Pacifier use has no effect on breastfeeding duration

Use of pacifiers does not interfere with breastfeeding up to age 4 months, according to a systematic Cochrane review.

The effect of pacifiers on the duration of breastfeeding has been controversial, with some observation evidence and data from a cohort study suggesting that early pacifier use shortens the duration of exclusive breastfeeding, whereas other evidence suggests no effect or a potentially positive effect of pacifier use on breastfeeding duration.

In addition, the World Health Organization advises against the use of pacifiers for breastfeeding infants.

In an attempt to resolve this controversy, researchers examined data from 2 randomized, controlled trials involving 1,302 healthy full-term newborns from mothers who were highly motivated to breastfeed.

Pooled data from the 2 studies revealed no significant difference between pacifier use and no pacifier use in the proportion of babies who were still exclusively or partially breastfeed at both 3 months and 4 months. The finding did not change according to the timing of pacifier introduction, either before or after lactation was established.

Among the concerns about pacifier use is that expression of milk from the breast may be compromised if infants’ suckling techniques are developed by pacifier suckling, which is short and fast and requires minimal effort, rather than suckling on the breast, which requires a wide-open mouth and slow and deep sucks.

Although the researchers recommend that mothers who are well motivated to breastfeed should make a decision on the use of a pacifier based on personal preference, they also advocate further research to assess short-term breastfeeding difficulties faced by mothers and long-term effect of pacifiers on mothers’ and infants’ health.

Jaafar SH, Jahanfar S, Angolkar M, Ho JJ. Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev. 2011;3:CD007202.