July 17, 2001 -- One of the things a new baby loves to do is cry. Many new moms, including those who are breastfeeding, are quick to give a pacifier to a fussy or crying baby. Yet, some small studies have suggested that pacifier use during breastfeeding can lead to early weaning by causing nipple confusion. In fact, the World Health Organization and the United Nations Children's Fund strongly discourage the use of pacifiers.
Now Canadian researchers, in a new study in the July 18 Journal of the American Medical Association, tried to settle the issue once and for all by determining whether pacifier use actually causes early weaning.
The researchers followed almost 300 breastfeeding women and their infants for three months. Some women in the study were counseled to avoid pacifier use and instead comfort their infant by breastfeeding, rocking, and carrying when he or she fusses, while the others just received information on breast-feeding without an emphasis on limiting pacifier use.
The researchers found that those counseled about pacifier use were more likely to avoid pacifiers, less likely to use pacifiers daily, and less likely to use a pacifier often during a given day. Overall, mothers who used pacifiers breastfed for less time. But, the researchers were unable to prove that pacifier use is a true cause of early weaning.
"Pacifier use can be an [indicator] that breast feeding is not going well," says study author Luisa Ciofani, MSc, IBCLC, a clinical nurse specialist at McGill University Health Center in Montreal. Pacifier use could also possibly indicate reduced motivation to breastfeed, Ciofani and her colleagues conclude.
Interestingly, the researchers also found that other methods of soothing an infant such as breastfeeding, rocking, or carrying seem to work as well as pacifier use.
So what's a mom to do?
That's a personal decision, experts tell WebMD.
"Pacifiers are engrained in peoples minds, " says Ciofani. "If you sent any mother to the store to buy five items, I am sure she would buy a pacifier."
But Ciofani encourages the natural approach: "Save your money. Don't buy formulas. Don't buy pacifiers. Breastfeed your baby.
"Breastfed babies have less allergies, less infectious disease such as ear infections, diarrhea, respiratory problems, less likely to be obese as children," she says. "Breastfeeding is also a benefit for the health of mothers. Their weight returns to normal sooner and some research suggests moms who breastfeed are less likely to develop breast or other cancers."
The bottom line, she says, is that pacifiers "won't enhance anything."
Yet other experts tell WebMD pacifiers won't do any harm so if they comfort your child, its OK to let them use one.
"I encourage parents to let kids suck a thumb or pacifier if the kid is interested in that," says Alan Greene, MD, assistant professor of pediatrics at Stanford University.
And that's good news for moms, because if you check out WebMD's parenting message boards, it becomes quickly apparent that many mothers are very pro-pacifier.
Still, Greene says he teaches parents early on to try out various methods of soothing to see what their newborn responds to whether it be rocking, singing, swaddling, or whispering.
"I go on at length about the benefits of breastfeeding and how healthy and helpful breast milk is for kids, but I also explain to them that all kids are built with a need for non-nutritive sucking," he says.
"I have never seen people who are motivated to breastfeed where it stops because of pacifier use," Greene says.
Kenneth Cohen, MD, a pediatrician at South Florida Pediatric Partners in Pembroke Pines, says he is neutral on the whole pacifier issue.
"I usually tell parents not to introduce a pacifier during the first month and after that babies will get an idea about nutritive nipples and non-nutritive nipples," he says. But if a child is still sucking on a pacifier at age 2, it's time to start cutting back on it's use.