WHAT’S NEW: Now we know: Pacifier use by breastfeeding infants is fine
This meta-analysis shows that pacifier use does not decrease breastfeeding duration in full-term infants. The new evidence contradicts current WHO recom-mendations, however, which are based on less rigorous studies.8,9,13,14 The AAP now recommends that pacifier use be implemented after breastfeeding is established.4 Based on the evidence, we think mothers who are motivated to breastfeed their infants should be allowed to make their own decisions regarding pacifier use, and pacifier use should not be discouraged.
CAVEATS: Effects on infant health still unaddressed
This meta-analysis did not report on the potential harms of pacifi-ers to infants >4 months old or to their lactating mothers. Potential problems of prolonged pacifier use (>4 months), such as increased risk of recurrent acute otitis media, oral candidiasis, and dental malocclusion, should be addressed with mothers, but should not lead to discouraging pacifier use in early infancy.15-17
CHALLENGES TO IMPLEMENTATION: There aren’t any
We see no challenges to implementation of this practice changer.
Acknowledgement
The PURLs Surveillance System is supported in part by Grant Number UL1RR024999 from the National Center for Research Resources, a Clinical Translational Science Award to the University of Chicago. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.