Pacifiers for Breastfeeding Ok

Pacifier use may help breastfeeding rates and prevent increases in formula supplementation

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Breast is best… but what about pacifiers? It's commonly been thought that giving a baby a pacifier might cause problems with breastfeeding.

In fact, one of the 10 steps to successful breastfeeding promoted by the World Health Organization and United Nation's Children's Fund includes withholding pacifiers from breastfeeding babies in hospitals.

But a recent study casts doubt on the validity of that line of thought.

"Pacifiers are okay for breastfeeding babies."

Lead researcher Laura Kair. MD, a pediatric resident at Doernbecher Children's Hospital at Oregon Health & Science University (OHSU) and colleagues wanted to find out whether taking away pacifiers from babies in the hospital might increase the rate of exclusive breastfeeding among infants.

They studied 2,249 babies born in the OHSU hospital between June 2010 and August 2011, nothing whether each baby was breastfed, formula fed or both.

In December of 2010, a hospital policy started that instructed nurses and doctors in the mother-baby unit (postpartum department) not to offer pacifiers to babies who were breastfeeding.

Pacifiers were locked up and those that were offered by nurses had to be "signed out" with information that explained the reason for offering it, such as soothing a baby during a painful procedure.

This policy was part of the hospital's plan to become a "Baby-Friendly Hospital," which means they follow the ten guidelines put out by the WHO and UN Children's Fund.

Kair and colleagues then compared feeding data before and after the new policy was implemented.

They found that 79 percent of babies exclusively breastfed from July to November of 2010 while pacifiers were routinely distributed to all babies.

This percentage dropped to 68 percent for the period of January to August of 2011 - during which times the percentage of breastfeeding babies that received supplemental formula increased from 18 percent to 28 percent.

Over the entire year, the percentage of formula-fed babies increased slightly from 1.8 percent to 3.4 percent.

"Despite the common belief among medical providers and the general public that pacifier use negatively impacts breastfeeding, we found limiting pacifier availability in the mother-baby unit to be associated with decreased exclusive breastfeeding and increased supplemental formula feeds," the authors wrote in their conclusion.

Dr. Kair added that her team hopes to increase discussion about whether enough evidence exists to continue promoting that breastfed babies not have pacifiers, whose use has also been linked to lower rates of Sudden Infant Death Syndrome (SIDS).

"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," Dr. Kair said.

"This subject poses an additional dilemma for parents and pediatric providers as pacifier use is associated with a decreased risk of SIDS, and the AAP recommends using a pacifier for sleep after breastfeeding is established," she said.

The study was presented April 29 at the Pediatric Academic Societies annual meeting in Boston. Information regarding the funding or potential conflicts of interest was unavailable.

The study has not yet been published in a peer-reviewed journal, which means other scientists have not had a chance to review the methods and data to ensure it passes their quality standards.

Reviewed by: 
Review Date: 
April 30, 2012
Last Updated:
April 30, 2012