There are many different opinions about the use of pacifiers out there. I find myself somewhere in the middle of two somewhat opposing sides. One side feels that pacifiers interfere with breastfeeding and cause nipple confusion in the newborn and are strongly against them. The other side uses pacifiers at the drop of a hat to soothe a fussy infant. Here is my middle of the road viewpoint on the subject.
Newborns have a very strong suck reflex. Infants suck first to eat (survival instinct in full force) and secondly to soothe and calm themselves. Many a breastfeeding mom has felt like a human pacifier and struggled with wanting to soothe their baby and the problems that arise (i.e. sore, cracked and sometimes bleeding nipples) with constant nursing. Even though It is natural for a newborn to want to nurse very frequently, sometimes even every hour, there should also should be periods where the infant is sleeping quietly and calmly for 2-3 hours at a time.
Infants can sometimes have difficulty soothing themselves. If the infant has been fed and is nursing well and just still seems fussy, a pacifier is a good choice to help them calm and get to sleep. Pacifiers should not be used as the first line of defense for a crying baby. Find out what is wrong first. If he is hungry, don't use a pacifier to keep him calm until you can feed him. If he is always offered breastfeeding first, he will usually not develop nipple confusion. Try swaddling him first before you introduce the pacifier. Many times the swaddling alone will calm him.
Studies have been done that show a correlation with pacifier use and lowering the incidence of SIDS (Sudden Infant Death Syndrome)**. Some think that it's a good idea to not introduce a pacifier until 2-3 weeks after birth so that breastfeeding is well established. I agree with this as long as you don't have an extremely fussy and irritable baby on your hands. Sucking is one of Dr. Harvy Karp's 5 "s" that helps tremendously in the calming of a colicky baby.
Here are my recommendations for pacifier usage in a nutshell:
1. Always offer feeding first if infant is hungry.
2. Do not use a pacifier to soothe prior to a feeding
3. Swaddle first, then use a pacifier if the infant has not calmed
4. Limit pacifier use to soothing before sleep. Don't keep putting it back in the infant's mouth during sleep. Don't use a pacifier while the infant is playing or otherwise occupied.
5. Wean the infant off of the pacifier before 12 months (earlier if you can).
I believe that if you follow these general guidelines, there are no detrimental effects of pacifier usage. These guidelines are of course, my opinion. I would love to hear how others feel about pacifier use. How do you feel?
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