The new issue of Advances in Neonatal Care (Oct. Issue) has two articles on breastfeeding in it which are very good, for the most part.  One is titled (strangely enough!) Are Pacifiers Associated With Early Weaning From Breastfeeding?  It examines the study that was published in JAMA in 2001.  They
did an analysis of the validity of the research and found that on the important points it was valid, but that a larger n was needed to show a smaller but still significant correlation between pacifier use and early weaning.  The study found no such correlation on randomization, but a significant
observational correlation which they felt suggested that pacifier use might rather be a marker of breastfeeding difficulties or lack of motivation on the mom's part.  This article feels that is a legitimate conclusion.  The article concludes,

<<The results of this study point to the need to consider changing our focus from promoting total avoidance of pacifiers in healthy full-term breastfed infants to designing better parental education about breastfeeding and striving for early recognition of breastfeeding difficulties, and providing
ongoing support after discharge.>>

The second article is Strategies to Support Extended Breastfeeding of the Premature Infant by Jane Morton, MD.  It carries pictures that are from the Breastfeeding Your Premie videos we just got and really like which was also done at Dr. Morton's facility, I believe.  The article is pretty good.  It
is accompanied by a 2 page checklist for parents.  I question a few things on it including the advice to always start with the most-full breast.  They add that many women have one breast that makes more milk than the other so not to be concerned if they start all the feedings on the same side.  They
also advise switching baby to the other breast as soon as the sucking and the swallowing slows down.  The rest of it looks pretty good.

Marsha

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Marsha Glass RN, BSN, IBCLC
Mothers have as powerful an influence over the welfare of future generations as all other earthly causes combined.John S. C. Abbot
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