The home visitors at Aspiranet
Welcome Home Baby Program and their supervisor, Odessa Caton sent in two questions about the recent Bulletin Blog alerting Beginnings Guides user’s to findings
that use of a pacifier reduces the risk of SIDS up to 90%. They ask, Does the pacifier recommendation apply to
breast fed and bottle fed babies? Does the research still indicate that
pacifiers are barriers to breastfeeding? The short answers: Yes. No. Pacifiers, SIDS & Breastfeeding The World Health Organization’s Ten Steps to
Successful Breastfeeding BG
Bulletin reader, Cathy Morris of the Heart of Georgia Healthy Start Coalition,
suggests waiting one month before offering a pacifier to a breastfeeding baby in
order to firmly establish breastfeeding. Both of
these advisories are supported by a number of studies linking pacifiers to
reduced breastfeeding. And they illustrate the ongoing controversy fueled in
part by a few studies that have found pacifier use promotes or supports breastfeeding, and in part by competing goals of promoting breastfeeding and
protecting against SIDS. None of
the reported studies is able to tell if pacifier use is a signal of
breastfeeding difficulties leading to early weaning, or the cause of such
difficulties. There is some new, perhaps more definitive research. New Findings A 2012 Cochrane Review of more recent and stronger
evidence from randomized trials reached this opposing conclusion: For mothers who are motivated to breastfeed
their infants, pacifier use before or after breastfeeding was established did
not significantly affect the prevalence or duration of exclusive or partial
breastfeeding for up to four months of age. The authors warn that this finding may not apply to mothers
who are less motivated; so the chicken-or-egg question about pacifiers and
early weaning remains. At least one author contends the Review is severely
flawed. So the longer, final answers to these good questions depend on who you
ask and how you interpret the evidence. Editors’ Conclusion SIDS is rare before age one month, (highest risk is 2-4
months); so there is little risk in waiting to offer a pacifier to a
breastfeeding baby. Recent research on the highly protective value of
pacifiers, along with new evidence that pacifiers interfere with breastfeeding
less than previously believed warrants a recommendation to offer a pacifier to
both breast fed and formula fed babies at all sleep times during the SIDS risk
period (age 1 to 6 months). You’ll see the change in the new 2012 edition of Beginnings
Parents Guide. And I’ll be
watching to see what WHO has to say about the new Review. Stay tuned. References Jaafar SH, Jahanfar S, Angolkar M & Ho JJ. (2012).
Pacifier use versus no pacifier use in breastfeeding infants for increasing
duration of breastfeeding (Review). The Cochrane Collabortion. Wiley &
Sons. Abstract free online: Jenik AG & Nestor V. (2009). The pacifier debate. Early Human Development 85; S89-S91. |
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CategoriesBeginnings GuidesBreastfeeding Health Education Health Literacy Parenting Education Prenatal Education |
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