>Is there actually any evidence that pacifiers alone (ie without bottles)
>can cause nipple confusion, or is it just an assumption or speculation?

I have seen babies given pacifiers and no bottles have nipple confusion (as
well as preference.)  I have found that these babies have a couple of
different behaviors.  Either they are unable to latch on to the nipple
because they are waiting for something hard to hit their upper palate before
they begin to suck or they do not seen to remember that they need to open
wide to get a nipple (caregivers push it into a mouth that is mostly
closed.)  The other thing that I see is a breast nipple that comes out of
the baby's mouth looking like one of those $%@$%@^%@#% (How is that for no
confusing abbreviations?) orthodontic pacifiers.  These kids get used to
humping up their tongues in the back of their mouths and then do the same
thing to mom's breast.  And then they tell me that the pacifier must be ok
because, "They gave it to the baby in the hospital."

Linda Pohl, IBCLC
Phoenix, Arizona USA
[log in to unmask]