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Telling parents not to use pacifiers because of nipple confusion is used as a scare tactic for promoting breastfeeding. 

Yes, you read that right. Somewhere someone decided to help women breastfeed more they should be warned about nipple confusion. That way they will be afraid to give a baby a pacifier or milk (human or formula) in a bottle. And that means more breastfeeding, right?

Wrong.

Often tactics like this backfire and many women who wish to use bottles and pacifiers will transition out of breastfeeding in order to be able to use these tools. 

What is nipple confusion anyway?

It is thought to be the problem where a breastfed baby is exposed to an artificial nipple, such as from a bottle or pacifier, but then the baby begins to show frustration with the breast and prefers the artificial nipple. Alternately, the use of an artificial nipple causes breastfed babies to suck differently after having used an artificial nipple. 

Guess what?  It’s all bunk.

There is no such thing as nipple confusion. 

What’s actually going on is something called “flow preference”. This is when a baby has a bottle of milk that flows quickly and easily. It requires little effort to drink the milk from the bottle and when the baby returns to the breast they get upset that the milk is not flowing as readily, plentifully or easily as it did from the bottle. 

This can lead to babies rejecting the breastfeeding experience in favour of bottle feeding. 

But what about pacifiers?

Pacifiers are a fantastic tool to use with small babies. They are designed to mimic the human nipple in order to provide babies comfort when a nursing parent cannot be actively nursing the baby. 

To understand more fully why pacifiers are such a great tool, we need to look at why babies want such a tool.

A baby is born with an intense urge to suck. When a baby sucks they produce endorphins which is a hormone with a powerful analgesic and relaxing effect. One surefire way of calming an upset baby is to let them suck: at the breast, on a finger, on a toy, or on a pacifier. This will create a strong sense of calm in the baby. 

For some babies, the urge to suck is huge. Some babies need to suck nearly constantly. But, most breastfeeding parents are not able to accommodate all of that sucking at the breast which makes the pacifier a perfect tool. 

Take a look inside any NICU and you will see all or most babies happily sucking on pacifiers. Hospitals know pacifiers are a fantastic self-soothing technique for babies. They also know that sucking on the pacifier strengthens muscles in the face and mouth as well as stimulates baby’s brains.

But, there is a worry that if a baby is upset and a parent relies too often on a pacifier. If a baby is getting a large portion of its desire to suck satisfied by a pacifier, they may not be spending enough time at the breast. There is a real concern that a baby who uses a pacifier a lot will not get enough breastmilk, will not gain enough weight and that the breastmilk supply will decrease.

So, the recommendation arose to avoid all artificial nipples until breastfeeding is “well established”. But when is that? Days? Weeks?  

The problem with waiting to introduce a pacifier to a baby is that if you wait too long, most babies will reject a pacifier. 

All is not lost, though. Pacifiers can still be used, they just need to be used in a mindful way.

If a baby is fussing ask yourself:

Has baby recently eaten? Could they be due to nurse? Did they get a full tummy of milk at their last feed? Is this a frequency day when I should nurse baby more often than normal?

Is baby eating 8 to 12 times every day? Is baby producing the appropriate minimum number of soiled and wet diapers for their age? 

Could baby need a cuddle? Are they perhaps lonely and in need of social interaction? Are you able to provide baby with a bit of physical and social connection or do you need to accomplish something else right now? 

Is baby fussy because of the temperature or physical discomfort? Does the baby need to be changed? Is the baby alert but can’t see you? Is baby tired and needing sleep?

When you feel compelled to give baby a pacifier, do a quick assessment of why the baby is upset or fussy. See if there is anything else they need first before offering a pacifier. If all of their needs – especially with regards to feeding – go ahead and offer the baby a pacifier. You can be reasonably sure your baby will suffer no ill consequences from its use.

There is no need to cut yourself off from a tool that could benefit your baby when you are able to use that tool safely.