Whilst some babies seemingly suffer no negative effects from using a pacifier, others can experience problems.

Before deciding whether to introduce one or even to make yourself aware of possible problems that can arise so you can identify them if you do decide to use, the info below is worth a read.

Here is what the LLL breastfeeding answer book has to say about pacifiers:

Pacifiers are used in many parts of the world to minimise the time spent nursing and to keep babies quiet and contented between feedings. In areas where an artificial feeding mentality exists, such as the US, the pacifier has come to be accepted as the primary source of comfort and mothers are cautioned to limit breastfeeding so as “not to let their baby use their breast as a pacifier”.

However, for as long as there have been mothers and babies - long before the pacifier existed -the breast has provided baby with comfort as well as food. When breastfeeding is the norm, the breast is accepted as the primary source of comfort, and a baby with a pacifier may be seen as “using the pacifier as a breast”

Whenever a substitute is used for the breast, there are consequences, and the pacifier is no exception. The consequences to pacifier use such as increased risk of early weaning, ear infections, slow weight gain, thrush, dental caries, incorrect sucking patters, earlier return of fertility and mastitis are direct results of the baby “using the pacifier as a breast”

Research conducted all over the world has found correlation between pacifier use and shorter duration of breastfeeding. One study in Brazil found that at 6 months 65% of the babies who had used pacifiers from one month of age had weaned from the breast compared with 25% of the babies who had not used pacifiers.

This association was found whether or not the baby had also been receiving bottles. Another study confirmed the correlation and also found that the more times per day the pacifier was used, the higher the risk for early weaning. Many more studies have reached the same conclusion.

Sucking differs from bottle to breast and can cause nipple confusion and soreness -studies mentioned show babies are twice as likely to have breastfeeding problems as those who did not (73% developed problems compared to 30% that did not)

In the early weeks when a baby is still learning to nurse the pacifier has been found to affect babys suck making him less effective at milking the breast. Less effective feeding has the potential to affect milk supply and weight gain, since the breast is not draiend as fully. Also, a placid baby may be content to suck on a pacifier without indicating a desire to nurs, even when hungry, resulting in fewer feedings per day. Several studies have found regular pacifier use is associated with few feedings and shorter breastfeeding duration.

Several studies have found a connection between pacifier use and ear infections. This is doubled if the baby has the pacifier 5 or more times per day.

Because the fungus that causes thrush thrives at room temp on moist surfaces a pacifier has the potention to transmit thrush. One study found a greater incidence of candida the fungus that causes thrust among babies who used a pacifier - the research suggested that using a pacifier may affect a baby’s ability to effectively clear sugar from his mouth

If a pacifier is used during thrush it should be boiled for 5 mins every day and replaced every 7 days.

Research indicates regular pacifier use may affect the growth of teeth and shape of the mouth and increase the risk of orthodontia in later life. A study done in Finland also suggests that the use of a pacifier increases the level of bacteria in the mouth that cause dental caries.

Regular pacifier use can contribute to mastitis because the baby spends less time at the breast.. If a mother tends to have an oversupply of milk, she may have an even greater risk of mastitis from pacifier use, particularly during the time she introduces the pacifier and her baby’s nursing patterns.

Source: LLL The Breastfeeding Answer Book