infants and it often starts in the womb. The prevalence of NNS in a society depends on ethnic and social-economic factors and childcare practices…” (1).
Pacifiers appear to be a staple part of newborn care in many cultures and countries and are often thought to be harmless or even necessary. “…observational studies suggest that early infant exposure to a pacifier may interfere with breast milk production and lead to early discontinuation of breastfeeding by three to six months… perhaps due to less frequent episodes of breastfeeding, ineffective sucking on the breasts which may lead to increased breastfeeding difficulty and thus decreased maternal motivation to breastfeed,” (1).
In a large study (2249 infants) in Oregon, USA, report an interesting finding: “Restricting pacifier distribution during the newborn hospitalization without also restricting access to formula was associated with decreased exclusive breastfeeding, increased supplemental formula feeding, and increased exclusive formula feeding… this observation occurred in the absence of accompanying restriction of formula to medical necessity [only] and without provision of scripted information on infant soothing,” (2).
This is yet the additional emphasis on the need to apply all the steps of the Ten Steps to Successful Breastfeeding. Taking individual steps out of context complicates the goal of exclusive breastfeeding. “WHO and UNICEF recommend that children initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first 6 months of life – meaning no other foods or liquids are provided, including water. Infants should be breastfed on demand – that is as often as the child wants, day and night. No bottles, teats or pacifiers should be used. From the age of 6 months, children should begin eating safe and adequate complementary foods while continuing to breastfeed for up to 2 years and beyond,” (3).
Do your local birthing facilities pass out pacifiers freely to the birthing families? Is evidence-based teaching also provided? What can you do to make positive changes in those facilities? Thanks for promoting and supporting breastfeeding!
Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA CHC
Professional Development Educator
1. Jaafar, S.H., Ho, J.J., Jahanfar, S., and Angolkar, M. (2016). Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding (Review). Cochrand Database of Systematic Reviews; Issue 8, Art. No. CD007202. DOI: 10.1002/14651858.CD007202.pub4.
2. Kair, L.R., Kenron, D., Etheredge, K., Jaffe, A.C., and Phillipi, C.A. (2016). Pacifier restriction and exclusive breastfeeding. Pediatrics; 131(4): e1101-e1107.
3. WHO UNICEF. Recommendations. Retrieved 8/1/20 from https://www.who.int/health-topics/breastfeeding#tab=tab_2
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