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Do pacifiers cause problems with breastfeeding? Letting go of binky fear.

When my son was five days old, I was in a panic over whether to give him a pacifier to satisfy what felt like his around-the-clock sucking proclivity. My carefully crafted birth plan for the hospital had banished all variety of artificial nipples. And my trusted breastfeeding book, as well as the emergency band of lactation consultants I called, said to wait two to four weeks “until breastfeeding is well-established.”

Then again there were all those swaddled baby bundles in the nursery chomping away happily on their pacifiers, and I had plenty of friends with the attitude that using paci didn’t make a drop of difference one way or another.

It turns out my friends were right.

I’m not the first or the last mom to break a sweat over whether sucking on a silicone nubby will confuse a breastfeeding baby or decrease a mom’s milk supply. In fact, the World Heath Organization lists, as one of its 10 steps to successful breastfeeding, “no artificial nipples.” But over and over, research shows that babies know the difference, and pacifiers don’t derail the budding nursing relationship between mother and newborn.

In April of this year, for example, Cochrane Reviews published a review of two randomized, controlled studies, including 1300 full-term, breastfeeding infants, and found that whether the baby had a pacifier did not affect the existence or duration of partial or exclusive breastfeeding, regardless of when it was introduced (even in the hospital). Another study from the University of Virginia School of Medicine looked at 29 studies on the subject and found no difference in breastfeeding outcomes.

That artificial nipples confuse babies is a misconception, plain and simple. Pacifiers get a bad rap because they’re associated with bottle-feeding (which can indeed confuse some babies early on and, if mom isn’t pumping while baby is feeding, can decrease her milk supply). Interestingly, the University of Virginia review found that when studies use rigorous scientific methods – randomly assigning babies to binky and binky-free groups, for example – pacifiers are exculpated completely. But when studies use “observational” methods, which are based on perception and usually a small sample, they often do find that pacifiers disrupt breastfeeding. In other words the skeptical stance on pacifiers has more to do with people’s feelings toward them, not fact.

Babies have a biological drive to suck. And they know the difference between non-nutritive sucking for comfort and when it’s feeding time. In the end, whether to use a pacifier with a newborn is just a blip on the screen that moms (like myself) get worked up about but doesn’t mean anything in the long run.

In the hospital I had an idealistic, do-it-all-myself mentality – using a pacifier felt like it would be cheating. Little did I know, a little cheating is a good thing. We weren’t meant to care for our babies all on our own, and I know now to take help where I can get it. If I were to do it over again, I’d offer my baby a pacifier as early as I felt like it and not worry about giving it up until his first birthday (I got rid of my son’s when he was five months so that he learned to sleep without it – he transferred his affection to his lovie). But looking around at babies nuzzled in their seats or their parent’s arms, they look so content with their pacifiers. Why would we want to take that away from them?

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