title: How are effective breastfeeding technique and pacifier use related to breastfeeding problems and breastfeeding duration?
abstract: BACKGROUND
  Inconsistent findings leave uncertainty about the impact of pacifier use on effective breastfeeding technique. The purpose of this study was to investigate how breastfeeding technique and pacifier use were related to breastfeeding problems and duration of breastfeeding.
  
  
  METHODS
  Data were collected from the intervention group of a randomized trial in which health visitors followed up with mothers for 6 months after childbirth. The health visitors classified the breastfeeding technique at approximately 1 week after birth and repeated the observation if a correction was necessary. Effective technique included positioning, latch, sucking, and milk transfer. Data on breastfeeding problems and pacifier use were obtained from self-reported questionnaires. The study population included 570 mother-baby pairs with complete information on breastfeeding technique and pacifier use. The primary outcome was duration of exclusive breastfeeding.
  
  
  RESULTS
  One-half of the mothers showed ineffective breastfeeding technique at the first\ observation, most frequently ineffective position (61%) and latch (52%). In the unadjusted analysis, only sucking and milk transfer were associated with breastfeeding duration. In the adjusted analysis, ineffective technique was significantly associated with mothers reporting early breastfeeding problems, which thereby influenced the breastfeeding duration. Pacifier use had an independent negative impact on duration of breastfeeding. A single correction of the breastfeeding technique was not associated with duration or occurrence of problems.
  
  
  CONCLUSIONS
  Observation of breastfeeding technique may help mothers in the stage of when they are establishing breastfeeding to avoid early and later problems, but breastfeeding technique is less useful in predicting breastfeeding duration. Use of a pacifier should be avoided in the first weeks after birth.
authors.affiliation: Department of Nursing Science at the Institute of Public Health, University of Aarhus, Høegh-Guldbergsgade 6A, 8000 Aarhus C, Denmark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Kronborg
authors.forename: Michael
authors.initials: M
authors.lastname: Vaeth
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008875:Middle Aged; D041361:Pacifiers / Q000706:statistics & numerical data*; D010298:Parity; D011247:Pregnancy; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult