Dear Laurie and others, I have been enjoying this thread on pacifier use and
find many of the comments made to be very thought provoking but I NEED to
play devil's advocate here;
Laurie states;
>>There is really no good argument for pacifier use.<<
I got a phone call today from a Mom that  I provided an initial consult to at
5 days, baby is now 3wks. old. The initial was for latch on probs d/t
engorgement and positioning issues which (i thought) was easily fixed with
positioning fixing. Come to find out the real issue is that Mom (I got a
glimpse of this at the first visit) has a very low threshhold for the
"troubles" associated with caring for an infant and this low threshhold is
further tested by; an active toddler and an apparently needy, unhappy
baby......I should say unhappy when he isn't at the breast. At the breast he
wants to be AT LEAST every 2 hrs. around the clock. Mom is also very unhappy
and "at the end of her rope", she sais.
We explored the possibility of: supply issues (her first thought but seems
unlikely after discussing with her), milk intolerance (Mom had stopped dairy
but is supplementing with cow's milk based formula 1x/day! ),reflux (baby
does spit some), COLIC! and various combinations therein with accompanying
suggestions. All were met with lukewarm response, including the LAST
suggestion/question of pacifier use. Mom sais he spits it out unless she is
there to hold it in. I suggested that she might benefit by a sling to carry
baby-he seems happier next to her (really? ; ) ), it is a better option if
reflux is an issue and she can (now throw daggers all!~!!) better use a
pacifier to help her span the feedings some.....
In case I haven't made it clear enough-this is a Mom who I'm sure will stop
breastfeeding if she doesn't see some quick abatement of her issues (without
having to pay for another consult!). This has already been reinforced by the
fact that he "sleeps the longest" after the bottle of formula.
I'm sure that this type of scenario isn't unique to my practice and I'm
curious to know how some of you who feel that pacifiers aren't an option,
would respond to this Mom in a way that lives within her means.

Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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