title: The impact of pacifier use on breastfeeding: a prospective cohort study.
abstract: 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.
authors.affiliation: Department of Paediatrics, The University of Auckland, Auckland, New Zealand. a.vogel@auckland.ac.nz
authors.forename: A M
authors.initials: AM
authors.lastname: Vogel
authors.forename: B L
authors.initials: BL
authors.lastname: Hutchison
authors.forename: E A
authors.initials: EA
authors.lastname: Mitchell
mesh_terms: 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