Are they good? Are they bad? Do I need to buy them? What kind? Will they cause nipple confusion?

This is a hot topic and one with lots of opinions. Here are the facts:

  1. Pacifiers are recommended by the American Academy of Pediatrics to help reduce the risk of SIDS (Sudden Infant Death Syndrome), BUT only after one month of age. This is to allow breastfeeding to get off to a good start.
  2. Most hospitals have pacifiers, but don’t generally give them to parents unless parents specifically ask and have been educated on the risks of early use.
  3. Pacifiers are useful for pain relief and stress. If a baby is separated from his mother for a procedure or because a baby is in the nursery, a pacifier can be helpful. This does not mean that the baby has to continue using it when the mother and the baby are reunited. Throw the pacifier away at this point.
  4. Sucking on a pacifier causes cholecystokinin to be released in the gut. This is a hormone that helps the baby feel full. Mothers should avoid any pacifier use in the early days so that feedings are not being replaced. This can lead to excessive weight loss. Any time the baby wants to suck, the breast should be offered.
  5. The feeling of the pacifier in the mouth is very different than the breast. In some cases, babies have difficulty latching after some pacifier use. They are confused: looking for the firm feeling but only finding a soft breast. These babies have the nipple in their mouth with their mouth open wide, sometimes moving head from side to side.
  6. One type is not better than another. They all have the ability to replace feedings and confuse a baby.
  7. Babies do not NEED to suck on a pacifier to know how to feed.

The moral of the story:

Avoid the pacifier unless necessary for pain or stress relief due to separation. If you decide to use a pacifier, use it in extremely limited bursts.

The rule of thumb: After baby has breastfed well on both sides and is asleep but wakes up when being moved, you can use pacifier briefly to help soothe baby back to sleep. Some babies have a higher suck need than others, so brief pacifier use can make life easier for everyone. However, if after 5-10 minutes of use baby is sucking very actively, baby is still hungry and should be fed more. If baby is sucking for comfort, the sucking will evolve into a passive suck fairly quickly.

My experience: As I’ve mentioned in other posts, I was a know-it-all, cray cray new mom with my first. I didn’t want him to have ANY artificial nipples at all. Ever. However, he hated the carseat. He would turn from my perfect angelic baby to a little demon whenever I strapped him into the carseat. (How dare I remove him from the boob and try to leave the house!) Well since I couldn’t breastfeed and drive at the same time, I had to come up with a solution. I would let him suck on my finger (index finger pad to the roof of his mouth). This worked like a charm. **I am not advocating unsafe driving!** But the finger is a good alternative if you need the kid to chill for a few minutes without a boob in his mouth!

Recipe for success: Avoid the pacifier until breastfeeding is well established.

Confused about whether your baby is hungry or not? Read here about feeding cues.

*If you’re using a pacifier a lot in the early days, that’s a red flag that things aren’t going well. You should work with a lactation consultant.

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