Pacifier Use May Not Reduce Breastfeeding

Breastfeeding rates not impacted by pacifier availability in the hospital

March 17, 2013 / Author:  / Reviewed by: Chris Galloway, M.D.

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(dailyRx News) Hospitals can be designated as "Baby-Friendly" if they put in place ten steps to encourage breastfeeding. One of these steps is not regularly handing out pacifiers.

However, restricting the use of pacifiers, at least as a policy on its own, may not increase the percentage of women who breastfeed exclusively.

In fact, a recent study showed the opposite.

After a hospital stopped routinely handing out pacifiers, exclusive breastfeeding rates decreased. Exclusive and supplemental formula feeding rates increased.

"Breastfeed your baby for at least six months."

The study, led by Laura R. Kair, MD, of the Department of Pediatrics, Oregon Health and Science University in Portland, looked for the relationship between pacifier availability and breastfeeding.

The researchers analyzed the rates of exclusive breastfeeding, breastfeeding with supplemental formula feeding and exclusive formula feeding among 2,249 babies.

All the children were born in the same hospital, which had recently stopped automatically distributing pacifiers to new moms.

The researchers compared the rates of these different feeding patterns for the five months before the pacifier restriction and the eight months after the new policy.

The hospital staff did not restrict formula, but the staff did discourage its use as standard practice.

From July through November of 2010, when pacifiers were routinely handed out, 79 percent of the 812 babies born during this time were exclusively breastfed. Also, 18 percent of them were breastfed while also receiving supplemental formula.

During the eight months after the pacifier restriction policy, the rate of exclusive breastfeeding was a little lower, at 68 percent of the 1,278 babies born. Yet the percentage of babies receiving supplemental formula while breastfeeding increased to 28 percent during this time.

The researchers also saw an increase in exclusively formula-fed babies from before the pacifier restriction to after it. Before the policy, 1.8 percent of the babies were exclusively fed with formula. After the policy, 3.4 percent were.

The babies born before and after the pacifier restriction policy did not differ significantly in terms of birth weights, methods of delivery, genders and lengths of stay in the hospital. The babies born during the month when the policy was introduced were not included in the study.

Therefore, the availability of pacifiers did not increase breastfeeding rates and may have actually reduced the rates of exclusive breastfeeding.

"Restricting pacifier distribution during the newborn hospitalization without also restricting access to formula was associated with decreased exclusive breastfeeding, increased supplemental formula feeding, and increased exclusive formula feeding," the authors wrote.

The study results do not necessarily mean that the pacifier restriction policy caused the drop in exclusive breastfeeding. The authors were unable to explain why the drop had occurred.

Regardless, the study does appear to show that pacifier availability does not necessarily reduce exclusive breastfeeding rates.

The study was published March 18 in the journal Pediatrics. The research did not receive external funding. The authors declared no conflicts of interest.

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Review Date: 
March 17, 2013
Last Updated:
March 17, 2013