Mother breastfeeds her baby and affectionately holds its head

Study Summary

Effect of restricted pacifier use in breastfeeding term infants

Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding.

Jaafar SH, Ho JJ, Jahanfar S, Angolkar M

Cochrane Database of Syst Rev, 2016 Aug 30;(8):CD007202

Abstract

The study presents findings from the meta-analysis of two randomized controlled studies (total of 1302 breast-fed full-term infants). Only mothers who were highly motivated to breastfeed were included in the study.

The use of pacifiers in healthy infants, from birth or as soon as breastfeeding had become established, had no significant impact on the prevalence or term of exclusive or partial breastfeeding up to the age of four months. Until further information becomes available, mothers who are motivated to breastfeed should make their decision on pacifier use according to their personal preference. Further studies are required to assess the impact for mothers who place a lower priority on breastfeeding.

Background

In the guideline "Ten Steps for Successful Breastfeeding", the World Health Organization (WHO) was recommending, up to 2018*, that babies in their first six months of life should be fed exclusively on breast milk. To begin and maintain breastfeeding successfully, pacifiers or artificial nipples should be completely avoided. Data available at the time raised concerns that infants who use a pacifier suckle less frequently at the breast and the resulting reduced milk production could lead to a shorter breastfeeding term. The study "Effects of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding" investigated the extent to which this hypothesis applied. An analysis was therefore conducted on the effects of restricted and unrestricted pacifier use on the breastfeeding term.

Methods

In conducting this review, a search was made of the Cochrane Pregnancy and Childbirth Group's Trial Register (30.06.2016) and studies found were analyzed. Two randomized controlled studies with a total of 1302 full-term, healthy, breast-fed infants were included in the analysis.^1,2

Findings

For healthy full-term babies, the use of a pacifier has no significant impact on the prevalence or term of exclusive or partial breastfeeding up to the age of four months.
For mothers who were highly motivated to breastfeed, the success of breastfeeding was unaffected by whether the pacifier was introduced before or after breastfeeding began.
A meta-analysis that included 18 case-control studies showed a significantly reduced risk of SIDS (Sudden Infant Death Syndrome) when a pacifier was used.³
Until further information regarding the use of pacifiers in breastfed babies becomes available, mothers who are highly motivated to breastfeed should make their decision on pacifier use according to their personal preference.

MAM Service

You can find the complete study at: mambaby.com/professionals

¹Jenik AG, et al. J Pediatr 2009;155:350-4
²Kramer MS, et al. JAMA 2001;286:322-6
*Note: The WHO guideline has since been updated (2018): https://www.who.int/teams/nutrition-and-food-safety/food-and-nutrition-actions-in-health-systems/ten-steps-to-successful-breastfeeding (accessed on 01.10.21)
³Hauck FR, et al. Pediatrics 2005;116(5):e716-23