by Heidi Green
May 04, 2012
“Breastfeeding not limited by pacifier use after all,” CBS News declares, in its coverage of a recent hospital study, while MSNBC proclaims there to be “no more nipple confusion.” A host of other media outlets concur.
Is it time, as Time magazine asks, to “bring back the binky?”
A surprising finding
The study that’s getting so much attention was conducted recently at Doernbecher Children’s Hospital of Oregon Health & Sciences University (OHSU). It has not been published in a peer-reviewed journal yet, but was presented at the 2012 Pediatric Academic Societies conference. (Please note that since it hasn’t been published, our sources of information are limited to the abstract, a summary by the American Academy of Pediatrics (AAP), OHSU’s press release, and media accounts.)
Unfortunately, this means we can’t know the researcher’s methodology, inclusion or exclusion criteria, and other pertinent details.
In December 2010, the OHSU Mother-Baby Unit halted the routine distribution of pacifiers to breastfeeding newborns. Pacifiers were instead kept in a locked supply management system that required the health care provider to type in a code, the patient’s name, and a reason for checking out a pacifier. Pacifiers were allowed in special circumstances, such as in conjunction with a painful procedure. In addition, parents were able to bring pacifiers from home, and these were not tracked.
Dr. Carrie Phillipi, associate professor of pediatrics at OHSU and resident pediatrician Laura Kair analyzed data on feeding of 2,249 infants. They determined that when pacifiers were still being distributed (July 2010–November 2010), about 79 percent of infants were breastfed exclusively during their hospital stay, but once the locked-pacifier policy was initiated, over the subsequent eight-month period (January 2011–August 2011), the percentage of breastfeeding infants decreased significantly to 68 percent. At the same time, the proportion of breastfed infants who received supplemental formula increased from 18 percent to 28 percent. The percentage of infants fed formula-only remained statistically unchanged.
Dr. Phillipi explained to The Oregonian’s Kathy Hinson that she and Dr. Kair “had sort of taken it on faith … that (avoiding pacifier use) would increase breastfeeding rates.” According to MSNBC, Dr. Kair notes that their expectation was in line with “the common belief among medical providers and the general public that pacifier use negatively impacts breastfeeding,” but instead they “found limiting pacifier use in the Mother-Baby Unit was associated with decreased exclusive [breastfeeding] and increased supplemental formula feeds.”
The researchers suggest that the seeming relationship between pacifier availability and breastfeeding should be viewed “as an interesting observation.” Dr. Kair explains that they “do not claim a cause and effect relationship,” but publicize this data “to stimulate dialogue and scientific inquiry into the relationship between pacifiers and breastfeeding.”
“Our overall goal,” she continues, “is to increase breastfeeding rates.”
Study raises questions
While the study raises some interesting questions about the researcher’s unexpected finding, it must be considered with caution in light of several facts:
Pacifier role still unclear
As explained elsewhere on baby gooroo, WHO and UNICEF recommend parents skip pacifiers since they may make it harder for parents to respond to their babies’ feeding cues, leading to a reduced milk supply and early cessation of breastfeeding. Meanwhile, the AAP continues to recommend pacifier use, on a restricted basis (e.g., when the baby is going to sleep), to reduce the risk of SIDS.
When it comes right down to it, each parent will need to weigh the risks and benefits of pacifier use and make a decision that feels right for their family. Breastfeeding mothers should remember that their baby’s sucking instincts are the “demand” that affects their milk “supply.” Some tips:
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