Do Breastfeeding and Pacifiers Mix?

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By Kelly Bonyata

It is recommended that pacifiers and other types of artificial nipples be avoided for at least the first three to four weeks of life. I’d personally suggest that most breastfed babies, if they get a pacifier at all, would be better off without a pacifier until the six-week growth spurt is over and mom’s milk supply is well established (at six to eight weeks postpartum, usually).

This allows mom to establish a good milk supply without losing any much-needed breast stimulation to a pacifier. Also, keep in mind that a pacifier is simply a substitute for the breast – it is not “required,” and many babies never use one.

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What should I consider before using a pacifier?
After the early weeks, pacifier use is less likely to cause problems as long as you are aware of some facts.

Never substitute a pacifier for a feeding at the breast or try to hold baby off longer between feedings with a pacifier. Your baby needs your milk to grow his brain and his body.

Some studies indicate that babies who take a pacifier tend to wean earlier than those who do not. Your baby’s desire to suck is one thing that keeps him nursing regularly, particularly once he is getting more of his calories from solids.

Babies who use pacifiers are getting their sucking needs met with something other than the breast, and thus these babies may decide to give up breastfeeding sooner than if they did not take a pacifier.

Babies who take pacifiers may be more prone to oral yeast (thrush), which can be transferred to mom’s nipples.

A number of studies have shown a link between pacifier use and an increased incidence of ear infections.

Pacifiers can result in choking or strangulation if the pacifier breaks or if it is tied around the neck (which it never should be). Follow all safety guidelines and keep an eye out for the many pacifier safety recalls.

Also, keep in mind that latex allergy is becoming an increasing problem; consider using a silicone pacifier rather than latex.

Prolonged pacifier use can result in teeth misalignment and occasionally leads to shaping of the soft palate or speech problems.

Giving baby a pacifier regularly will increase mom’s chances of ovulating and getting pregnant. Exclusive breastfeeding, depending upon your breastfeeding frequency and other factors, is a method of birth control that can be more than 98 percent effective during the first six months and 94 percent effective during the second six months. Ensuring that all of baby’s sucking needs are met at the breast increases the effectiveness of this method of contraception.

When to avoid the pacifier
If you observe any of the following problems, it is recommended that you discontinue pacifier use until the problem is resolved.

Baby nurses less frequently or for shorter durations when a pacifier is used (newborns should be nursing at least eight to 12 times per day).

Baby is having difficulties latching or nursing effectively (pacifier use sometimes makes it harder for baby to become proficient at nursing).

Baby is having problems with weight gain (in which case baby needs to nurse as often as possible).

Mom is having problems with sore nipples (pacifier use can contribute to latching problems, which cause sore nipples).

Mom is having milk supply problems (in which case she needs to put baby to breast at every opportunity in order to increase milk supply).

Mom and/or baby have thrush, particularly if the thrush is hard to get rid of or keeps returning.

Baby is having repeated ear infections (an increased incidence of ear infections has been linked to pacifier use).

As long as you keep the above points in mind and only use a pacifier sparingly, it is up to you whether and when you wish to comfort baby yourself or with a pacifier. However, keep in mind that there is no scientific evidence that suggests that babies have a need to suck that is independent of the need for food.

When a baby is indicating a sucking need, it’s generally best that baby be encouraged to nurse, especially if there is a weight gain concern. The breast was the first pacifier and in most cases remains the best.

© 2003 Kelly Bonyata

Kelly Bonyata is an accredited breastfeeding counselor and has been helping mothers and babies to breastfeed since 1997. Kelly maintains kellymom.com, with information on breastfeeding and parenting topics.