This is such an emotive issue and I am enjoying all the posts.  I would prefer that babies
are not given pacifiers for the many reasons shared here on Lactnet,  but the reality is
that in some societies babies are expected to have them - "he can't use you as a pacifier"
- this means you are a bad mother!

But, I do believe that mothers need to make informed choices.  Yes, it appears that pacifier
use may reduce the incidence of SIDS if mothers are not comfortable with co-sleeping,  But,
as Carol pointed out, pacifier users experience more attacks of otitis media (Niemela 1994,
1995).  Also oral thrush has been found to be twice as common (Manning 1985, Sio 1987, Amir
1995).

For babies that wake up when being put down 10 minutes after a feed, I like to share with
mothers the information regarding cholecystokinin (CCK).  The levels of CCK are high when
the baby comes off the breast - 10 minutes later it drops to baseline and rises again 30
minutes after the end of a feed.  (CCK  is a hormone that is produced after a large meal and
causes sleepiness.)  So, baby may need to go back to the breast briefly after 10 minutes or
he may need to be held for 30 minutes before being put down.

In practice, after sharing info, I find that many mothers are willing to at least wait 4 to
6 weeks before offering the pacifier - by then some clever babies will refuse them!

Jean Ridler  RN  RM  IBCLC
Cape Town, South Africa
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