Marilee,

If I can add my opinion--which is based on the studies in the literature, the
reality of how most mothers breastfeed, and personal experience.  I'll bet those
who advocate having babies find their fingers/thumb have not had a finger/thumb
sucker personally!

My first daughter found her index finger when she was 4 mo. old and became an
AVID finger-sucker.  She held her hand palm up when she sucked, which put a lot
of pressure on the gumline and through the years pulled her front teeth all out
of whack.  What was cute when she was an infant was *incredibly* irritating to
me when she was three. (I'm not the most relaxed mother, I'll admit it!)  It is
impossible to put limits on a finger or a thumb because it is always with them.
When she hit four the dentist insisted that it was time to stop, so with my
daughter's cooperation we did the painting yucky stuff on it for a week.  It was
a hard week, she needed lots of support especially at bedtime to fall asleep
without it, but she weaned from it.  I've since read that this shouldn't really
be an issue dental-wise until the permanent teeth emerge, but I am convinced she
would have been sucking just as avidly at 6 or 7, so doing it at 4 saved a lot
of arguments.  (She's now 16 and continuously cracks her knuckles, which also
drives me nuts.)

Because of this experience I almost pushed a pacifier on daughter #2 when she
hit about 4 months and also began exploring her fingers and thumb.  I can
remember having a wide assortment of brands on the tray of her walker as she
checked them all out (settled on a Nuk).  I found this MUCH easier to deal with
as she got older since I could put limits on it's use ("no, 2-year-olds don't
walk around the department store with a Nukky in their mouth, you can have it
when we get home. . .")  Eventually it was down to bedtime use, and when she
lost it in our bed one evening when she was 3, we made sure it stayed lost (she
coped fine).

Child #3 was a son, who cared not for fingers, thumb, or pacifier.  All the kids
weaned at roughly the same age (25, 31, and 27 months).

So the advice I give is--
1.  If at all possible, baby should have nothing but the breast in their mouth
for at LEAST two weeks, until they have been proven to be nursing well (no sore
nipples, well over birthweight at 2-week checkup).  If mom's nipples need a
break the first few days, finger is preferable to pacifier.
2.  Many breastfed babies get enough sucking at the breast so that they don't
need a pacifier; it is often very appropriate to give bottle-fed babies
additional sucking.
3.  Comfort sucking at the breast is appropriate and beneficial, babies DO NOT
"use their mothers for a pacifier."
4.  If baby has a very high need to suck (at the breast very frequently,
spitting up excess milk, starting the look like the Pillsbury Dough Boy), *I*
think a pacifier is preferable to baby's finger or thumb, and tell them why.

I think a pacifier is very appropriate for working mothers whose babies do not
have unlimited access to the breast.  Sometimes these babies drink more milk
than their mothers can pump, simply because they want more sucking.  A pacifier
after feedings (or a slower bottle nipple) can bring their intake down to
reasonable levels so they continue to feed frequently when they're with mom.

Sorry to be so long-winded!

Becky Krumwiede, RN, IBCLC
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