Ann and all,

The article The Effects of Pacifier Use on Breastfeeding Duration by Cynthia R
Howard, et al is on the Pediatrics electronic pages. Go to
<A HREF="http://www.pediatrics.org/">Pediatrics</A>  and scroll down the table
of contents till you see the article and click on full text.

The authors found that mothers who had introduced a pacifier by 6 weeks were
more likely to have problems with insufficient milk supply and to find
breastfeeding inconvenient. Pacifier introduction by 2 weeks was associated
with a sigificant reduction in the frequency of breastfeedings and at 12 weeks
with pacifier introduction by 6 weeks.

Howard et al also found that pacifier use was not significantly associated
with a decrease in the duration of breastfeeding *prior* to 3 months
postpartum, but *were* after 3 months pp. They also concluded that the shorter
duration of breastfeeding in the pacifier group after 3 months could not be
attributed to nipple confusion. In the discussion of their results, the
authors bring up the question of why pacifiers shorten breastfeeding duration.
Is it because the mother's milk supply is insufficient due to less than
optimal feeding and length? Or do mothers use pacifiers to facilitate weaning
as in the 1997 Victoria study from Brazil?

Finally, the authors recommend that parents be educated about alternative ways
to comfort infants, the importance of frequent breastfeeding to build and
maintain the milk supply, the desirabilty of full breastfeeding for the first
6 months and continuing breastfeeding with the appropriate addition of solid
foods for at least 12 months.

Warmly,
Carol Kelley  LLLL
Taylors SC USA in the Blue Ridge foothills
mailto:[log in to unmask]

Reference: Howard CR, et al. The effects of pacifier use on breastfeeding
duration. Pediatrics 1999;103(3)