Binkies, corks, soothers, dummies. Whatever you call pacifiers, conventional wisdom holds that giving them to newborns can interfere with breastfeeding.
New research, however, challenges that assertion. In fact, limiting the use of dummies in newborn nurseries may actually increase infants' consumption of formula during the birth hospitalisation, according to a study to be presented Monday, April 30, at the Paediatric Academic Societies (PAS) annual meeting in Boston.
Studies have shown that breastfed infants have fewer illnesses such as ear infections and diarrhoea as well as a reduced risk of certain cancers, obesity and asthma. Moms benefit, too, from more rapid loss of pregnancy-associated weight gain, reduced risks of certain cancers and improved cardiovascular health.
Based on that evidence, the American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for the first six months of life.
To encourage exclusive breastfeeding, the World Health Organization and United Nations Children's Fund recommend that hospitals caring for newborns follow Ten Steps to Successful Breastfeeding. One of the steps states that artificial teats or dummies should not be provided to breastfeeding babies. Medical centres that follow the 10 steps can be recognised as Baby-Friendly Hospitals.
How the study was done
In their study, Laura Kair, MD, and Carrie Phillipi, MD, PhD, from Oregon Health & Science University (OHSU), sought to determine if eliminating routine dummy distribution on the hospital's mother-baby unit increased the rate of exclusive breastfeeding.
OHSU, which has been working to become a Baby-Friendly Hospital, implemented a policy in December 2010 restricting nurses from routinely giving dummies to breastfed newborns. The dummies were locked up and nurses had to enter a code and a patient's name in order to access them for special circumstances (e.g., to help soothe infants undergoing painful procedures).
Drs. Kair and Phillipi analysed feeding data on 2,249 infants born between June 2010 and August 2011.
Results showed that the rate of exclusive breastfeeding on the mother-baby unit decreased significantly after dummies were restricted from 79% of infants in July to November 2010 to 68% in January to August 2011.
In addition, the proportion of breastfed infants receiving supplemental formula increased from 18% before the policy was changed to 28% afterward. The percentage of infants fed only formula remained statistically unchanged during the study period.
"There is a great deal of energy nationally as well as internationally in support of increasing the number of Baby-Friendly Hospitals," said Dr. Kair, paediatric resident at OHSU Doernbecher Children's Hospital. "Taken together, the 10 steps improve exclusive breastfeeding rates in the hospital. However, the effect of pacifier use on initiation and duration of exclusive breastfeeding has not been well-established in the medical literature.
"Our goal with publicising this data is to stimulate conversation and scientific inquiry about whether there is sufficient evidence to support the universal recommendation of not offering dummies to breastfeeding infants in the first few days to weeks of life," Dr. Kair added. "This subject poses an additional dilemma for parents and paediatric providers as pacifier use is associated with a decreased risk of sudden infant death syndrome (SIDS), and the AAP recommends using a dummy for sleep after breastfeeding is established."
(EurekAlert, April 2012)
Formula fed babies don't always overeat