Many mothers have questions or concerns regarding the use of a pacifier while breastfeeding. Pacifiers have long been used as a soothing technique for a crying baby. So why does this work so well, and what complications can using a pacifier cause to breastfeeding? Let’s look at these issues below.
When a baby suckles, the hormone cholecystokinin is released into the intestine. Cholecystokinin is responsible for satiety and sleepiness, helping to soothe the infant. This hormone is released when a baby suckles on a pacifier or the breast. The first release occurs about 10 minutes after suckling and the second about 30 minutes after. Overuse of pacifiers can result in missed hunger cues, missed feedings, and inadequate weight gain.
Pacifier use can also affect the initiation of breastfeeding. Many infants, when placed skin to skin with mom, uninterrupted after birth, will find the way to the breast on their own and begin to suck. Studies have also shown that the early use of a pacifier can reduce the frequency and duration of breastfeeding.
Using a pacifier before two weeks of age and before breastfeeding is well established can result in ineffective suckling by the baby. Decreased stimulation to the breast results in reduced milk production. Early weaning or supplementation often occurs when a mom feels she has a low milk supply.
If a pacifier is used, it should only be offered after about 3-4 weeks or until breastfeeding is well established. Some hospitals use pacifiers as a soothing technique for infants during painful procedures such as circumcision.
The statement below is found in the Breastfeeding Policy by the American Academy of Pediatrics.
“Given the documentation that early use of pacifiers may be associated with less successful breastfeeding, pacifier use in the neonatal period should be limited to specific medical situations. These include uses for pain relief, as a calming agent, or as part of a structured program for enhancing oral motor function. Because pacifier use has been associated with a reduction in SIDS incidence, mothers of healthy term infants should be instructed to use pacifiers at infant nap or sleep time after breastfeeding is well established, at approximately 3 to 4 weeks of age”. If the pacifier falls from the infant’s mouth during sleep, it does not need to be replaced.
Seek the assistance of a lactation consultant if you are having problems with your baby latching and sucking at the breast before introducing any artificial nipples or pacifiers. Often a lactation consultant will recommend offering the infant a clean finger to suck on instead of using a pacifier. They can also counsel you on other soothing techniques that may work for you and your baby.