from: NEW BEGINNINGS,
Vol. 12 No. 6, November-December 1995, pp. 172-3
Gwen Gotsch, Oak Park, Illinois, USA
In many parts of the English-speaking world,
pacifiers are called dummies. They stand in
for mother's breast, as a dummy stands in for
a human being in a department store window or
in an automobile crash test. There are times
when dummies serve good and useful purposes;
there are also times when a dummy just cannot
do the job.
Babies are driven to suck. Without this drive,
they might not get the nourishment they need
to grow and thrive. Sucking also soothes babies.
The steady rhythm, the concentration on one
task, and the pleasurable stimulation of nerve
endings help babies pull themselves together
and overcome the many distractions of a big
and confusing world.
There was a time when "experts" frowned
on the use of pacifiers. These same advisors
also discouraged parents from picking up babies
who cried. Fortunately, the world has grown
a little more tolerant of babies' needs, including
the need to suck. The contented newborns lined
up at the window of the hospital nursery may
very well have pacifiers in their mouths.
However, wait! What is wrong with this picture?
Those pacifiers are artificial nipples. Moreover,
artificial nipples, attached to bottles or not,
can interfere with breastfeeding. This is one
of the problems with offering a pacifier to
a breastfed baby, especially one who has not
yet mastered nursing at the breast.
Sucking on an artificial nipple is different
from sucking at the breast. The artificial nipple
is already formed and rigid. The breast is soft
and flexible. The baby must open his mouth wide
to latch on to the breast, and the nipple goes
to the back of the mouth, away from the movement
of the gums and tongue. A caregiver can coax
a pacifier into a baby's closed mouth. The muscles
of the mouth and face and the tongue move differently
when sucking on an artificial nipple; the action
used to drink from a bottle or to calm down
with a pacifier will not get milk out of a breast.
Switching back and forth from breast to artificial
nipple is a lot to ask of a baby in the early
days of learning to breastfeed. A baby who tries
to suck at the breast the way she sucks on a
bottle nipple or a pacifier will quickly become
frustrated and may cry, fuss, or refuse to nurse.
She will not get much milk, and she may have
a difficult time learning to breastfeed effectively.
Sucking on a pacifier can also interfere with
a mother's milk supply and eventually with infant
growth. Babies who satisfy some of their sucking
needs with an artificial nipple will spend less
time stimulating the breast, possibly interfering
with milk production. Cutting feedings short
and offering babies pacifiers may deprive them
of the high-calorie, high-fat hind milk, which
is produced at the end of feedings and is important
for growth. A recent study in Brazil found that
babies given pacifiers by one month of age were
at a higher risk for weaning over the next 24
Pacifiers can be risky for breastfed babies.
When it comes to comforting newborns, they are
not right for the job, and mothers should avoid
them until breastfeeding is well established,
at least for the first three or four weeks.
Pacifiers should not be offered to babies who
are having trouble learning to latch on or to
suck correctly, or to babies whose mothers are
concerned about their milk supply or about their
baby fussing at the breast.
Instead, newborns that need to suck should be
offered mother's breast. Some babies will nurse
almost continuously, or for long periods in
their first few days. This is good for them.
They are rewarded with Colostrum and a bountiful
milk supply within a few days. They avoid the
physical and emotional agonies of crying. They
learn to be calm.
Of course, babies have to be with their mothers
if they are to depend on nursing for comfort.
The kind of postpartum mother-baby separation
that makes pacifiers helpful should not be allowed
to occur in the first place. In addition, with
careful attention to positioning, latch-on,
and how well the baby is sucking, nipple soreness
can be kept to a minimum, or even avoided completely.
As they get older, babies may still need to
continue sucking even after their tummies are
full--perhaps they need to go to sleep, or to
wake up, or just to relax. This
comfort sucking is different from the active,
vigorous suck a baby uses to bring down the
milk that will satisfy hunger. At this point,
some mothers may choose to use a pacifier. However,
breastfed babies can do their comfort sucking
right at the breast, because the mother's milk
flow slows to a trickle as the baby's sucking
becomes less intense. Babies can continue sucking
without stuffing themselves and without swallowing
a lot of air.
Bottles and artificial nipples do not have this
infant-controlled regulatory system. The milk
flows at a steady rate, and a baby with a full
tummy who wants to suck for another ten minutes
may end up overfed, with gas bubbles and spitting
up soon to follow. Here is where a pacifier
can fill an important need.
Pacifiers sometimes serve useful purposes in
breastfed babies, too. They can calm a baby
whose mother is unable to nurse at the moment,
because she is driving, paying for groceries,
or caring for an older child. They may soothe
a colicky baby whose mother's arms, breasts,
and patience are severely overtaxed. They can
comfort a baby who for one reason or another
is too distracted or too frantic to nurse at
the breast. Mothers of twins find pacifiers
helpful when one baby just has to wait while
mother takes care of the other. Hospitals use
pacifiers for premature infants, to stimulate
their sucking reflex and to help them associate
sucking with the delivery of food, even while
they are still being tube-fed.
Frequent use of pacifiers can create little
"addicts" who are rarely seen without
a "plug" in their mouth. Overuse of
pacifiers will also create breastfeeding problems,
and a mother with concerns about her milk supply
or a baby who is reluctant to take the breast
should reevaluate the choices she is made about
pacifiers and bottles. However, mothers know
their babies best. A well-informed approach
to the decision about using a pacifier will
help them make good decisions about what is
best for their families.
Pacifiers and comfort sucking at the breast
both have their place. There are times when
a dummy can stand in for a mother's breast,
ease a baby's distress, and
restore peace to everyone. Nursing for comfort
helps ensure a plentiful milk supply and brings
warm feelings to mother and baby. When pacifiers
are used judiciously, a mother can have it both
to Breastfeeding Problem