The impact of pacifier use on breastfeeding: a prospective cohort study.
OBJECTIVE
To determine the predictors of pacifier use during the first year of life and to assess the influence of pacifier use on the duration of breastfeeding.


METHODS
A prospective cohort study was conducted. Three hundred and fifty mother-infant pairs were followed to 1 year of age to determine the impact of the use of a pacifier on the duration of breastfeeding.


RESULTS
A cohort of 441 mothers were enrolled and 79% participated. Ninety four per cent were followed up to 1 year. Daily pacifier use was associated with early cessation of breastfeeding (risk ratio (RR) 1.71; 95% confidence interval (95%CI) 1.29, 2.28) and a reduced duration of full breastfeeding (adjusted (adj.) RR 1.35; 95%CI 1.05, 1.74). Finger sucking was not associated with a reduced duration of breastfeeding (RR 1.05; 95%CI 0.81, 1.37). Pacifier use less than daily was not associated with a change in duration of breastfeeding (RR 1.02; 95%CI 0.75, 1.39). Most mothers commenced the use of a pacifier within the first month. Multiple logistic regression analysis found that the use of a pacifier was associated with male gender (adj. RR 1.97; 95%CI 1.23, 3.13), maternal smoking in pregnancy (adj. RR 2.23; 95%CI 1.01, 4.95), and low maternal confidence with breastfeeding (adj. RR 2.70; 95%CI 1.48, 4.93).


CONCLUSIONS
Daily pacifier use is associated with a reduced duration of breastfeeding. Less frequent pacifier use does not reduce the duration of breastfeeding.
Vogel
A M
AM
Department of Paediatrics, The University of Auckland, Auckland, New Zealand. a.vogel@auckland.ac.nz
Hutchison
B L
BL
Mitchell
E A
EA
D000328:Adult; D000704:Analysis of Variance; D001942:Breast Feeding; D005260:Female; D006801:Humans; D007224:Infant Care; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D009520:New Zealand; D011446:Prospective Studies; D012306:Risk; D013997:Time Factors; D014886:Weaning