Iboly!

Tegnap elküldtem a cumis levelet a cikkek miatt (meg az érdekesség 
miatt), de azt hiszem ez a hozzáfűzés hozzátartozik a teljes képhez.

Judit


Teresa Pitman wrote:
>>Evan wrote:
> 
>  Kramer, Barr, Dagenais and Young, et al (2001) did a randomized, controlled
> study on women who intended to breastfeed for at least 3 months and who were
> delivered of singleton newborns of at least 37 completed weeks gestational
> age and 2500g birth weight.  All women were given a breastfeeding promotion
> package (informational pamphlets and a 45-minute interview with a nurse
> trained in lactation consultation), but the women in the experimental group
> were asked to avoid pacifiers when the infant was fussing and to first offer
> her breast to try and calm it
> 
>>down.  If that failed, she should try to carry or rock the infant.  The
> 
> control group had all options for calming the infant discussed, including
> pacifier use.  The results showed the difference in weaning prior to 3
> months was not significantly different between the experimental (18.9%) and
> the control group (18.3%).  This study is important because it is a
> randomized, controlled study instead of using convenience sampling.  The
> study found no evidence that pacifier use is harmful for breastfeeding, but
> also that there were no beneficial effects of pacifiers on infant crying or
> fussing.  The non-pacifier soothing methods in the experimental group
> appeared to be adequate.
> 
> 
> I think I would have two questions about this study. Most parents decide to
> use (or not use) pacifiers based on many factors, and the instructions they
> were given might not have been enough. I'd want to know how many of the
> parents in each group actually used a pacifier, how often and for how long.
> Secondly, I think that three months may be too short a time period to
> determine the potential risks of pacifier use. It is just after this -
> around four months - that nursing strikes, decreased milk supply, and other
> problems often crop up and sometimes these seem to be related to pacifier
> use. I think it would be more valuable to look at the six-month mark or even
> a year - after all, that's what the AAP recommends as a minimum. I do think
> that pacifiers can increase the number of babies who wean before a year.
> 
> 
>>     Baker (2000) looked at studies that used convenience sampling of
> 
> women that had the option of using a pacifier.  She determined through
> review of studies that there was a relationship between pacifier use and
> breastfeeding outcomes, but the correlation between these two variables did
> not support pacifiers as the cause of decreased breastfeeding duration.  She
> found that if a pacifier is used for the purpose of delaying feeding it
> could cause a decreased milk supply, but if it is used to soothe an infant
> after a feeding or to help the infant fall asleep it may not.
> 
> 
> Again, I would want to know what the breastfeeding duration being considered
> is. If it is three months, I don't think this study tells us much. I think
> that when the breast becomes seen as primarily a source of food, and the
> pacifier more connected to comfort (such as when falling asleep) there is an
> increased risk of early weaning as the baby is able to get food from other
> sources such as solid foods or from a cup. It is those "comfort feeds" that
> become most important to the baby after the first year - nursing to sleep,
> nursing when hurt or upset, nursing to calm down. If the pacifier has become
> the source of soothing and help to fall asleep, those nursings may be lost.
> 
> I don't think that pacifiers are evil and used one myself with my third
> baby; I was also nursing his two-year-old sister and had an overly generous,
> fast-flowing milk supply. He often wanted to suck but did not want the extra
> milk. I found it sometimes helped to let him suck on a pacifier after
> nursing. I think, though, that it needs to be used cautiously and
> discontinued as early as possible.
> 
> Teresa Pitman
> Guelph, Ontario
> 
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