Pacifiers are a real hot-button issue, like so many other topics when it comes to parenting. Are they a gift from the angels, or a tool of the devil? Is it better to use a pacifier or encourage a baby to suck their own thumb? What about breastfeeding and pacifiers? SIDS and pacifiers?

It’s all so confusing! And most of us have an opinion. Usually one of the following:

  • You will never catch my kid with a pacifier.
  • You will never catch my kid sucking their thumb
  • Don’t let that baby use you as a pacifier

Here’s what the World Health Organization says about pacifiers for breastfed newborns in the hospital:

GUIDELINE: Health professionals, including nursery staff, should educate all breastfeeding mothers about how the use of pacifiers may interfere with the development of optimal breastfeeding. Breastfeeding babies should not be given pacifiers by the staff …When a mother requests that her breastfeeding baby be given a pacifier, the health care staff should explore the reasons for this request, address the concerns raised, educate her on the possible consequences to the success of breastfeeding, and discuss alternative methods for soothing her baby. If the breastfeeding mother still requests a pacifier, the process of counseling and education and informed decision should be documented.

The main reason moms seem to use pacifiers in the hospital? It’s late, the baby has been on the breast for hours, and mom and dad are really tired. Why not just use a pacifier to get the baby to sleep?

It’s pretty clear in the research that WHO cites, that using a pacifier in the early days can sabotage breastfeeding because mom doesn’t get a good handle on how to breastfeed, basically ignores baby’s feeding cues, and if she isn’t nursing when the baby cues may miss feeds, leading to higher bilirubin levels and/or frantic kids, along with engorgement for mom.

On the other hand, a hospital in Ohio recently found that their exclusive breastfeeding rate went DOWN when they stopped giving out pacifiers!

Pacifiers are popular here in southeastern Vermont. I had a mom show me a collection that she had been given at her shower (they were wrapped in the bows), wondering which one was best for her baby. There’s no evidence that one is “better” than another, although one piece pacifiers are probably safer as they don’t come apart. (Babies have choked on the two piece ones.)

Pacifier use is such a cultural issue that it can be hard to deal with. For example – we have pet names for pacifiers! Is it a binky? A nunny? A passi? (Check out 160 pet names for the pacifier)

Here at The Birthing Center we do have pacifier education cards that state the case for being careful with pacifier use in the early days of breastfeeding.

  • Begin with a good milk supply: get breastfeeding off to a good start before using a pacifier. Nursing well today means lots of milk tomorrow.
  • Ask for help from a nurse or breastfeeding specialist if you think your baby is not nursing well, wants to nurse too much, your nipples hurt, or you just plain want help! We have tips to make nursing easy and comfortable.
  • Breast is best; offer breast for comfort and food in the early days. Don’t use the pacifier to put off a feeding. The act of sucking on the pacifier releases a hormone that makes baby sleepy – but s/he is still hungry.
  • You are the best comfort for baby. In case you cannot feed right away (driving, working, etc) always offer the breast as soon as possible in case baby is hungry.

A couple of other things have come up lately, most particularly that babies can get pretty sick from the bacteria (over forty kinds!) and resulting bio-films on pacifiers. You can see what some of the research looks like at Are Binkies Making Babies Sick? It’s a good idea to run the pacifier through your dishwasher regularly if you choose to use one.

What does the American Academy of Pediatrics have to say?

“The AAP does not support a categorical ban on pacifiers due to their role in SIDS risk reduction and their analgesic benefit during painful procedures when breastfeeding cannot provide the analgesia. Pacifier use in the hospital in the neonatal period should be limited to specific medical indications such as pain reduction, calming in a drug exposed infant etc. Mothers of healthy term breastfed infants should be instructed to delay pacifier use until breastfeeding is well-established usually about 3 – 4 weeks after birth. “ (You can read more at Pacifiers: Satisfying Your Baby’s Needs)

So what about “using you as a pacifier?”

Well, if you think about what life was like for humans as a species for about the first gazillion years or so, the baby didn’t have much choice. It was mom or a thumb. And if you didn’t want your baby eaten by a wild animal, either you or a relative or friend held the baby all the time. The breast(yours or somebody else’s!) was easy-access. Probably the sharpest retort to this is “don’t let that baby use the pacifier as mother”!

Babies need just the kind of twenty-four hour stimulation that mothers provide best. Food, touch, talking – all the things we need to become real human beings. In the beginning sucking is a part of what we need to grow and mature. Pacifiers were pretty much invented when formula/bottle feeding became more popular, because you can’t let a baby suck on an empty bottle, and you can’t give non-stop formula in a bottle. (Your baby would just throw up.) A pacifier worked pretty well to keep the baby from overeating.

So don’t be afraid to be your baby’s mama – loving, soothing, sucking and all. And if you choose to use a pacifier, use it wisely, and, as always when somebody gives you advice you didn’t want, just smile and say thanks.

Because if there’s this much controversy and this many different ways to do it “the right way” – you can do whatever you want and things will probably be fine.