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Do pacifiers impact breast-feeding?

MONDAY, April 30, 2012 (Health.com) — Pacifiers can soothe agitated infants, but some experts—including those at the World Health Organization (WHO)—discourage pacifier use in the first six months of life because of concerns that it may interfere with breast-feeding, widely seen as the best way to feed a newborn.

New research, however, casts doubt on the notion that pacifier use disrupts breast-feeding. In an analysis of feeding patterns among 2,249 infants in a single maternity ward over a 15-month period, researchers found the proportion of infants who were exclusively breast-fed dropped from 79% to 68% after pacifier use was restricted in the ward.

Meanwhile, the proportion of infants who needed formula in addition to breast-feeding jumped from 18% to 28% after the change in policy, according to the preliminary results of the study, which were presented today at the annual meeting of the Pediatric Academic Societies, in Boston.

“We were surprised—even disappointed—to find that our exclusive breast-feeding rates went down and supplemental formula feedings went up,” says Carrie Phillipi, M.D., senior author of the study and an associate professor of pediatrics at Oregon Health & Science University (OHSU), in Portland.

The conventional wisdom is that pacifier use creates “nipple confusion” in newborns, says Pete Richel, M.D., Chief, Pediatrics Dept at Northern Westchester Hospital, in Mt. Kisco, N.Y., who was not involved with the study.

The theory is that infants suckle their mother’s nipple differently than they do a bottle or pacifier, and may have difficulty latching on to the mother if they’re given too much exposure to artificial nipples.

In addition, the body produces breast milk according to demand, so frequently giving infants a pacifier may in some cases compromise the mother’s milk supply, Phillipi says.

Prohibiting the use of pacifiers and artificial nipples is one of the 10 steps for encouraging breast-feeding that hospitals in the United States must take to earn a “baby-friendly” designation from the WHO and the United Nations Children’s Fund (UNICEF).

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