Pacifier Use and Breastfeeding

Resident’s Name: Joanne Lewis Date: April 17, 2009
Article title: The Effects of Early Pacifier Use on Breastfeeding Duration
Author(s): Cynthia R. Howard, MD, MPH, et al
Journal: Pediatrics
Volume (number): 103(3)
Month, Year: March 1999
Major topic: Pacifier use, breastfeeding
Type of Article: Prospective study
Main Purpose: To evaluate the effects of pacifier use and the timing of pacifier introduction on breastfeeding duration, problems, and frequency.
Overview of method of research: 265 breastfeeding mother-infant dyads were followed. Maternal interviews were conducted at delivery, 2, 6, 12, and 24 weeks, and thereafter every 90 days until breastfeeding ended. At each interview, information was gathered regarding breastfeeding frequency, duration, and maternal or infant problems, proportion of diet composed of breast milk, use of supplemental foods/liquids, and pacifier use. Breasting duration is defined by the following categories: full and overall. Full breastfeeding means that the infants are primarily breastfed and do not receive daily supplements. Overall breastfeeding is defined as the length of time an infant receives any breastfeedings.
Findings: 15% of mothers began pacifier use before leaving the hospital, another 36% began use by 2 weeks postpartum, another 17% began use by 6 weeks postpartum, and by the time the infants were 6 months of age, 74% of the mothers had initiated pacifier use. Women who introduced pacifiers to their infants compared with those who did not tended to be 1st-time mothers, to have shorter goals for breastfeeding, and to be slightly younger. Pacifier introduction by 6 weeks was associated with a significant increased risk for shortened duration of full breastfeeding and overall breastfeeding. Breastfeeding frequency was significantly decreased at 2 weeks postpartum in women who had initiated pacifier use by 2 weeks and at 12 weeks postpartum in women who had initiated pacifier use by 6 weeks. Mothers who had initiated pacifier use by 6 weeks were significantly more likely at 12 weeks postpartum to report that breastfeeding was inconvenient and that they had experienced problems with not producing enough milk.
Key points/Summary: Pacifier use in the first 6 weeks was associated with decreased full and overall duration; however, pacifier use in this study was associated primarily with long-term breastfeeding duration and did not affect short-term outcomes. There was no significant correlation between pacifier use and breastfeeding duration up to 3 months postpartum.
Assessment of article: Interesting article – the statistical analysis was difficult for me to understand.