Never dealt with physicians on this question, but mothers always ask about pacifiers.  Sometimes it helps to joke that cavewomen did not pick them off pacifier trees, but that pacifiers were invented to go with bottles.  Babies are wired for breastfeeding, and for a lot of sucking to build milk supply quickly in those early days, and that comfort sucking is important physiologically too.  Babies love the breast because it's multipurpose  (and that's why it's so important to get breastfeeding comfortable!).

Bottle-fed babies really need pacifiers, since they finish a bottle so quickly, and if a mother wants to sit and rock and cuddle the bottle-fed baby, she needs something else to offer.  We lost our breastfeeding traditions for a couple generations, so pacifiers became standard pieces of baby equipment.  But breastfed babies don't need them (and often aren't that interested in them) because they have the real thing.  And in the early days, when we're trying to help the baby get consistent with a big, wide-open breastfeeding suck, the closed-down pacifier suck, on a firm object, doesn't send the right message.

I usually add that the pacifier can be a tool in certain situations.  Nature didn't plan ahead for car-seats, or all sorts of modern situations where mothers and babies have to be apart.  When a baby is in the NICU, or when mothers are back at work, it's useful for caregivers to have lots of comforting ideas.  If a mother has a over-abundant milk supply, it can be hard for the baby to control the flow to get the needed comfort sucking .

Sometimes it helps to acknowledge the good motives -- we all want babies to be happy.  But as breastfeeding becomes the norm again, babies have less need for this substitute.

Margaret Wills, IBCLC, Maryland

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome