I know what you mean.  In spite of recommending that a mom avoid
using them especially while baby is learning, the reality is that
some will and if they do we difinitely would like to see them use
"the lesser of the evils".
The first choice when something other than a breast is going to go
in baby's mouth would be mom's (or dad's or whoever) clean finger or
even a knuckle.  (I remember encouraging mine to suck on the knuckle
of my little finger whenever I needed to hold them off briefly or
just give some extra oral satisfaction.)  This way at least baby
continues to feel skin in the mouth and they have human contact to
help sooth or satisfy, not just being dropped in a box (crib) with a
plug in the mouth!
My personal feeling is that the NUK is the last choice.  When I
mention that to a mom and she asks why, I simply show her a drawing
of it in profile and ask if she wants hers to look like that.  If a
mom's nipple has a NUK shape when baby lets go, we know right away
that we need to work on the latch.
If a parent is going to use a pacifier I tell them to look for one
that would feel the same in baby's mouth either side up, and the MAM
does fit that cirteria (or is the singular criterium?)
Winnie IBCLC

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