Methodist Health System Services

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Breastfeeding and Pacifier Use

Pacifiers are not recommended while establishing breastfeeding.

For successful breastfeeding, it is better if your baby begins by learning and practicing only the unique style of sucking that draws milk from the breast.

Different Sucking Styles

To understand why pacifiers are not recommended when you begin breastfeeding, you need to know a little about nature and anatomy.

Your baby was born pre-programmed to learn to suckle the breast, and the way your baby sucks changes when he or she switches from your breast to the artificial nipple of a pacifier or bottle.

Breast

To correctly latch on, the baby opens his or her mouth wide, lowers the tongue over the bottom lip and coordinates tongue and jaw movements to draw the full nipple and pigmented areas around the nipple to the top and back of the mouth. Baby's strong rhythmic sucking draws milk from the breast.

Artificial nipple

Much less effort and coordination are required to feed from a bottle or suck on a pacifier. The baby must open his or her mouth only slightly. The mouth, tongue and jaw need not form as tight a seal. Little sucking is required, and the baby may develop a "lips-only" sucking style.

Prevent Nipple confusion

If you offer pacifiers or bottles in the first few weeks, your baby may confuse these very different sucking styles and not learn to latch on and breastfeed successfully. This is called "nipple confusion", and it creates problems for you and your baby.

Your baby may suck ineffectively, unable to empty the breasts for best nutrition. The reduced stimulation and inadequate emptying will decrease your milk production, and your baby's attempts to suck only the end of the nipples will create nipple soreness for you. You may also miss important feeding cues if your baby's mouth is busy with a pacifier , resulting in reduced milk intake and inadequate nutrition.

Avoid pacifier-related problems

Research shows that giving a pacifier to a breastfed baby before breastfeeding is established increases the risk of:
  • poor weight gain
  • dehydration
  • jaundice
  • plugged milk ducts
  • engorgement
  • mastitis
  • early weaning
  • increased ear infection
  • increased oral thrush and other infections

View comfortable positions to hold your baby breastfeeding, and view a diagram of successful latch-on by a breastfeeding baby.


After breastfeeding is established

Offer a sleep-time pacifier - after breastfeeding is established.

The American Academy of Pediatrics recommends the use of a pacifier at your baby's sleep times after breastfeeding is established, typically after your baby is one month old.  Studies indicate a protective effect of breastfeeding and the use of a pacifier to reduce the baby's risk for Sudden Infant Death Syndrome(SIDS). Offer a pacifier at sleep time only - not in place of food, comfort or playtime.

Instead of a pacifier for fussiness, try these things

Resist the temptation to reach for a pacifier when your newborn is fussy. There are many ways to calm a baby, including these:
  • breastfeed
  • change the diaper
  • cuddle the baby
  • place the baby skin-to-skin on your chest
  • swaddle the baby
  • sing or talk to the baby
  • play soft music
  • add or remove clothing
  • walk or rock the baby
  • place the baby in a swing
  • pat, stroke or massage the baby
  • and remember to never shake a baby!


Babies use 40 muscles to breastfeed and only 4 muscles to bottle-feed.