Study: Pacifiers Not To Blame For Early Weening

July 17, 2001 -- Babies do not stop breastfeeding early simply because of the use of pacifiers, researchers say.

But frequent pacifier use as well as early weaning do point to breastfeeding problems. These problems can have negative implications for the baby, both nutritionally and emotionally, according to a study in this week's Journal of the American Medical Association.

The findings partly clear the pacifier of its bad reputation but not entirely, says Ronald Barr, professor of pediatrics and psychology at Montreal's McGill University and co-author of the study.

"This result is the first evidence from a randomized, controlled trial, the strongest design we have for assessing causality, to indicate that pacifiers are not a cause of early weaning," he said. "The assumption that pacifiers were a cause of early weaning was the strongest argument for discouraging their use in a variety of campaigns, including the World Health Organization's Baby Friendly Hospital initiative.

"The use of the pacifier, in and of itself, is not likely to have anything to do with how long the infant can, will, or will want to breastfeed."

Indication of Other Problems

Rather, early weaning and pacifier use may indicate other breastfeeding problems, Barr says. These may include a mother's pain associated with nursing or inconvenience for working mothers who cannot nurse at work.

But the results are far from a ringing endorsement of pacifier use.

"This is not a paper that shows much positive effect for pacifiers either, at least in regard to the one thing that their very name implies they do well — pacify infants," Barr said. "For the kind of distress — fussing and unsoothable crying — that infants do for minutes and sometimes hours at a time there was no measurable difference between the infants that used, or did not use, pacifiers."

Pacifiers present a host of health considerations for babies even when early weaning is out of the picture, according to other experts.

"Pacifier use often becomes a habit that, because it is convenient, is difficult to break," said Joseph Zanga, M.D., chair of the department of pediatrics at Loyola University. "A pacifier in the mouth when the baby is beginning to teethe may cause some deformation of the palate and teeth. Also, when babies have pacifiers in their mouths, they can't do the vocalizations that they have to do when they are learning to talk."

Zanga added that he is not surprised pacifier use and early weaning are due to the same underlying causes.

"There's no question that infants who are given pacifiers regularly do not nurse as long, nurse as often, or get as many benefits from nursing," he said. "In these cases, something has occurred that has made breastfeeding not a good idea in the parents' minds, which leads to a faster process of weaning and the use of a pacifier as a substitute."

Avoiding Further Complications

Barr said the best thing new mothers can do to avoid problems with breastfeeding that lead to early weaning is consult a breastfeeding expert and to exercise patience with nursing.

"Consultation with a wise and sympathetic breastfeeding counselor is very important," Barr said. "It helps if that consultation comes earlier rather than later, and 'anticipatory guidance' in breastfeeding, especially for new mothers, is important to prevent later breastfeeding problems.

"One of the problems with much breastfeeding practice is the belief that there is one right way to do it," he said. "Parents have more options as far as breastfeeding strategies go than they may be aware of."