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  • Adrienne Koznek, IBCLC

What About Pacifiers?!


As a lactation expert (and by extension, a person who works with babies), I get asked about pacifiers quite often. Unsurprisingly, the answer is not so black and white.

So what's the big deal?

First, there is my "professional party line" about pacifiers - generally artificial nipples should be avoided until breastfeeding is established. There are a few reasons why, which I will discuss.

Then there is the parenting reality - pacifiers are a parenting gadget. And, like most parenting gadgets, they have their benefits and their risks. Here's the thing - overall, from a professional standpoint, I'm conservative with my recommendations about pacifiers, but I'm also a hypocrite because my own child used one (even before breastfeeding was established). Because life happens and we all do the best we can with the resources we have.

First things first - "nipple confusion" is not a thing. Babies are not confused about what is in their mouth. Second - baby is not "using mom as a pacifier" but rather doing their biologically normal behavior of being fed and also soothing themselves via nursing. There is nothing wrong with the baby who comfort nurses. Often, breastfeeding is about more than milk.

BUT - here is where reality can sometimes set in. Pacifiers can certainly be a useful tool for the baby who has breastfed well (as in, had a full feed and your breasts feel softer) but still wants to nurse for comfort and you need to get them in the Ergo, cook dinner, fold laundry, etc etc. Babies need to suck, and parents need to meet both their baby's and their own needs.

What are potential risks of pacifier usage? Dental malocclusion is a real thing, for one. Will this happen if a baby has some pacifier usage for a few months? Perhaps not. But this is something to consider when using a pacifier. What I'm most concerned with when it comes to offering a pacifier, however, is the potential for missing feeding cues and thus inadvertently lowering parent's milk supply. For example, it may make sense to give a newborn a pacifier when they wake up and are a little fussy, but in all likelihood, that newborn needs to eat when they awaken. Missed feedings = missed message to the body about making milk.

The American Academy of Pediatrics recommends pacifiers as a means of reducing SIDS, which is of course a wonderful thing. Guess what else is protective against SIDS? Breastfeeding! That's why nursing at night is great!

In summary, take the advice that resonates with you and leave the rest. I got stressed out pulling research just to write this piece and I'm not a sleep-deprived first time parent to a newborn who is learning everything as they go!

Will giving a pacifier destroy a breastfeeding relationship? Probably not. But be sure to consider appropriate timing and usage.

#parenting #pacifiers #breastfeeding

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