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Can I give a pacifier from the start?

Here are the pros, cons and everything in between

First off YOU CAN DO ANYTHING YOU WANT as long as you aren't putting anyone at risk.

When speaking with clients I always lead with, 'you're the expert here---you know yourself, your family and your baby better than I do. There is nothing more attuned and informed than your gut.'

Having said that, decisions are best made with a mix of your gut, your family's priorities and trusted information...all guiding you to make an informed decision that serves you. Once you've got all the info, your intuition works even better.

So let's get down to it...

Why do folks use pacifiers very early on?

Well, a number of reasons

  • Very fussy babe

  • Oral-motor disfunction

  • A babe that has to undergo procedures or has a condition which may cause them pain (using it to soothe and regulate)

  • It may give the parent some breathing room for themselves when baby needs comfort but we aren't able to rock baby, etc. in that immediate moment. The act of sucking is extremely comforting to an infant and can regulate different elements of their nervous systems like breathing, stress level, etc. It's certainly not the only way to soothe a baby, but it may be part of your arsenal of things to try

  • Because it's what we see in the drugstore, in movies and in images of sleeping or content infants. Sometimes folks think that all babies need or want pacifiers and it's a part of parenting...which it might be, if that's what your family chooses.

The OG pacifier is baby's fingers.

Pacifier use or not, babies seek out and use their fingers to soothe themselves even prior to birth. When I gifted my partner a 3D ultrasound on my tummy (our baby refused to show us their sex and we are people that wanted to know) I was so amused to see my baby rhythmically sucking on her thumb. So, as much as we try to, or are instructed to not introduce anything into baby's mouth prior to the establishment of breast/chestfeeding, babies will find these fingers and use them day and night.

The concern for lactation consultants and postpartum supporters is that we have been taught that introducing pacifiers very early on *will* disrupt breastfeeding/chestfeeding. The truth is, it might or it might not. Some infants are extremely adaptable and can go from breast/chest to bottle to pacifier and it has no influence on feeding. Whereas, other babes may be sent off track and it may create issues that weren't there before. There's no way for me to tell you it 100% will or won't mess up feeds but I also am not an extremist and I am not here to use fear as a tactic and tell you what to do. It's not my vibe, and it doesn't help anyone.

Why *might* it affect breast/chestfeeding?

The main reason why a pacifier *might* affect breast/chestfeeding has to do with something called the extrusion reflex

  • This reflex is responsible for the forward movement of baby's cupped tongue over the lower gum which allows them to take a breast and morph it into the shape of a teat in their mouth. This tongue/mouth position allows baby to "hold on" to the breast/chest in a way that provides a good seal and suction without causing pain.

  • Because pacifiers and bottles have this shape pre-formed, the baby *may* have the extrusion reflex blunted over time and bottle feeding/the sensation of a pacifier becomes "imprinted" on their brain. In this case, the feel of the pacifier in the mouth and how they hold this object in their mouth (more shallowly than a breast) can become more dominant than the extrusion reflex.

  • This *may* lead to baby not using the extrusion reflex at the chest/breast to form a teat and instead baby may use their upper and lower gums to "hold on" to the breast. This clamping down is often a source of nipple/breast pain during latching.

  • This by no means will happen to *every* baby but there is a chance it could happen to some.

  • Once the feel of a pacifier or bottle nipple is "imprinted" on baby's brain it doesn't mean that breast/chestfeeding can't again be taught to baby with frequent exposure to the breast, but it may take some work and may end up being another issue to "manage" when you're already exhausted and don't have much bandwidth.

This is why lactation consultants often encourage parents that have a goal of exclusive breast/chestfeeding to wait a few weeks until the skill of forming a teat (with help of this reflex) is imprinted on their spongey little brain. If you can't wait, that's also OK too.

Now here is where it gets confusing

We (lactation consultants and postpartum nurses, etc.) are also taught that the use of pacifiers at nap and bedtime reduces the risk of SIDS (sudden infant death syndrome), based on research. This confuses me! So wait...are we supposed to tell clients not to use pacifiers or to use pacifiers?!!!

If I am confused I can't imagine how you, the parent making the decisions feels.

I guess a middle ground would be: if you want to lower the risk of both SIDS and pacifiers affecting latch, hold up for a few weeks until you feel like you and baby have a hang of it all. But like I said, it's up to YOU.

Some things to remember with pacifier use:

  • If your newborn baby is using a pacifier make sure that they are having at least 8 feeds a day. They can be close together or spaced out, just try to count 8 in those early early days. Sometimes a pacifier can blunt hunger cues. Because in the very early days we are building up our breast scaffolding, so to speak, we want to get as many feeds in so our bodies lay down more milk making cells, which serve us ongoing.

  • Make sure to inspect pacifiers each time you clean them. Are there cracks, holes or is the silicone/latex/natural rubber/whatever breaking down? If so, throw that sucker out. We are trying to avoid a choking risk with this one.

  • If your baby has thrush, make sure to sterilize pacifiers frequently (plop it in boiling water for a few minutes), as they can be a vector for yeast.

  • Don't tie a pacifier around a baby's neck, avoiding strangulation here.

  • Longterm and very frequent use *may* affect the alignment of teeth/cause some speech issues according to some research.

For the record I tried to give my baby a pacifier because she HATED the car in a way that was super distracting to my driving and caused me a lot of anxiety, and her a lot of stress. I tried every pacifier on the market and eventually I found one that she would take sometimes. So, there's also a chance that you hum and hah over it all and then your baby just refuses it all together. Ugh.

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