Are you a new mom navigating the ins and outs of breastfeeding? You might have heard that pacifiers are not recommended for breastfed babies, but is this really true? Is there any good reason to delay or avoid introducing a pacifier to your little one if you're exclusively breastfeeding them? Here, we'll explore the potential benefits and drawbacks of using a pacifier while nursing, helping you make an informed decision at the end of it. Read on to learn more!

Will introducing a pacifier ruin breastfeeding?

Newborn babies' number one way to regulate their nervous system is by sucking.  Sucking helps them get the food they need to grow at such a rapid rate and also helps calm them as they transition to life outside of the womb. 

According to The American Academy of Pediatrics, “the controlled action of sucking promotes feelings of security and allows infants to self-soothe and to initiate the process of self-regulation.”

The American Academy of Pediatrics, AAP recommends waiting to introduce a pacifier until 3-4 weeks of age until “milk production is firmly established.” This is due to the fact that early milk removal and breast stimulation are KEY for your long-term milk production.  In the critical days and weeks after birth, we want to give the baby lots of time at the breast to help build a great milk supply and support optimal growth. 

However, there are times that it just might not be possible or feasible for you to latch your baby, and using a pacifier can be helpful to calm your baby until you are able to latch them to the breast. 

Times when using a pacifier can be helpful for breastfeeding babies 

• Pacifiers can be helpful for premature babies who are learning to eat from the bottle or breast and are being fed with a feeding tube (Foster, Psaila & Patterson) 
• It can be helpful for some babies with low tone to help strengthen their lip tone (Wilson -Clay & Hoover 2017) 
• It can be helpful during painful procedures when breastfeeding isn’t feasible 
• If the parent is feeling overwhelmed and needs a minute to calm and regulate before returning to the breast 
• During car rides when your baby needs to be strapped into the car seat

Motivation to breastfeed and pacifier use 

When motivation to breastfeed is considered, researchers (Jaafer, Ho, Jahandar & Angolkar, 2016), have found no significant association between pacifier use and nursing outcomes for the first 4 months of life. In layman's terms, if you are motivated to breastfeed, then occasional, mindful use of the pacifier is not likely to have negative outcomes on your breastfeeding journey. 

The bottom line: we need babies to be latching ALOT in the early days in weeks, this is normal newborn behavior and supports the mom’s milk production and infant growth. BUT for many breastfeeding families, a pacifier is a tool that can help you cope with the high demands of having a newborn. If you can latch the baby DO IT. There is no spoiling a newborn and comfort feeding and cluster feeding are a NORMAL part of newborn life. But if your baby is screaming while you are in the shower/in the car/ or rage crying in a closet IT IS TOTALLY OKAY TO GIVE THEM A PACIFIER!

What type of pacifier should I choose for my breastfeeding baby?

If you have made the decision to offer your breastfed baby a pacifier you will need to decide which shape will work best for him 

 All pacifiers have 3 parts 

1. The guard 
2. The ring or handle 
3. The nipple 

 Nipples come in a variety of shapes 

1. Cylindrical 
2. Cherry 
3. Butterfly 
4. Orthodontic 

The AAP recommends choosing a pacifier that is made from a single unit or material rather than 2 types of materials (silicone & plastic). 

I recommend choosing a pacifier with a cylindrical shape.  These pacifiers allow the baby to practice cupping the tongue around the nipple, keep the mouth slightly open and encourage the tongue to go past the gum line.  Sucking on a pacifier with a cylindrical shape will promote a suck that is more similar to breastfeeding. 

Here are some of my favorites 

1. Evenflo balance pacifier: (I am a big fan of their bottles too) 
2. Ninni Co: these pacifiers are made of extremely soft silicone and can be especially helpful for babies with oral dysfunction or tongue ties because the texture and shape are more similar to the breast and can help strengthen the suck 

The other pacifier shapes orthodontic and butterfly have a flattened surface and limit tongue cupping and movement. These pacifiers encourage a choppy suck pattern and can increase latching difficulties at the breast. 

Avoiding pacifier overuse

As discussed before it is okay to use the pacifier as a tool when the breast is not available BUT we want to make sure we are not using it too much which can undermine breastfeeding. 

Here are some times when I would not recommend using the pacifier 

• To space out feeding sessions 
• Os when you are due to be feeding soon. Pacifier use may prevent the baby from showing important feeding cues. Click here to read my blog on recognizing feeding cues. 

Pacifier use and sleep

Two important things to note when talking about pacifier use and sleeping:

1. Sucking while going to sleep has been associated with a reduced risk of Sudden Infant Death Syndrome (SIDS) 
2. Once the baby is asleep the pacifier DOES NOT NEED TO BE REINSERTED.  This is important because when humans are not eating or vocalizing our tongues should be resting on the roof of our mouths with our lips closed. This is called “oral resting posture” and promotes nasal breathing and helps shape the upper palate.  When babies are asleep we want them to have their tongues on the roof of their mouths and not the pacifier. 

When should I stop using the pacifier?

According to Dianne Bhar, MS CCC-SLP, CIMI in her book, Nobody Ever Told Me (or my mother) That! Everything from bottles to breathing to Healthy Speech Development 

• Between birth and 6 months pacifier is used for calming only (or when falling asleep) remove the pacifier when calm and asleep. There is no reason to put the pacifier in your baby’s mouth if they are calm
• Between 6-10 months of age begin to wean your baby from the pacifier offering it only when baby is most cranky or needs to sleep 
• By 6 months of age, your baby can chew or moth on teething toys or fingers to calm and soothe
• By 10 months goal is to be completely weaned from the pacifier

It is important to note these are not rigid “rules” but rather guidelines. Remember if you are struggling with weaning your baby from the pacifier reaching out to a pediatric speech-language pathologist, would be helpful. 

Knowing how to use a pacifier with a breastfed baby can make all the difference in proper infant oral development and calming a fussy baby. Whether you choose to use a pacifier or not, helping your baby become established in breastfeeding is key. Breastfeeding promotion and support should be available to all parents, no matter their choice or situation. You don't have to figure it out alone - join Boob School today to learn everything you need to meet your breastfeeding goals! From learning how to ask for help, building your feeding plan, and dealing with common issues like supply concerns and soreness, we will be here for you every step of the way. 

In Boob School, we believe that you can achieve the experience that's best for your family - whatever it is! Together let's work on providing our babies with the healthiest start in life by giving infants the tools they need from early on in life.

Cheering you on, always!!

XOXO

Kelly

Boob School Founder and CEO

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