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Subject:
From:
Barbara Wilson-Clay <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 15 Oct 1999 11:00:42 -0500
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To state that study after study about pacifier use identifies pacifier use
as cause of bfg failure is not exactly accurate.  There have been studies
that suggest there may be a relationship which hastens weaning, but maybe
those studies have assumed causality but have missed coincidence.  Or maybe
(and this is my observation) the baby who gets real "confused" by pacifiers
is a baby who is nursing poorly to begin with.  Or the mother is
sub-consciously intending to wean and uses the pacifier as a weaning tool.
In 20 years of this work, I have seen many pacifier-using babies breastfeed
like champs!  And I have seen many dysfunctional feeders hooked on pacis who
couldn't make the breast work and were depending upon pacis for SOME REASON.

 I think that poor bfg is a MARKER for a baby with a problem, and
respiratory function is looming large in my mind as an issue.  The most
interesting thought I've been presented with in years is the idea that
during non-nutritive sucking an alternate respiratory center operates.  If a
baby has a depressed primary respiratory control center (for any of a myriad
of reasons) he or she learns that NNS reduces apnea episodes.  So the paci
or thumb sucking keeps them breathing and serves a survival function.  I
have speculated that these babies who can only sleep with a breast in their
mouth may have the same issue.  I slept with two babies like that, who just
wanted to nurse all night.  They would not take pacifiers, but one, when
weaned at age 2.5 during my next preg. began to suck her thumb during sleep
and cont. til kindergarten.

The research on this alternate respiratory control function deal is
stronger, in my opinion, than the work on pacifier use ruining bfg. We have
to keep an open mind when good science is challenged by better science, or
by a new perspective -- even if it rocks our dogma. We also have to try to
understand more intelligently how to identify why babies are not bfg well,
and have to perfect our skills in terms of helping them overcome the
problems in ways that preserve and protect bfg.  It's a lot like the
co-sleeping issue.  We have to look for ways to make things work.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html

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