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BREASTFED BABIES AND PACIFIERS – GOOD, BAD, OR NECESSARY EVIL?

Pacifiers are practically the universal sign for babies. But moms want to know if breastfed babies and pacifiers are a good thing, or do pacifiers hurt breastfeeding? Which are the best pacifiers for breastfed babies?

Row of colorful pacifiers on a string

If you are a new mama, then you want to do the best thing for your baby. If you are a breastfeeding mom, then you want to avoid things that could interfere with breastfeeding.

Using a pacifier while breastfeeding is a little bit complicated. You may have heard they are bad. You may have heard they are good.

The whole topic of breastfed babies and pacifiers can be confusing.

I’ll try to clear things up so you can make an informed decision about giving a pacifier to your baby.

OTHER NAMES FOR PACIFIERS

Not everyone calls it a pacifier. There are other names, but it’s the same thing.

  • Binky
  • Paci
  • Dummy
  • Soother
  • Dodie
  • Comforter

DO PACIFIERS HURT BREASTFEEDING?

When I first became a lactation consultant, we provided new moms with two different pacifiers at the hospital where I worked. They were two very different shapes. I wondered which was the best pacifier for breastfed babies. Was one pacifier better than the other in relation to breastfeeding?

I am a research-loving kind of girl, so I started researching pacifiers and breastfeeding. I wanted to know what the scientific evidence said.

What the research at that time said was that babies who were given pacifiers didn’t breastfeed as long. A shorter duration of breastfeeding meant they were not exposed to the good things about breastfeeding for as long.

Many of the valuable things from breastfeeding are dose-dependent. That means that the more breast milk a baby gets over time, the better chance that she will experience those benefits.

Because of what I learned from my research, we stopped handing out pacifiers to every baby. We educated moms on the reasons they should not use a pacifier.

newborn baby in hospital bassinet

DO PACIFIERS HELP PREVENT SIDS?

Fast forward to 2005. Research came out that showed a decreased rate of SIDS when babies were given pacifiers at times of sleep (Source).

But we also know that breastfeeding reduces the rate of SIDS (Source). New moms were left asking, “Should I use a pacifier or not?”

To make that decision, you should look at the pros and cons of pacifiers. There has also been more recent research on how pacifiers can impact breastfeeding.

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PACIFIER PROS AND CONS

Pacifier

Benefits of Pacifiers

  • Pacifiers are associated with a lower risk of SIDS.
  • Pacifiers can calm a baby when a mom is unable to breastfeed
  • They are an important tool for calming babies in the NICU
  • Can help improve baby’s who are having difficulty sucking properly (Source)
  • Sucking on a pacifier can provide pain relief to a baby (Source)
  • Some babies can’t comfort nurse if their mother has an oversupply of milk. Using a pacifier helps them meet their sucking needs.

Pacifier Cons

  • Pacifier use has been associated with nipple soreness in the early stages of breastfeeding (Source).
  • An increased incidence of ear infections has been seen with babies who use pacifiers (Source).
  • Increases need for braces later on (Source)
  • Pacifiers can be germy (Source).

RECENT RESEARCH ON PACIFIERS FOR BREASTFED BABIES

The latest research has not shown that pacifier use affects the duration of breastfeeding or whether a mom exclusively breastfeeds(Source).

The reason for the conflicting research results from 25 years ago may be from increased education around the use of pacifiers and breastfeeding. There also has been increased emphasis on delaying the introduction of a pacifier until breastfeeding is going well.

It was thought that one of the reasons that pacifiers were found to result in decreased length of breastfeeding was that maybe moms who were struggling with breastfeeding were more likely to use a pacifier. In other words, the breastfeeding problems were causing the pacifier use, as opposed to using a pacifier was causing a problem for breastfeeding.

Another way that pacifiers can interfere with breastfeeding is that babies tell us they are hungry by oral cues.

  • Smacking their lips
  • Sticking out their tongue
  • Sucking on their hand
  • Opening and closing their mouth

If they are sucking on a pacifier, these cues can be missed. A baby can get very hungry, and if the first sign you notice that they want to eat is crying, they may have reached a disorganized state. This can make latching more difficult.

BABY sucking on her hand

Pacifiers used to be recommended to help with reflux symptoms. Research has not supported this (Source).

WHAT THE AMERICAN ACADEMY OF PEDIATRICS SAY ABOUT PACIFIERS

The current recommendation from the American Academy of Pediatrics states, “For breastfed infants, pacifier introduction should be delayed until breastfeeding is firmly established,” (Source).

Once breastfeeding is established, the AAP advises that a pacifier be offered at all times of sleep. That includes daytime naps and nighttime sleep.

DIFFERENT TYPES OF PACIFIERS

There are several different shapes for pacifiers.

STRAIGHT

The Phillips Avent Soothie Pacifier is an example of a straight pacifier.

FLAT

BLUE PACIFIER

ORTHODONTIC

PINK PACIFIER

BULB-SHAPED TIP

BLUE PACIFIER

BEST PACIFIER FOR BREASTFED BABIES

I have been unable to find any research that has looked at the effect of different pacifier shapes on breastfeeding.

To determine which pacifier was the best pacifier for breastfed babies, I consulted speech and occupational therapists. They make their decision based on what a baby should be doing with her tongue when sucking. The idea is that you want a baby to use their tongue the same way on a pacifier and bottle as they do when they breastfeed.

The pacifier for breastfeeding infants that they recommended is the Phillips Avent Soothie.

BENEFITS OF THE SOOTHIE PACIFIER

  • The Soothie has a straight nipple shape. This shape encourages a baby to curl his tongue around the pacifier.
  • One-piece construction. This is the safest because there are no small parts that can present a choking hazzard.
  • Made of silicone
  • Latex-free
  • BPA free
  • Dishwasher safe
  • Available in a variety of colors
  • There is a cute bear shape option
  • There’s also a cute version with a stuffed animal attached.
    • Giraffe
    • Elephant
    • Dog
    • Owl
    • Lion
    • Duckling

PACIFIER SHAPES TO AVOID FOR BREASTFEEDING BABIES

Orthodontic shaped pacifiers encourage babies to push their tongue against the flat part. If they do that when breastfeeding, it can cause soreness or push the nipple out of their mouth.

Our therapists also said that they saw issues in babies who had used these orthodontic shaped pacifiers when they were older.

  • When babies started solids, they had more feeding difficulties.
  • Speech problems
PINK PACIFIER

Flattened pacifiers encourage the baby to suck with a flat tongue. Sucking with a flat tongue is another thing that can cause breastfeeding problems.

BLUE PACIFIER

WHEN SHOULD YOU INTRODUCE A PACIFIER TO A BREASTFED BABY?

As I mentioned above, the AAP recommends that you want to get breastfeeding well established before introducing a pacifier to a breastfed baby.

I consider breastfeeding well established when:

  • Baby is back to birth weight
  • Baby is gaining at an average rate from breastfeeding alone
  • You are not having any nipple pain from breastfeeding
  • You are able to breastfeed without thinking about all the details.
    • You’re not consciously thinking about where your hands are or how you’re holding your breast.
    • You are not counting swallows because your baby is gaining plenty of weight
    • You get the idea. You are on autopilot when you breastfeed.

WHEN TO GIVE BREASTFED BABY PACIFIER

You want to offer your breastfed baby a pacifier whenever he is going to sleep. If he tends to fall asleep while breastfeeding, you do not need to pull him off the breast to put in the pacifier. When he comes off the breast slip the pacifier into his mouth.

If he lets the pacifier fall out after her falls asleep you do not have to put it back in (Source).

mother giving her baby a pacifier while he is in a crib

IS IT OKAY TO GIVE A NEWBORN A PACIFIER?

It’s best to avoid giving a newborn a pacifier.

Brand new babies want to suck a lot. It is how they help bring the milk in and stimulate a good milk supply. Frequent feeding also helps minimize newborn weight loss.

It is best to wait a few weeks before you introduce a pacifier to a baby. Wait until breastfeeding is going well.

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HOW TO AVOID PROBLEMS FROM USING A PACIFIER WHILE BREASTFEEDING

  • Do not use a pacifier to delay feedings
  • Do not use a pacifier to shorten feedings
  • Do not use a pacifier in place of a feeding
  • Limit pacifier use to sleep time. This will help when it is time to start baby weaning off pacifier use.

HOW TO GET A BREASTFED BABY TO TAKE A PACIFIER

Some parents are surprised to find out that not every breastfed baby will take a pacifier. I offered pacifiers to all three of my babies and none of them would take it. I had two thumb-suckers. The third one just wanted to breastfeed. He wasn’t a fan of bottles either.

If your baby doesn’t take the pacifier when you first offer it try again every few days. Putting some drops of your breast milk on it may make it more appealing for your baby.

Try offering it when your baby is sleepy. Another good time to try is right after a feeding.

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baby holding a pacifier

PACIFIER SAFETY

  • Pacifiers are not a DIY item. Only use pacifiers that are made to be used as pacifiers. Way back in the day people used to stuff bottle nipples with cotton and use them as a pacifier. This practice can be very dangerous.
  • One-piece pacifiers like the Soothie are the safest because there are not different pieces that can come apart.
  • Never tie a pacifier around a baby’s neck or wrist. This is a strangulation hazard.
  • Check pacifiers for signs of deterioration.
  • Use the correct age range that is recommended.
  • Wash them regularly.

WHEN TO WEAN OFF PACIFIER

In order to avoid some of the detrimental effects pacifiers can have on the teeth you will want to think about the best time for weaning baby off a pacifier.

The highest risk of SIDS is in the first six months. You will not want to wean your baby from the pacifier before this time. The AAP recommends weaning from pacifiers at a year.

It is not always as easy as deciding when to take away pacifier. Your baby may not agree with you about when to stop pacifier use. Try these strategies to help your baby with weaning from a pacifier.

  • Limit the times your little one can use the pacifier to sleep times.
  • There’s always weaning off the pacifier cold turkey. Make it disappear one day.
  • Use your ninja negotiating skills. Offer something else in place of the pacifier. You could offer a toy or a special treat.
  • Depending on your child’s age, a sticker chart can be motivating for some kids.
  • A friend of mine cut her toddler’s pacifier in half and said it was broken.

FINAL THOUGHTS ON BREASTFED BABIES AND PACIFIERS

Pacifiers do have some benefits.

By waiting until breastfeeding is established and limiting their use to sleep time they should not interfere with breastfeeding.

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