Lori,
First some anecdotal experience and then my current stand on pacifiers.  I
nursed my babies 19 and 22 years ago respectively. Not knowing any better I
offered them both pacifiers right from birth. In fact as a NICU nurse I was
very good at convincing them to take those pacifiers (we had lots of practice
with that in the NICU).  My first nursed frequently...easily every hour to
hour and a half through the day....sometimes more often. My second, a more
mellow sort, breastfed every three to four hours like clockwork. Both gained
at a nice average rate maintaining the 50th percentile.  At six months both
spit out their pacifiers for good and went on to breastfeed for many more
months.  One needed orthodontia...the other didn't. Neither has ever had a
dental ..  So I certainly did not have personal negative experiences with
pacifiers.  I am very cognizant of the research, however, and try not to
bring my personal experiences into my practice. I  advise families to
withhold pacifiers and bottles for at least the first 3 weeks until the baby
has mastered "Breastfeeding 101".  I find that when parents are able to do
this many breasted babies will then refuse pacifiers.  I never say never,
however.  There are definitely babies with intense sucking needs and mothers
who are unwilling or unable to satisfy these needs at breast. When we make
the requirements too hard for breastfeeding we lose folks.  I also think that
we need to take the individual temperament of the baby into account.  Some
babies are just high need and it is so easy to blame their fussiness and/or
need for constant stimulation on some problem with breastfeeding. If a
pacifier helps mom and baby get through the day, then by all means I think it
is worth it.  Someone mentioned that sucking needs decrease around 6 or 7
months. I think it would be a very good idea to advise parents to distract
baby from the pacifier around this time.

Kathy Boggs, RN, IBCLC
(taking a middle of the road approach in Mtn. View, CA)

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